Saturday, May 31, 2014

Selective Outrage on VA


There is bipartisan outrage over charges that veterans seeking health care at Veterans Health Administration clinics were forced to wait much longer than two weeks to be seen by physicians — and in some cases the delays may have been several months, all while some VA executives were collecting cash bonuses for their performance.

Timothy Noah of MSNBC reported May 24 that wait times for appointments may have been falsified at the Phoenix VA hospital and the department was investigating whether long wait times contributed to the deaths of 40 veterans at that facility. Similar complaints have been heard about other VA facilities. As Noah wrote, “This is a ghastly problem involving potentially criminal behavior.”

But, Noah added, while VA wait times for appointments are bad, private-sector wait times aren’t much better.

Conservatives have claimed that the scandal proves that the VA was never the model for excellence (and, by implication, the argument for socialized medicine) claimed by liberals like Paul Krugman, Ezra Klein and others, including Noah. “But the VA scandal does not raise questions about the quality of VA care, which continues to rank highly; it raises questions about the availability of VA care,” Noah added.

“To conclude from the VA scandal that VA hospital care was poor would be like concluding from Harvard’s 6% admission rate that Harvard did a lousy job educating students,” Noah noted. “The difference, of course, is that Harvard isn’t supposed to admit everybody, whereas the VA is supposed to book appointments for already-qualified veterans within 14 days. It isn’t doing that. News stories about the Phoenix VA and some other bad actors indicate the wait can be many months, but an internal VA estimate — one based on ‘hard’ time stamps and therefore less vulnerable to manipulation than the records allegedly falsified — puts the average wait at about 21 days.” (On May 28, acting Inspector General Richard J. Griffin said in an interim report that the average wait for a first appointment at the Phoenix hospital was 115 days and “inappropriate scheduling practices are systemic throughout” the nationwide VA health care system. The inspector general has not determined whether any veteran died as a result of delayed appointments and treatment.)

While directly comparable data for the private sector are unavailable, a recent survey of wait times to see private physicians found the average wait time for a Medicare or Medicaid patient to see a private specialist in 2013 was 18.5 days. Noah added that in Boston, which has a high concentration of top-quality private-sector hospitals, the average wait time was 45.4 days.

Republicans led the call for VA Secretary Eric Shinseki to resign before the department’s inspector general completed his review of the complaints. Some Democrats running for re-election also called for Shinseki’s resignation after release of the IG report. (This was published before Shinseki resigned Friday.)

Many of those same Republican senators who are critical of the VA backlog blocked a bill on Feb. 27 that would have improved veterans’ access to health care among other things but under Senate rules needed 60 votes to proceed. Only two Republicans, Sens. Dean Heller (R-Nev.) and Jerry Moran (R-Kan.), joined 54 Democrats and independents in voting for the $24 billion veterans benefits bill, despite endorsement by every major veterans organization, as 41 Republicans voted against it.

Sen. Bernie Sanders (I-Vt.), chairman of the Veterans Affairs Committee, who had sponsored the bill, said he would introduce another bill to increase accountability at the Department of Veterans Affairs and make another attempt to improve VA health care, education, job training and other benefits.

"In recent years, as a result of the wars in Iraq and Afghanistan, 1.5 million more veterans have entered the VA health care system,” Sanders said in a press release. “Congress must do everything possible to make certain that the VA has the financial resources and administrative accountability to provide the high-quality health care and timely access to care that our veterans earned and deserve.”

The new accountability measure that Sanders will introduce would grant VA secretaries the power to remove senior executives because of poor job performance, his office said. Under current law, officials in what the federal government calls the Senior Executive Service may be dismissed or demoted, with rare exception, only for misconduct.

Unlike a bill that the House passed May 22, the Sanders measure would avoid politicization of the VA by preventing any new administration from discharging hundreds of high-level civil servants without due process for political reasons.

If Republicans are outraged at the VA’s delay of health benefits for veterans, they also ought to share their concerns with Republican governors and legislators who are preventing the coverage of a quarter-million veterans who don’t qualify for VA care but could get care under the Affordable Care Act.

Ezra Klein of Vox.com added, “It’s a relief to see so much outrage over poor access to government-provided health-care benefits. But it would be nice to see bipartisan outrage extend to another unfolding health-care scandal in this country: the 4.8 million people living under the poverty line who are eligible for Medicaid but won’t get it because their state has refused Obamacare’s Medicaid expansion.

