Monday, January 28, 2008

In Budget Space, No One Can Hear You Scream

Arizona state budget stuff. My suggested headline was above, but apparently the editor isn’t an Alien fan. And it’s his split infinitive, not mine.

East Valley Tribune, Jan. 27, 2008

The idea that government spending should increase only based on inflation and population growth means that you believe government shouldn’t do anything that it didn’t do 5, 10, or 15 years ago. That’s not just quantity; it’s quality, too.

The 1990 census put Arizona’s population at 3.67 million; the 2000 census showed 5.13 million residents; and the Census Bureau estimates the current population at 6.34 million. That’s a lot of growth -- about 73 percent. Sounds like a lot of room, until you actually think about it.

Twenty years ago, before the 1986 tax referendum resulted in any actual pavement, metro Phoenix still had only 31 miles of urban freeways. So today we could only have the population-growth number more, which would be about 54 miles -- about a quarter of what’s been built and is still under construction with the county-wide sales tax.

But with freeways, it wouldn’t quite work that way; costs for land acquisition and construction, much less maintenance, increased greater than the rate of overall inflation. (We’ll be giving back much of that real estate appreciation over the next few years, but it’s too late to save any money on right-of-way purchased during the boom.) So while some Tribune op-ed columnists think we should be able to tool around town just fine on 73 percent more freeway miles, we’d actually have less miles -- and more congestion.

Don’t like traffic jams today? Imagine what they’d be like if these number-crunchers had gotten their way.

Same thing with health care. Maybe some people want to live in a state where you’re entitled to the exact medical care we had when we started letting numbers rule our lives. Any sort of improvement in care, or new treatment for disease? Forget it, because we’d have limited ourselves solely to making up inflation and population growth.

The population-and-inflation number would be a double whammy, however, because it ignores changes within the overall population. As the nation (and Arizona) ages, that increases demand for health care. But the formula doesn’t care about that; not only do you get only the treatments that existed years ago, but you only get the same amount of care that you needed five, ten, or fifteen years ago. Unless some resources get freed up because a lot of people older than you have died, but unfortunately for us Boomers, the generation ahead of ours seems to be living longer. That might be considered a good thing -- unless you’re one of these “limit spending!” types.

Has the incidence of autism among children increased tremendously, far more than population growth generally? Are there new treatments available that offer hope? Might we want to fund research to determine the causes and perhaps a cure? Sorry, but the population-and-inflation formula means we ration research, education, and treatment. If the number of autistic kids increases more than overall population growth -- which is has, big time -- those “extra” kids are out of luck.

If you’re going to limit government to population-and-inflation, that also means you can’t create new crimes, or lengthen sentences for existing ones, without decriminalizing others or releasing other prisoners earlier. Actually, that might make some sense; few government programs cost as much for as little proven benefit as the death penalty.

But unfortunately, the population-and-inflation types never start there, it’s too much fun to try to take away education and health care from those less fortunate than they.

What’s most puzzling about the current budget wrangling is that basically all of the “cut wasteful spending” types had a hand in the current budget (or an alternative that spent 99.9 percent as much). If that number included tons of things we easily could live without, then why didn’t these guys take care of it last year?

Instead, we’re getting the usual “across the board” cuts or appeals to some bogus population-and-inflation formula that would make somebody else responsible for the results of their ideology. It’s all theoretical and abstract, the political equivalent of planning the crime, then wearing gloves -- so your fingerprints never appear on the victims.

Monday, January 21, 2008

What If We Had Privatized Social Security?

My proposed headline, Privatizing Medicare: Another “Great” Idea From Those Wonderful Folks Who Gave You The Iraq War, was way too long but I’ve always been a
Jerry Della Femina fan.

East Valley Tribune, Jan. 20, 2008

After reading Dr. Tom Patterson’s
column from last Monday casting scorn on the American public for liking Medicare, I take it he doesn’t much like the program. That’s OK, not everybody has to like everything, so all pizzas don’t come with anchovies. But if Medicare’s future financing is such a mess, why did Republicans waste time trying to privatize Social Security instead?

