Tonight, at around 8 p.m., the Senate will vote on a "motion to proceed" with the debate over health care reform.
To be clear, this isn't actually a vote on whether to pass health care reform--or even a vote on whether to hold such a vote. It's a vote on whether to begin talking about whether to have a vote on whether to pass health care reform. And yet the outcome is not a foregone conclusion. The Republicans will filibuster, which makes them quite literally opponents of an open debate but also means the Democrats need sixty votes to proceed. Yes, it's crazy. But, then, so is the design and modern function of the United States.
As of last night, Senate Majority Leader had commitments from fifty-eight Senators, thanks to announcements from Ben Nelson of Nebraska and Ron Wyden of Oregon. That left just Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas.
Landrieu just announced she'll vote "yes," so that just leaves Lincoln, who is likely to support the motion as well. She's facing a tough reelection fight in her home state, where support for Obama is notoriously low. She undoubtedly feels the need to make a public show of her angst and reluctance, before voting to proceed. Reid is, I'm sure, more than happy to accommodate that.
Substantively, there's really not much to say at this point. But I'll be posting updates on my twitter feed, @jcohntnr, in case anything significant happens on the Senate floor or at Michigan Stadium (where, to my chagrin, the Wolverines aren't faring as well as the Democrats).
From her interview with Bill O'Reilly:
O'REILLY: Do you believe that you are smart enough, incisive enough, intellectual enough to handle the most powerful job in the world?
PALIN: I believe that I am because I have common sense and I have -- I believe the values that are reflective of so many other American values. And I believe that what Americans are seeking is not the elitism, the kind of a spineless -- a spinelessness that perhaps is made up for that with some kind of elite Ivy League education and a fat resume that's based on anything but hard work and private sector, free enterprise principles. Americans are -- could be seeking something like that in positive change in their leadership. I'm not saying that that has to be me.
[Sic].
As always, be sure to check out economic news on The Stash, environment and energy coverage on The Vine, the latest on health care at The Treatment, metro policy debate on The Avenue, and Marty Peretz's The Spine. Also be sure to take a look at TNR's new blogs by William Galston, Simon Johnson, Ed Kilgore, Damon Linker, and John McWhorter.
CO2 emissions in East Asia are growing faster than GDP.
Why have gold prices soared despite low demand?
Krugman and Delong on whether Obama should worry about the carry trade.
Our continuing housing problems.
40% of gov't debt will be refinanced in the next year.
Conservatives have been quick to blame the administration for the slow delivery of H1N1 vaccine. Not long after Obama declared the swine flu pandemic a national emergency last month--a measure that cleared the way for hospitals to make special preparations for infected patients--Missouri Representative Roy Blunt pounced on the administration’s “onerous regulatory and legal environment” as a cause for the vaccine delays. In the Weekly Standard last week, Bill Kristol held up the swine flu response as an example of the coming “big government health care” boondoggle. “Surely this spectacle, happening in real time before us, will give even more Democrats pause. Do they really want to be known as the Swine Flu Democrats?” Earlier this month, Rush Limbaugh declared that the problem was on par with the Bush administration’s disastrous federal response to Hurricane Katrina.
But how much blame should the government really get for the shortage? Late last month, Sheryl Gay Stolberg reported on the administration’s efforts to respond to the threat of a pandemic. From the start, she reported, Obama seemed determined to put forth a coordinated plan for dealing with the outbreak, studying past government responses to flu epidemics with the help of former administration officials and adding swine flu updates to his regular intelligence briefings. The administration created a government website and public service campaign to inform the public of precautionary measures they could take to avoid the flu. And, most importantly, they moved swiftly to contract with a roster of vaccine manufacturers and got the first doses out to high-risk patients earlier than every country but Australia and China. “[T]he Obama administration left little to chance,” she notes.
One thing they didn’t fully appreciate, however, was the inherent unpredictability of the vaccine manufacturing process. Flu vaccines are typically prepared by injecting the virus into fertilized chicken eggs and incubating them until they become infected. The egg fluid is then harvested and mixed with an embalming fluid, which prevents the virus from causing illness but triggers a response from the immune system that will prevent a future infection. As Allison Bond explained in Discover, there is ample opportunity for the process to become complicated if the egg rots, or the virus grows slowly or produce a weak vaccine. (As Bond notes, HHS devoted $1 billion in funds to develop new vaccine-making technology in 2006, but those technologies weren’t ready for use when H1N1 started spreading earlier this year.)