“As appalling as the wait times are for VA care, the people living in states that refused the Medicaid expansion aren’t just waiting too long for care. They’re not getting it at all. They’re going completely uninsured when federal law grants them comprehensive coverage. Many of these people will get sick and find they can’t afford treatment and some of them will die. Many of the victims here, by the way, are also veterans.”

The Kaiser Family Foundation estimates that more than 7.5 million uninsured adults would be eligible for Medicaid but live in one of the 24 states that have refused the expansion. Of that group, 4.8 million who live below the poverty line would be ineligible for subsidies in the insurance exchanges. So they’re out of luck. And so are 258,600 uninsured veterans who the Urban Institute estimates would be eligible for Medicaid if their states accepted the expansion.

In Texas, for example, Medicaid expansion under the Affordable Care Act would provide 1,727,000 working-poor Texans with comprehensive health insurance, including 48,900 veterans. Without the medical care, which the federal government would pay for, as many as 3,000 uninsured Texans are expected to die, health-care experts at the Harvard Medical School and City University of New York have estimated. (The study found that as many as 17,000 people could die of premature and avoidable deaths in the 24 states that have rejected Medicaid expansion. Likewise, in Florida, Medicaid would cover 1,212,000 working poor, including 41,200 veterans, and 2,200 could die. In Georgia, Medicaid would cover 599,000 working poor, including 24,900 veterans, and 1,100 could die. In North Carolina, 511,000 working poor, including 23,300 veterans, and 1,100 could die. All state officials have to do is accept the federal money. Other states whose Republican leaders are intent on denying medical care to their working poor, including veterans, include Alabama, Alaska, Idaho, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, Oklahoma, South Carolina, South Dakota, Tennesse, Utah, Virginia, Wisconsin and Wyoming. (Pennsylvania hasn’t moved forward yet, but its officials are negotiating with the Obama administration to do so.)

Republican who claims to be “pro-veteran” and “pro-life” but votes to deny VA benefits in Congress or Medicaid expansion at the state level is a hypocrite who is more to blame for the denial of health care and avoidable deaths of veterans than Eric Shinseki is on his worst day.

Republicans ought to be ashamed, but that notion seems quaint nowadays. — JMC

From The Progressive Populist, June 15, 2014
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Selections from the June 15, 2014 issue














Wednesday, May 28, 2014

Another proof that it’s time to raise taxes on the ultra-wealthy

By Marc Jampole

The number 400,000 has taken on a new significance. It’s a big number, and when you add a dollar sign in front of it, it looms even larger. 

As it turns out, only about the top one percent of all individual or joint tax filers report adjusted income of $400,000—the actual number to make the top one percent of income earners is $388,905, but $400 K is close enough. 

What I find so fascinating about the number 400,000 is that it is also what you get if you take four percent of the median annual salary of CEOs of the companies on the S&P list of the 500 most frequently traded large publicly owned American corporations.  What that means is that if you put the salaries and bonuses of the heads of a very representative sample of the largest companies in American in a list from top to bottom, the halfway point will be $10.5 million in income in 2013. By the way, the 0.5 in this number means $500,000!

Keep in mind that some make much more, for example, Nabors Industries’ Anthony Petrello, who grabbed $68.3 million in 2013.

In other words, these five hundred (mostly) men and women make so much money that four percent of their mean salary is more than what more than 99% of the rest of us make. BTW, my numbers for CEO salaries come from a recent survey by Associated Press/Equilar of CEOs of the companies in the Standard & Poor 500.

And what do these CEOs do to earn all that money (which doesn’t include expense accounts and other perquisites of their exalted offices)?

Let’s start with what they don’t do. They all have one or more assistants that do their scheduling and keep their lives in order. There may be a president working under them and there will certainly be executive vice presidents and senior vice presidents for all of the various departments.  These companies have an average of 44,000 employees who do the actual work of creating and selling the products and services.  An S&P 500 CEO on average makes 257 times what the average employee makes, a tremendous increase from even five years ago when these corporate titans made a mere 181 times what their average employees make.

We know CEOs make major corporate decisions, but they have the help of the board of directors. We know that they are the face of the company, but when they speak in public, they have gotten their facts and figures from their company’s financial people and engineers and they have gotten their words from their PR folk. CEO’s do have the grave responsibility of meeting with elected officials, other corporate leaders, investment bankers and other powerful and/or rich people.

