The Clinton Health Plan Redux

I admit I was taken by surprise when Hillary Clinton announced a plan for healthcare reform earlier this week. Variously called (with some implied derision) Clinton Healthcare 2.0, Hillary Plan 2.o, or worst, Hillarycare, this new proposal is a scaled-back version of the plan she and her husband proposed in 1993. It calls for an increased government presence in the healthcare market, but includes a significant role for private insurance companies. Most controversially, it requires all citizens to carry health insurance, whether private or government provided.

As of yet I have not reviewed the plan in detail, but I wanted to make at least one timely comment. Ms. Clinton will, as she was in 1993, be taken to the woodshed over every detail in her new plan. The abuse will come, almost exclusively, from loudmouths who have no health care reform program of their own. These complainers will come from two groups: the Ostriches who think U.S. healthcare is perfect as it is, and the Cloistered Privileged who believe we are only one or two tax credits away from health nirvana.

It is not a foregone conclusion that I will vote for Clinton given the opportunity. However, she earned my respect in 1993 and earns it all over again with her new proposal. In the 14 years since the Clintons put forward their original healthcare reform plan, only one other serious politician has proposed an equally comprehensive plan, and that is John Edwards. That alone shows how much political courage it takes to attempt healthcare reform in this country.

And she didn't have to stick her neck out again this time. She is ahead in all the polls; there was no need for her to take this political risk. That she did tells me that she is serious about getting reform legislation through if elected president, and that is encouraging.

While Clinton proposes real reform, the Bush people are in a fistfight right now to block improvements to the State Children's Health Insurance Plan, or SCHIP, an extension of Medicaid that provides health coverage to children whose parents make too much money to qualify for regular Medicaid. SCHIP covers 4 million children, and the stubborn White House is threatening to veto any enhancement to the plan that would allow it to cover more kids. In fact, the Bushies want to cover fewer kids, not more. A presidential administration that won't come to an agreement with Congress over a program that covers less than 2% of Americans is clearly incapable of addressing the interests of the other 98%. (Hey, I have an idea -- let's impeach him!)

In school, I was educated under the Baconian ideal (or Jeffersonian, if you please) that the path to healthy debate is to put all ideas, no matter how silly, on the table and then sort through them, synthesizing and winnowing until a useful solution emerges. Deriding serious ideas like this one, especially when there are no other politicians proposing anything else, is a clear violation of this spirit of free debate.

Let the woman talk. Let her opponents present their own plans. But the one unacceptable outcome is the one we endured in 1993 -- to shoot down the only idea out there, and then do absolutely nothing. 

Update on Thursday, September 20, 2007 at 12:34PM by Michael Hebert

The original version of this article stated that Hillary Clinton is the only major politician to put forth a health reform proposal since 1993. I amended this when I discovered that John Edwards has his own plan. I apologize, especially to the Edwards campaign, for the error.

The Blistering: Chapter XII

To read this serial novel from the beginning, go here.

Here We Go, Embryo 

 

"Check it out," Cardinal said. "Go through the entire truck. Don't even think about letting anyone go until you check everything thoroughly."

"Don't worry," the Head ELF said. "We've got that covered."

One of the ELFs, a woman Cardinal had already noted looked exceptionally good in black tights, inflated the escape chute on one of the doors of the plane and slid down to the ground. Then she ran the short distance to the truck the FBI had parked and abandoned alongside the plane, throwing open the back door and slipping inside. Through one of the windows on the plane, Cardinal could see seven crates in the trailer, each one with a stainless steel milk-bottle-shaped container inside it. Using a short crowbar she had pulled from her belt, she pried open the tops of the crates and opened the covers of the milk bottles. Cold vapor overflowed. She looked up to the Head ELF,who was standing at the top of the chute, and gave a thumbs up.

"All right. Release the passengers."

One by one the passengers filed out, except for Marsha. "I'm staying here with you," she said to Cardinal.