Just imagine if Bush had gotten his way with Social Security as he did with Iraq. We’d have invested our private accounts in AAA-rated obligations that -- surprise! -- were actually stinking piles of bad mortgages. Not only would your house’s value be dropping by double-digit percentages, but so would your retirement plan. Bush and the Republicans are pitch-perfect market timers; they wanted us to buy at the exact top, just before the crash.

How frequently do these guys get to be so spectacularly wrong before we stop swallowing their claims? Think about it before you sign on with the latest right-wing plan to “improve” your life.

All of Dr. P’s problems with Medicare -- rapidly-increasing costs, daunting demographic trends, too few primary care physicians, no time to talk with patients, and “futile, end-of-life procedures” -- aren’t problems of Medicare, they’re problems of the U.S. health care system.

Doctors not taking new Medicare patients? It’s not a Medicare problem. Has Dr. P tried the private insurance market, where “your” doctor may or may not remain on your health insurer’s list of approved providers, or where, after lining up physicians for all your family members, your employer suddenly switches plans and you have to start all over?

No reimbursement for “cognitive” care, talking with patients and working through problems? Does Dr. P really think it’s better in the private sector?

Too many specialists, and too few primary care physicians? It’s not just Medicare, the entire system is providing those wrong-headed incentives. If we actually thought the imbalance between primary and specialist care was a serious problem, then we’d pay for more medical schools. Second, can’t pro-market guys fix the problem pretty easily by paying primary care doctors more and specialists less? (I’m curious if that sentence will make it past the editors; the concept of “paying a specialist less” is, to many, an obscenity unsuitable for a family publication.)

Rapidly-increasing costs? Well, you’ve got to sort through the two types of cost increases in health care. Costs go up because some things cost more today than yesterday, like paying nurses more because that’s the only way to hire enough (that’s health care inflation) and because we use more health care now than last year, both because we’re older and because of treatments and technology that weren’t available previously (that’s utilization).

As you get older, you tend to need more care; reducing your age isn’t usually a viable option. But it does raise the question about those “futile, end-of-life procedures” encouraged by Medicare’s financial drivers that so upset Dr. P. Few patients get admitted to the hospital with a chart that says “6 months to live, max.” When it’s your life on the line, you tend to err on the side of more treatment. But if Dr. P is so worried about our country’s financial health and Medicare’s pernicious incentives, I’m happy to tell everybody if he’s hospitalized, don’t hesitate, pull the plug!

What Dr. P doesn’t mention is the unfunded cost projections also affect the private health care system. What’s looming isn’t just Medicare,
but all health spending. Merely shifting people from one side to the other through (highly regressive) tax-advantaged accounts won’t make the problem disappear; it’ll just get it off the government’s books -- and help relieve ‘wingers from any sense of obligation to their fellow citizens who fall ill.

Privatizing Medicare with “Health IRAs” makes as much sense as did invading Iraq or attempting to privatize Social Security. It’s the same people and the same result -- and with their track record, it’s a good bet that if they get their way, the next day you’ll get really, really sick.

Monday, January 14, 2008

Guess Who Won The Oh-So-Crucial "Coppersmith Primary"?

The Napolitano endorsement of Barack Obama took a lot of people by surprise, both in Arizona and nationally. I normally don't get to break political news when I have to file 3 days in advance of publication. And for those of you who like inside baseball, the Obama people were calling me and the other Richardson supporters in Arizona the day after the NH primary. Very interesting -- a very nimble campaign. Let's hope they can keep it up. I love the Richard Land quote, even if I hope I can live long enough to throw my dentures at him at the old folks' home, because on everything else he's WRONG WRONG WRONG.

East Valley Tribune, Jan. 13, 2008

As we political types differ from apes in zoos because we'll swallow anybody's offal, not just our own, I was truly surprised by the New Hampshire results. But it's a happy surprise, because suddenly, Arizona's Feb. 5 primary matters.