Sarcasm aside, there is no way to justify these salaries, which are significantly higher both in absolute terms and as a percentage of the average worker’s wages in the rest of the developed world. CEOs in Europe and Japan make less money and pay more in taxes. While CEOs are very talented, they aren’t so talented as to be unique—a Pascal, Einstein or Hawking is as rare among CEOS as they are among scientists, if not rarer. There are thousands of other people just about as talented who would be happy to take their jobs for third or a quarter of the money. Or less. The proof that scarcity of talent is not the cause of the outsized salaries is that the European and Japanese business leaders make so much less on average than American CEOs when compared to their workers.

As a society, we can’t really control how a corporation decides to spend its money, as long as it does so legally. But we can raise taxes on these outsized salaries. And it makes sense to do so, not only as a matter of fairness, but to return the level of government service to what it used to be in the days when governments fixed potholes, funded many more large science projects and provided high-quality public colleges at a low cost.  We can also raise the minimum wages, which would force these modern oligarchs to pay all of their employees more.

Tuesday, May 27, 2014

Study proves with numbers that politicians tend to vote for what rich people want

A new study makes the amazing discovery that politicians usually vote conscience—unfortunately it’s the conscience of the rich people who contribute the most to their campaigns. 

In an article titled “Testing Theories of American Politics: Elites, Interest Groups and Average Citizens,” Martin Gilens of Princeton and Benjamin Page of Northwestern analyze 1,779 American opinion studies between 1981 and 2002 that included the income level of the survey participants. Gilens and Page also looked at the policies advocated by the largest 25 lobbying groups in the country and the ten industries spending the most on lobbying.  The two professors then compared what these various groups wanted and what actually passed in legislatures.

Here are some results reported in The Economist¸ the only mass media outlet to report on the study as of this writing: 
·         When lots of wealthy people (more than 80%) liked a policy, it went into effect 45% of the time.
·         When very few wealthy people (fewer than 20%) supported a policy, it went into effect 18% of the time.
·         Whether very few of a vast majority of people with average income wanted a policy did not matter: policies passed 30% of the time in either case.
·         Interest groups representing the non-wealthy such as unions have little or no impact on what policies our elected officials support, vote on and implement.

I imagine if Gilens and Page crunched the numbers since 2010 they’d find that politicians are doing the bidding of the wealthy and ignoring everyone else even more than they used to.  It was in 2010, of course, when the Supreme Court freed corporate interests to spend whatever they liked on campaigns in the Citizens United decision.

Campaign spending and the effects of the Citizens United and the more recent McCutcheon v. FEC have remained a major trend of news coverage since the first laws limiting spending passed in the 1970s.

Isn’t it a bit odd then that only one major media outlet (a smaller one at that) has covered this major new study? Odder still that a Google New search revealed a mere 58 articles in total among the tens of thousands of media in the Google News universe?  Wouldn’t you think that the media would pick up this story faster than you can say “Picketty picked a peck of pickled Paretos”?

Contributing to campaigns and lobbying are only two of five ways that business interests and the wealthy control the policy decisions in the United States. Control of the mass media through ownership is another. We also can’t forget a fourth way that the wealthy get their way: funding political and economic research, again with their large war chests of accumulated capital.

The final way that the rich gain the ear of our elected officials is by running for office themselves.  The Center for Responsive Politics has found that slightly more than half of all members of Congress are millionaires.  Since the birth of the Republic, rich folk have always had an inside track whenever they decide to run for office. Michael Bloomberg, Carly Fiorentina, John Huntsman, John Edwards, Meg Whitman and Mitt Romney are only the latest generation of the ultra-wealthy to throw their hats in the ring for elected office. Gores, Kennedys, Roosevelts, Harrimans, Danforths, Rockefellers and Ross Perot come to mind without an Internet search.

Because of the impact of these other factors, it’s impossible to conclude how much funding candidates and lobbying contribute to the stranglehold the wealthy and especially the very wealthy have on the American political decision-making process. 

It will therefore take more than just new campaign finance limitations to move from a one-dollar-one-vote to a one-person-one-vote model. We will also need to reinstitute laws that prevent concentration of media ownership in a few hands.  Passing laws that make campaigns, lobbying organizations and think tanks liable for the factual lies they tell will also help. But, of course, corporate interests are trying to get the state laws that do exist about campaign lying to be declared unconstitutional.  