With a great deal of effort, the ELFs hoisted each of the seven milk bottles into the plane. Once they were all on board, the female ELF started going through them again to get an accurate embryo count. As she worked through the second bottle, she suddenly paused, as if the liquid nitrogen had frozen her also.

"Something is wrong here," she said. Quickly she went over to the overhead bin above the seat she once occupied. She took out a box and from it extracted a microscope. Plugging it into an outlet in the food prep area, she took an embryo out, laid it on a slide, and examined it under magnification.

"Damn!" she said. "They gave us chicken embryos."

Boy, that would have been embarrassing if they had tried to implant them, Cardinal thought.

The Head ELF stood there, wordless. He started to shake, with rage, probably. Then he picked up the two bomb-briefcases and slid down the chute. The other three followed, leaving Marsha and Cardinal in the plane, watching.

"Should we follow them?" Marsha asked.

"I'm pretty crazy, but even I wouldn't chase after an angry fundamentalist with a bomb under each arm."

The four ELFs scrambled into the cab of the truck, Head ELF at the wheel. He fired up the diesel engine and gave it the gas. The truck raced off in the direction of the police, who were advancing on the plane now that the hostages were safe. When the truck was 100 yards away from the police, all four jumped out, one by one. The truck rambled to the police's position, crashed through their line, and exploded. The blast shook the plane.

"Nice move," Cardinal said to Marsha. "They didn't time it very well though. It looks like the cops had enough time to get out of the way."

"So what do we do now?" Marsha said. "The cops will arrest us for sure for assisting the hijackers."

"I have a plan." Cardinal went to the front of the plane and kicked open the door to the cockpit. The plane was idling, and all the instrumentation was still switched on. Cardinal sat down in the pilot seat and gripped the yoke.

"John, you fool," Marsha snarled, "You don't know how to fly a 737." She grabbed him by the collar and yanked him out of the seat. Then she picked up the flight plan notes and studied them. She sat down, opened the throttle, and taxied down the runway. "When we land in Des Moines, you're going to figure out how we get out of the mess that will be waiting for us."

Next Episode: Jet Blues 

Tom Tancredo, Neo-Segregationist

This past week Louisianians learned the name of a new congressman, Rep. Tom Tancredo (R), Colorado. Tancredo, a Republican presidential candidate (who knew?), broke the placid waters of the Labor day weekend news cycle with a series of vicious comments about the state of Louisiana. Tancredo, it seems, does not feel Louisiana deserves federal aid for its recovery from Hurricane Katrina. It is "time the taxpayer gravy train left the New Orleans station," Tancredo told the press August 31. “The amount of money that has been wasted on these so-called ‘recovery’ efforts has been mind-boggling. Enough is enough."

Tancredo feels that it is time for the federal government to turn the recovery over to local government. “At some point, state and local officials and individuals have got to step up to the plate and take some initiative,” he said. “The mentality that people can wait around indefinitely for the federal taxpayer to solve all their worldly problems has got to come to an end.” According to Tancredo, about $1 billion had been wasted in fraud and abuse in the recovery effort.

Upon hearing this, my first question was, Who the hell is Tom Tancredo? With a little searching, I found that Tancredo is indeed a presidential "hopeful," if someone who finished fourth in the Iowa straw poll after the three top candidates sat it out can say he has hope. Tancredo, dubbed "Mr. Bigotry" and rated the 6th worst congressman in America by Rolling Stone magazine in 2006, also made news a month ago when he told a crowd in Osceola, Iowa that he would bomb the Muslim holy sites of Mecca and Medina in retaliation for a terrorist attack on the United States. (Lest anyone think this was a slip of the tongue, he said the same thing in Florida in 2005.)

He is also on record insinuating that illegal immigrants are terrorists. The day after the bomb-Mecca remark, he told another Iowa crowd: "You have to ask yourselves, why would anybody pay $25,000 to $50,000 to be smuggled into the United States? It's not to work over here at the Quick Stop or the 7-11. If you pay $50,000 to be smuggled into the United States or somebody is paying that for you, it's probably for some other purpose, not to just get a job that no American will take."