The GOP race already was pretty interesting, because Sen. John McCain -- despite relentless cheerleading by the other daily newspaper, which eight years later is still trying to make up for mentioning McCain's volcanic temper (scroll down to the fourth letter -- yes, Pat Murphy is still out there!) -- is anything but a favorite son. Arizona's presidential preference election is a "closed" primary, in which only those voters registered to a party can participate.

That means that while more than 28 percent of Arizona's registered voters are independents, they can't participate. (The 0.69 percent registered as Libertarians also can't participate, but they should have philosophical objections anyway.) New Hampshire exit polls showed McCain winning because of independents and losing among self-described conservatives to the recently-converted Mitt Romney, and self-described conservatives are the only people voting in Arizona GOP primaries.

Unfortunately for McCain, the only issue that seems to matter to GOP primary voters is his weakest, immigration. Mix in that independents can't vote, under-the-radar evangelical networking could deliver voters for Mike Huckabee, and some LDS identity politics could help Romney, so we just might get a competitive GOP primary in McCain's home state.

It's too late to open up the Feb. 5 vote to independents. Anyway, allowing independents to vote is opposed by state GOP chair Randy Pullen, who won't shed a tear if McCain loses.

As for the Democrats, after New Hampshire, I figured that Hillary Clinton wins Arizona, easily. Partially it's Bill Clinton's continuing popularity (Hey, Arizona -- how did that George W. Bush thing work out?), but it's also the apparently mass reaction, especially among older women, to the media's collective assault on Hillary, the whole "tears, wrinkles, brittleness, and her alleged cackle" business. It would be ironic if Bob Dole's 1996 unofficial campaign slogan "Annoy the Media!" sealed the deal for Hillary Clinton in 2008.

But two days ago, the only person who might make a difference in an Arizona Democratic primary, Gov. Janet Napolitano, endorsed Barack Obama. She was scheduled for a press conference, then a trip to Nevada for some campaigning. I still think Hillary is ahead here, but things just got much more interesting. And if you follow politics, there are fewer things more fun than having your state be "in play" for a maximum of four weeks, which is where we Arizonans find ourselves today. It's like being Ohio, but with better weather.

While my personal endorsement record, also known as the "kiss of death," remains unbroken (as an endorser for former Florida Sen. Bob Graham in 2004 and New Mexico Gov. Richardson this year, my personal mantra remains "Vote for the resume, not the awkward campaigner!"), I've also signed on with Obama, for my own idiosyncratic reasons. It's not so much policy disagreements, or hope vs. experience, as it is my deep desire that this election be about new arguments, not the old ones.

Michelle Cottle of The New Republic interviewed Dr. Richard Land, head of the public policy arm of the Southern Baptist Convention, who believes that just as we self-obsessed Baby Boomers have ruined popular music, we're keeping American politics as an oldies station. If Hillary wins, we'll have the last Boomer campaign, one last fight over our split over Vietnam. Land says the war may be over, but Boomers will never let the argument die: "We're going to be throwing our dentures at each other when we're in the old folks' home. The problem is our generation split over this, and we both still think we're right."

And as Boomers, it's all about the argument; what you actually did doesn't matter. That's why John Kerry has a Bronze Star, a Silver Star, and three Purple Hearts, while Jon Kyl got two draft deferments, and guess whose patriotism gets questioned?

So I'm changing my radio station presets, no more oldies. And I'm endorsing Obama; no more Clinton Derangement Syndrome. Let's listen to something new instead.
Coppersmith Humor

I assume that it's much funnier in the original Uighur.

Monday, January 07, 2008

Let's Go To The Tapes!

Last week was surprisingly hectic, and I had to miss a chance to go on the local public TV station's Horizon program Thursday evening to analyze the Iowa caucus results because I already had made an appointment to give blood. Hey, am I a stereotypical liberal, or what? But this week, I'll have the New Hampshire results earlier in the week and can look ahead to the all-important, make-or-break, first-or-second-in-the-West Nevada caucus! (That's sarcasm, folks.)