It’s certainly been a big news week for lady parts, as some of my lady colleagues at TNR have pointed out today. But while the conservative fear-mongering about “government rationing” is an obvious political ploy, some vital questions about how much women will have to pay for preventative care in the Democratic health-care bill have yet to be resolved.
Reid’s merged Senate bill left out part of an amendment that Barbara Mikulski had successfully introduced into the Senate HELP legislation, which requires insurance companies to include women’s preventative services as part of all minimum benefit packages, for little or no cost. Mikulski argued that women of child-bearing age end up paying an average of 68 percent more in out-of-pocket costs, partly due to reproductive health needs, and often ended up delaying or forgoing care (like mammograms) because of the expense. The provision—which was in neither the House nor Finance Committee legislation—was slated to be in Reid’s bill this week, but “CBO decided at the last minute there was a problem and it was removed until that is resolved,” Mikulski spokesperson Rachel MacKnight said in an email today.
The problem, according to sources familiar with the issue, was that the Mikulski’s amendment wasn’t specific enough in terms of how it would determine which services would be covered, simply saying that it would be it up to the discretion of HHS to set the guidelines for coverage. As such, the provision was so broad that CBO ended up having to give it a very high—i.e. expensive—score, and Reid ended up leaving the language out of the bill.
Today the European Union finds itself with two new top leaders--Herman Van Rompuy, the EU’s first president, and Catherine Ashton, the new high representative of foreign policy. If the names are unfamiliar, you’re not alone. In fact, the buzz surrounding Van Rompuy, who has been the Belgian prime minister for less than a year, and Ashton, who was most recently the EU’s trade commissioner, is that there is no buzz.
Take this morning’s headlines from around the world: “Leaders lambasted over low-profile EU job nominees,” “Europe’s leaders strike up the bland,” “Von Rampuy—The Reluctant Leader,” “Herman Van Who?” and “Van Rompuy-Ashton appointment: The EU has opted for the quiet life.”
So who are these people?
Well, OK, maybe not rich. But it should mean higher wages, if it includes the tax on expensive health policies.
That's according to Jonathan Gruber of MIT, who's been studying this and just released a new memo on the subject. As he did previously, he reverse-engineered numbers from the Joint Committee on Taxation to extrapolate wage growth. His findings?
Worker wages rise by $55 billion by 2019
This amounts to almost $700 per insured household in 2019
Worker wages rise by $234 billion in aggregate over this time period
This is also a very progressive wage adjustment. In every year, the share of wage gains accruing to those with incomes below $100,000 is about two-thirds of the total, and the share of wage gains accruing to those with incomes below $200,000 is over 90% of the total.
I'm swamped with reporting right now, so I can't really speak to the study's methodology or validty. But Gruber is certainly among the most respected and intellectually honest experts in this field. And if you'd like to draw your own conclusions, just read the full paper with the scratch-work. (Just make sure to leave me your thoughts in the comments!)
Mayor Michael Nutter of Philadelphia made a comment that prompted nervous laughter early in a forum the Metro Program held with the National League of Cities (NLC) yesterday on the looming local government fiscal crisis. Deadpan, he said: “Hearing a presentation that the recession is over reminds me of a sign I saw one time a couple years ago that said, ‘Mission Accomplished.’”
The man has a point. That GDP does not equal jobs is well understood. Less clear, and worth keeping in mind as some key indicators start turning around, is that the recovery is going to come only over time in three stages. First, GDP and labor productivity will rebound as they are now. Then firms will hopefully start hiring again. And eventually, once the labor market tightens and depending on what sort of jobs the ‘next economy’ creates, wages will start rising too.
The conundrum is this: The U.S. economy is just entering stage one, and progress towards stages two and three is hardly guaranteed. Indeed the situation is still getting worse in parts of the economy. The Mortgage Bankers Association issued a press release yesterday announcing that this quarter’s home loan delinquency rates reached another record high. Percent increases in GDP don’t pay mortgages, quipped their senior economist, wages do. And with the number of unemployed still rising, fewer people receiving a paycheck will equal fewer people making mortgage payments on-time, simple as that.