Reviewing his web site, I found his "On the Issues" page, which lists his political positions, presumably in their order of importance. These are, in descending order: immigration reform, abortion, income tax reform, judicial nominations, something called "Fast Track Authority" (which turns out to be an attack on NAFTA and CAFTA), and, oh, yes, he almost forgot -- Iraq. Right after Iraq comes Social Security reform, a rehash of President Bush's failed attempt to privatize Social Security. (I didn't think a politician alive was still pushing that corpse. He is worried about $1 billion in waste in Louisiana but wants to hand over a multi-trillion dollar Social Security trust to the honest folks of Wall Street.)

In summary, we are dealing with, near as I can tell, a bona fide lunatic. And while there is no reason to pay attention to the appeals of a lunatic, because he is a publicly elected official and a presidential candidate, there is a need to examine his logic. Most lunatics follow some kind of logic, and the only way to diffuse lunatic thinking is to understand it.

Tancredo's logic derives from the politics of hate, and is the ultraconcentrate of the long-employed Republican strategy of divisive politics. You can follow the common theme: Tarenco the immigrant-hater, the Islam holy site razer, the Katrina-baiter. He builds his political base by bashing unpopular or vulnerable groups. He writes off the voters he alienates, seeking instead to consolidate his base at their expense. He is like a schoolyard bully, befriending those who laugh as he humiliates his enemies.

We're rather used to this political type in our part of the country. Back in the old days, we called them Segregationists. A Segregationist, after all, is a politician who wants nothing to do with black people at any time except during election season, when they serve as convenient recipients of invective. Tarenco, in the spirit of classic Segregationism, cares nothing for Louisiana except that spreading anti-Louisiana prejudice locks in a couple of percentage points in the polls.

He gets it wrong, by the way, but this is of no concern to him. He states that local politicians have been stuffing Katrina money into their pockets, but there is no evidence that this is true. To be fair, there has been a rash of public officials indicted for corruption in recent years, including former Governor Edwin Edwards, local judge Ronald Bodenheimer, former Secretary of State Jim Brown, New Orleans School Board member Ellenese Brooks-Sims, New Orleans City Councilman Oliver Thomas, and, most famously, Rep. William "Mr. Freezer" Jefferson. But none of these fallen politicos have been involved in mismanagement of Katrina funds -- they were convicted of crimes that occurred prior to Katrina. To date, no Louisiana politician has been accused of, much less charged with, corruption involving Katrina funds. Not that I don't think eventually some problems will be found, but if you are going to accuse an entire state of being a confederacy of crooks, you could at least come up with a single example.

I will take a liberty here and say that, despite the history of corruption in Louisiana, it is unlikely that many politicians will be caught stealing Katrina funds. Federal funding has been notoriously gift-wrapped in red tape, and local officials have complained loudly and regularly that they cannot get the money promised to them. Every dime given out is subject to scrupulous review, and Louisiana has had to meet accounting standards exceeding those required of New York after 9/11. The pressure is so great that few politicians would dare touch Katrina money. Yes there has been some corruption, but most of it has been either federal, in the form of FEMA no-bid contracts awarded to people with federal connections, or contractor fraud, which victimizes local citizens and the state as much as it does the federal taxpayer.

The government has audited every penny given to the Gulf Coast since Katrina. If Louisiana politicians are stealing it, let's hear about it. A little proof would be quite nice.

Tarenco's own numbers damn his anemic thinking. He charges that $1 billion was misspent, which is a lot of money, but this is out of a total outlay of $114 billion. In other words, by Tancredo's own account, more than 99% of Katrina dollars have been properly spent. A 1% rate of "misspending" -- which is not synonymous with corruption, by the way -- hardly qualifies as a "gravy train,"and I am sure beats the hell out of the federal record in Iraq. Unless, of course, you are a bigoted Republican presidential candidate, in which case it is not really the 1% improperly spent that is the problem, it is the 99% that may possibly, somehow, have helped someone with brown skin.