Sexually explicit TV star replaces stolid man of honor as American Airlines’ ideal traveler

Over the past three weeks, I have found the same eight-page slick mostly black-and-white advertising brochure for American Airlines inserted in one or other of my daily newspapers—The New York Times and Wall Street Journal—at least six times. This extended advertisement for American’s rebranded first class international service demonstrates how the image of the upscale consumer has changed over the past 60 years.

The cover depicts Gregory Peck, a film star active from 1944 into the 1980s, nattily dressed in a business suit, looking up towards the sky. His hands are in his pocket as he looks thoughtfully at a great expanse of sky. The top of a pencil thin pin striped handkerchief shows at the top of his coat breast pocket. In a blurry background we see the wing of an American airplane. A small headline reads, “In 1953, we invented transcontinental service.”

Turn the page and we see a two-page spread that shows an entire jet and actor Neil Patrick Harris dressed just as nattily as Peck and still as a businessman, walking inside the terminal. The headline is bigger, “Today, we reinvent it.”

What follows are two more photo spreads. In both, Neil is on the left page inside a plane and actress Julianna Margulies is on the right page, also in a plane. The two thespians are each alone and engaged in activities that reflect the headline of each page: Service. Comfort. Connectivity. Luxury. Julianna looks stunning, dressed in classic simplicity in what could be business wear or a cocktail dress. The photo is black and white, but if it were in color, her dress would still be black, I assure you.

The last page shows the tail of an American jet in full color with the headline “The legend is back.” In fact, the tail is the dominant visual image throughout the eight pages, getting into three photos, as many as Neil Patrick Harris.

American’s image of the luxury traveler sure has changed! From Gregory Peck to Neil Patrick Harris (with an assist from Julianna Margulies).

Already by 1953, Gregory Peck was typecast as the mythic American straight arrow—a little stiff and formal, honest and forthright, sincere, always following the rules, no nonsense, dedicated to principles. He had established this stereotype in such films as “The Yearling,” “Spellbound,” “Gentlemen’s Agreement,” “Snows of Kilimanjaro,” “Captain Horatio Hornblower” and “The Gunfighter.” He even played the ruthless and devious King David as an earnest school boy in “David and Bathsheba.” This stolid, straight-shooting image of Peck developed long before “The Man in the Grey Flannel Suit,” “On the Beach” and “To Kill a Mockingbird.” American Airlines uses Peck’s persona to represent its image of its customers in 1953—the idealistic American off to conquer the world for democracy (and capitalism).


And what does Neil Patrick Harris represent?  For the past 10 years, his resume consists primarily of playing the same exact role in both a long-running sit com and three Harold and Kumar movies: that of a raunchy and immoral stud who will bed any woman and whose only interest in women is their bodies and sexuality. Whether playing it straight or satirizing, he is the quintessential cool-as-Sinatra laddie boy with emotions suspended in early adolescence, down to the interest in style and consumer toys and the inability to engage the opposite sex except in games of sexual conquest.  Ironically, all the time that he has played the role of an insufferable heterosexual lothario, in real life Harris has been a completely out-of-the-closet gay. He is currently playing the lead role in the revival of “Hedwig and the Angry Inch,” a Broadway musical about a transgendered rock star.

Whether approving or disapproving of Harris or the characters he plays, no one can doubt that he represents an amoral or polymorphic sexual adventurism. 

Julianna Margulies also represents sexual freedom in a backhanded way, since she is best known for two roles on TV—in “ER” and “The Good Wife”—in which she played a beautiful and talented woman whose man sleeps around and otherwise embarrasses her. Perhaps the secret narrative of the eight-page ad is that she is running away from these sorrows, but still looks like ten million bucks.

The overt message is obvious: The ideal international traveler is still rich and stylish, but now he can also be a she, and in both cases, their travel abroad is sexy and sensual. The self-sacrificing idealist has been replaced by the fun-loving sybarite.

But beneath the surface commercial message lies an ugly anti-feminist narrative. The mythic contemporary man in the ad is a spiffy philanderer (whose real-life alter ego excludes women as potential sexual partners); the mythic contemporary woman is an alluring victim of philandering.  The cultural references which viewers conjure in seeing these two actors does not paint a pretty picture for women. No matter how accomplished, wealthy or beautiful they are, American Airlines seems to be saying that at heart women are just pieces of tail.  
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