Like Michelle, we’re happy to see The New York Times giving front-page space to the new recommendations for mammograms and pap smears. And we, too, hope that the revised pap smear guidelines aren’t subjected to the same shameless politicization that quickly engulfed the mammogram ones. But we want to quibble with Michelle's point that “cervical cancer simply doesn't terrify women en masse the way breast cancer does.”
Breast cancer is indeed a much bigger threat to women. This year alone, according to the American Cancer Society, about 10 times as many women will die of breast cancer than of cervical cancer. But there's a generational gap when it comes to dread about these diseases. For women who are in their twenties, like us, cervical cancer is very high on the list of health fears. It’s not difficult to see why: We've come of age in the Gardasil era, with everyone from public health officials to gynecologists to even teachers telling us how urgently we need the vaccine to protect us against HPV, the virus that causes the vast majority of cervical cancer cases. (The FDA recommends vaccinating girls as young as nine.) And we’re constantly reminded of how ubiquitous HPV is: The CDC estimates that 20 million Americans currently have it, while another 6.2 million will be infected each year. Stunningly, more than half of college-aged women get HPV within the first four years of having sex.
It’s safe to say that the increased focus on HPV screening and vaccination has been a good thing, because the rate of cervical cancer deaths has dropped significantly over the last 50 years. But, like the Gardasil push, more screening has also heightened anxiety among young women. You'd be hard-pressed to find a woman our age who--if she hasn't faced the situation herself--doesn't know someone who has dealt with the fear that an abnormal pap smear causes, the subsequent, painful test to determine if there are pre-cancerous cells on the cervix, and the (again painful) surgical procedure to remove any dangerous cells. Add to all of that the sexual stigma that accompanies cervical cancer (it is, after all, a cancer that you get from a highly contagious STD), and it's clear why so many young women are freaked out.
Here’s hoping that, in addition to reducing harmful and invasive procedures that science deem unnecessary, the new pap smear guidelines help women breathe a little easier.
Ron Wyden will have his day and, in somewhat scaled-down fashion, he'll have his way.
Majority Leader Harry Reid, Finance Chairman Max Baucus, and Wyden just announced that they will be amending health care legislation to include a compromise version of Wyden's free choice amendment.
A press statement explains the details of the deal, which culminated weeks of hardball negotiations:
Under the Senate legislation as it is currently written, Americans with employer-provided coverage, whose income is below 400 percent of the federal poverty level and whose premiums are between 8 and 9.8 percent of their total income will be exempt from having to purchase health coverage but will not be able to access the exchange to qualify for government assistance to purchase insurance. The agreed to amendment will make it possible for these individuals to convert their tax-free employer health subsidies into vouchers that they can use to choose a health insurance plan in the new health insurance exchanges. The Congressional Budget Office estimates a previous version of this provision will expand coverage to more than a million Americans.
Of course, Wyden once crusaded for something much grander: Opening the exchanges to everybody. But employers and labor hated the idea, effectively killing it. That Wyden was able to get anything at all represents an accomplishment--and, perhaps, the start of something bigger, as he hinted today:
As I have long said, empowering Americans to choose the health insurance that works best for them and their family is the single best way to hold health insurance companies accountable. While this is just one step in the direction of guaranteeing choices for all Americans, it is a major step because – for the first time – it introduces the concept of individual choice to a marketplace where it has long been foreign. This is a significant step toward real reform.
I was pretty shocked by this new poll that found that 52 percent of Republican voters think ACORN stole the 2008 presidential election for Obama. I wanted to get some perspective, though, so I looked for polls that assessed voters' feelings about the 2000 elections. I figured that, even with hanging chads and all, fewer Democratic voters would have considered Bush illegitimate back then than those Republicans who now feel that way about Obama. So I was pretty shocked to find this CBS Poll from January '01, which found that 76 percent of Democrats didn't consider Bush the legitimate winner of the 2000 election. Now, granted, this poll was taken only a few months after the Florida fiasco--which, unlike ACORN, was actually real, not to mention fresh--but still . . . 76 percent!
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