Louisiana has 9 electoral votes, and Mississippi 6. In Tancredo's deluded mind -- he thinks he will one day be president, so he is deluded, QED -- those electoral votes are worth jeopardizing for the chance to lock in the angry white man vote in Iowa and New Hampshire. It is a calculation that shows up in the thinking of many political people. Sacrifice the good graces of one population to gain another, as long as it gets you re-elected.

Here on the Gulf Coast, we know we are collectively a small voice. We can't swing a national election, and won't likely make the difference in the congressional balance. We depend on people on the national level to remember us because it is the right thing to do, because our recovery process is only beginning. It will take a sustained effort to see it through, and we do not have the brute political strength to ensure that we will not be forgotten.

Tancredo is not smart enough to come up with creative approaches to make sure federal funds in Louisiana are well spent. Instead, he is content simply to cut funding off. This is another weapon in the Neo-Segregationist arsenal -- the argument of economic efficiency, which states that the government bears no responsibility for the problems of people who cannot pay their own way.

The argument of economic efficiency has replaced the pseudo-Darwinist argument of the survival of the fittest as the ready excuse for conservative cruelty. Survival of the fittest, while logically a viable argument, has the drawback of being overtly cruel, just as nature itself can be a merciless killer of the weak. Economic efficiency recasts this cruel doctrine, but makes no change to the final outcome. Instead of arguing that the weak must die by natural law, economic efficiency argues that free markets are incapable of rescuing groups that are not economically viable because the expense would destabilize the market itself. It costs too much to save the Gulf Coast, and if we try we will weaken the U.S. economy. On this basis, the arguments that New Orleans is too poor, that its government is too corrupt, that keeping the flood waters out is too expensive all gain traction.

Though it may make a certain logical sense, the efficiency argument is a slap in the face to anyone who believes in altruism. Human beings should not, and do not, make all choices based on economic logic. A simple example from my own professional experience: My medical practice obeys what insurance people call the 80/20 rule -- that is, 20% of patients soak up 80% of the costs. The average patient is well and only requires minimal medical care, while a small percentage of very sick ones demand constant attention and energy. This sick minority is not economically productive. Most are elderly or disabled and do not work. Our country pays untold billions to care for such patients, and does so not because the patients are worth the money, but because they are people and deserve to be treated with dignity.

I do not mind treating patients who are not economically productive, even at considerable expense. I consider it he price we pay for being human. We think of humans as beautiful and dignified even when they are not economically viable, and we care for them for precisely this reason. The day I am told that I should stop caring for people who cannot pay their own way is the day I stop practicing medicine.

It should not be necessary, in a nation as decent and humanitarian as America claims to be, to have to justify over and over again that more than a million souls deserve better than to be called a gravy train station. We are not a bunch of crooks, and we are not out to rip off the rest of the country by funneling tax dollars into a network of bars and brothels. Much as we help sick people to live on because they want to live, dunderheads like Tancredo might consider helping a sick city live on because it wants to. It is not as if New Orleans cannot be economically viable. New Orleans only needs sufficient national commitment to convince business investors that the city has a future.

Enough of Tancredo and his hateful, self-serving threats. Anti-gay, anti-immigrant, anti-New Orleans -- and hurling invectives like an old Segregationist. If he wants to really attract attention he should go to a nursing home and verbally abuse Alzheimer's patients for wasting taxpayer money. After all, an elderly patient with Alzheimer's is less likely to contribute to society than New Orleans.

If Tancredo's comments were motivated by pure logic and not by prejudice, this would be the logical extension of his argument.

The Distinguished Senator From Idaho

Here in New Orleans we got a hearty laugh last week over the travails and resignation of Senator Larry Craig from Idaho. Wednesday was the second anniversary of Hurricane Katrina, so it was a much needed respite from the heavy sentiments of the week.