I had fun with an angry 'winger reader who, after this column, was furious that I'm always so negative about Bush. I explained that I write for the nearly 70% of Americans who disapprove of his performance, while my paper's op-ed pages are 2-to-1 slanted the other way. So it's my job to speak for -- wait for it -- the silent majority. I could hear his gasket blowing miles away.

East Valley Tribune, Jan. 6, 2007

I'm writing this column six hours before we learn the results from Iowa, so I desperately need a topic that will still be relevant three days later. But I'll resist the temptation to join all the other pundits in denouncing the Iowa caucuses, because people who have no problem with the college football Bowl Championship Series (or communities that host a BCS game) probably shouldn't complain too loudly that the Iowa caucuses are undemocratic, illogical, and unfair.

Instead, you may have missed -- with all the ongoing Bush administration scandals, it's getting awfully hard to keep up -- the Justice Department opening a criminal investigation into the CIA's destruction of interrogation videotapes.

The investigation, to be headed by a career prosecutor from Connecticut because of potential conflicts of interest (the CIA's Inspector General expects to be a witness; the U.S. Attorney in the Eastern District of Virginia prosecutes cases for the CIA), appears to be focused solely on the destruction of videos of interrogations of two "senior Qaeda operatives," Abu Zubaydah and Abd al Rahim al-Nashiri.

The destruction of the tapes is pretty significant, because as the two co-chairs of the 9/11 Commission detailed in The New York Times last week, the Commission asked repeatedly and specifically for documents of all types from any al-Qaeda interrogations. Former GOP governor Thomas Kean and former Democratic congressman Lee Hamilton were pretty blunt: "What we do know is that government officials decided not to inform a lawfully constituted body, created by Congress and the president, to investigate one [of] the greatest tragedies to confront this country. We call that obstruction."

Yikes, not much wiggle room there. Kean and Hamilton are a bipartisan pair of retired politicians. You know, the kind of older white guys who get "centrist" columnists all hot and lathered about the excess partisanship and lack of consensus in today's Washington. (Yesterday's Washington being a halcyon wellspring of mutual good feeling and fantastic accomplishment, just the way every middle-aged guy recalls himself being a lot more attractive as a youngster than he actually was.) Did it ever occur to these pundits that there's a lack of consensus in Washington because a lot of us Americans actually disagree about issues? Face it, how could anything on which Austin Hill, Bob Satnan, and I all agree even be worth discussing?

So the Justice Department will investigate the destruction of those two sets of videotapes, but as Laura Rozen wondered, does anybody really think that the CIA had only one copy of videos of interrogations of "high value" detainees? That nobody at the Agency worried about maybe missing a word or having a second translator make sure everything got into English correctly? That they'd really destroy all records of every single interrogation after 2 days? That nobody in Washington ever wanted to see video of the interrogation to see what those idiots in the field may have missed? Ever since Hammurabi was king of Babylon, government agencies always have kept copies. You really think the CIA didn't?

Those interrogation tapes probably would make the Bush administration's attempts to draw distinctions between "torture" (what we don't do!) and "tough" or "enhanced" interrogation methods (which we use, but we can't explain what we mean, because it's classified!) lose the rest of its plausibility once everybody can see exactly what was done. If cell phone pictures of Abu Ghiraib were powerful, just consider what looking at a waterboarding tape would be like. And as Emily Bazelon and Dahlia Lithwick wrote last month, what happens to the government's terrorism cases if defendants now have proof that the prosecution used evidence collected under circumstances that will turn your stomach?

This isn't a big mystery. The Qaeda interrogations would be President Bush's "Rodney King video." Bush will get off -- if the administration can't once again blame a few bad apples, they always can pardon themselves -- but the stain on our nation's honor won't be so easily remedied.