Most Americans did not know the distinguished senator from Idaho until the story of his arrest for solicitation of gay sex broke about two weeks ago, but here in Louisiana we were well acquainted with him. The Senator, you see, did not make his career only out of gay-bashing, but also out of Katrina-victims-bashing. Shortly after the hurricane, he sprinkled insults in the press like Johnny Appleseed.

After first referring to New Orleans as "Baghdad on the Bayou," he said this to the Lewiston Morning Tribune of Lewiston, Idaho:

Fraud is in the culture of Iraqis. I believe that is true in the state of Louisiana as well.

In the McCall Starr News (McCall, Idaho):

Louisiana and New Orleans are the most corrupt governments in our country, and they always have been.... A rookie cop in New Orleans, they pay him or her $17,000 starting pay and then wink and say you better make the rest of it on the street.

Craig was using the corruption of Louisiana politicians as an excuse to deny Katrina victims aid. About one of the hardest-hit areas, the Lower 9th ward, he said,

I'm not humorous when I suggest we should turn it back to what it was, a wetland.

And as a member of the Senate Appropriations Committee, Craig was in a position to ensure that his views became reality.

Well, well, well, how the mighty hath fallen. Since Mr. Craig seems to have no qualms about kicking people when they are down for political gain, surely he will understand if we rain on his gay pride parade now. And so, with no further ado, I offer a few Larry Craig jokes I wrote up this morning for you to share with your friends at the water cooler. One warning: If you don't like raunchy humor, cover your eyes.

Q. Didn't Larry Craig once say all New Orleans Police officers were corrupt and took bribes?

 A. Yeah, and I bet he wishes he met one of those in the Minneapolis Airport!

 Q. I heard Larry Craig was thinking of running for president.

A. Yes he was. His campaign got off to a good start but then it went into a stall.

 Sen. Craig: Doctor, I get a headache every time I have sex.

Doctor: Stop hitting your head on the toilet during encounters.

Q. How does Larry Craig keep his weight down?

A. Every day for lunch he has a peanut butter and KY jelly sandwich.

Q. A priest, a Baptist Minister, and Larry Craig went into a bar. Do you know what they each ordered?

A. The priest had an Irish Whisky, the minister had a Kentucky Bourbon, and Craig had a Scot on his rocks.

Q. What's the difference between a case of the clap and Larry Craig?

A. You can't catch the clap on a toilet seat.

Q. I heard that Larry Craig is starting to take a more moderate position about the Iraqi war.

A. Yeah, he has been polling and has decided to take a wider stance.

 

Ms. Craig: Larry, I'm leaving you for another man.

Larry: Let me know if he's got a brother.

Q. I thought Larry Craig was a lifelong devoted Republican.

A. So did I, but in the last two weeks he admitted he has lost interest in Bushes.

Q. Why is Larry Craig against gay marriage?

A. Because it's not American Standard.

Q. When will you stop humiliating the distinguished senator from Idaho?

A. When he gives us the 9th Ward back.

And finally:

When he was a boy, little Larry Craig lived in a huge mansion with his wealthy parents. The Craigs employed a handyman named Marc. One day, as Marc was trying to fix a leaking faucet, he squatted down under the sink for a better look at the plumbing. As Marc bent over, his pants slipped down from the waist, exposing almost all of his rear end. Little Larry gawked at the sight.

His grandmother saw him doing this and called him aside. "Larry," she said, you shouldn't stare. It's not polite. Next time you see someone in a compromising position like that, direct your gaze into the air."

A few days later Larry had his friend Tommy over for play time. The Hispanic maid, Adelle, was cleaning out the oven. She was wearing shorts, and as she bent over her rear end stuck out provocatively. Tommy could not resist staring.

"Tommy," the toddler Larry squealed, "gaze airborne, not maid!"

So long, sucker!