Ezra Delivers An Elbow From The Sky

Ezra Klein's takedown of David Brooks entire column is a beauty to behold. I'll just leave you with the last two lines.

Brooks isn't wrong in the sense that "I disagree with him." He's wrong in the sense that the column requires a correction.

Taken To The Woodshed

Somehow I doubt Charles Lane will be trying to attack Ezra Klein again any time soon.

Punks jump up to get beatdown!

Ezra Klein Has Done It Again

I did a post about the flame war between Matt Taibbi and Tim Fernholz over Taibbi's new Rolling Stone article over the weekend. Well for my money Ezra Klein has just ended the debate. I know there are people who will defend Taibbi's article because they like him. Hell, I usually like his work too. But its going to be hard as hell for them to try to defend him again Klein's post. I would have thought Fernholz had made a strong case but evidently some folks reflexively dismissed it because of their affinity for Taibbi and also because Fernholz only highlighted a few problems with the piece. But Ezra pretty much takes it apart piece by piece. I have no doubt that there will still be some Taibbi fans who disagree, but their arguments are almost by necessity are going to have to be disingenuous. Hell everybody makes mistakes or puts out bad product at times, this time it was Taibbi.

Deal with it.

Joe Lieberman Is A Lying Sack Of Shit

I know I am not breaking any news here with the headline. But Ezra Klein fisks his latest wankery, the claim that President Obama never talked about a public option in health care before the election.

In the immortal words of Dana Milbank, "What a Dick"

Long Term Ramifications

Ezra Klein games out the long term implications of the Stupak amendment. Here's a hint, it ain't good!

Ahem

I am not sure what this means for his job security at WaPo but Ezra Klein basically just called out Fred Hiatt over his op ed column about the House health care bill. Now he wasn't belligerent and was very respectful in his response but basically he called bullshit on Hiatt's column and there is no way of getting around that.

Fred Hiatt's column today calls the House's health-care reform bill "a step closer to bankruptcy." But he's not really talking about the House's health-care reform bill, which he admits the Congressional Budget Office has assessed as not only deficit neutral but deficit improving. He's talking about, first, a fix to Medicare reimbursement rates that really isn't part of health-care reform, and, second, the capacity of Congress to make hard decisions about, well, anything. Fair points both, but neither here nor there when it comes to the House legislation.

To take them in order, the $250 billion Medicare payment fix is actually the outgrowth of another bill: The 1997 Balanced Budget Act. That legislation created a payment formula for Medicare that tied the program's payments to the period's extremely low growth in health-care costs. But then cost growth accelerated again, and Republican and Democratic congresses alike began voting to reject the formula's cuts. Bringing the formula back into line with the growth of health-care costs will require a hefty $250 billion. But we'd have to do it whether President Obama pursued health-care reform or not. Just ask President Bush, who had no interest in health-care reform, but saw Congress reject these payment cuts in 2003, 2005, 2006, 2007 and 2008.

Hiatt's more compelling objection is that Congress will continue to duck the hard questions of health-care reform and vote to avoid making the cuts and reforms that are written into the bill. As he says, "history suggests that legislators will not be deaf to the complaints of seniors and those who treat them when it comes time for the ax to fall."

This may be true. The problem, however, is that it obviates any possible solutions. For instance: In the final line of the column, Hiatt proposes that "Obama puts his clout behind the progressive ideals of thrift and cost containment." Elsewhere in the column, Hiatt laments that Congress did not "end the tax break for employer-provided insurance" or "empower an independent commission that could make cost-control decisions" or "rais[e] taxes on anyone who earns less than $250,000 per year." But if Congress will simply thwart any effort at cost containment, what's the point?

Taxes can be rolled back (see the Bush tax cuts) or indefinitely delayed (see the AMT). Commissions can be ignored or overturned. Cost controls can be repealed and weakened. I'm not necessarily arguing that Hiatt's pessimistic conception of Congress is inaccurate, but the appropriate response is either nihilistic or revolutionary. It cannot, however, be to propose different and harder cost controls than the ones Congress itself has passed.

Now I realize that I probably quoted more than what's usually acceptable but I hope he doesn't mind because I wanted you to get a very good idea of how thoroughly he PWNED Hiatt who is essentially his boss.

I have to give him major respect for not letting Hiatt's BS stand even though they work together and I can only hope that there is no retribution. Ezra is a monster when it comes to health care policy and WaPo would be a fool to let him go any damn way!

Laughing Stocks

It will never happen, but if there were any justice in this country the House Republicans would be totally discredited and in fact held in contempt by the media for putting forth this steaming pile of bullshit purporting to be a health care reform bill.

I will let Ezra take it away:

Late last night, the Congressional Budget Office released its initial analysis of the health-care reform plan that Republican Minority Leader John Boehner offered as a substitute to the Democratic legislation. CBO begins with the baseline estimate that 17 percent of legal, non-elderly residents won't have health-care insurance in 2010. In 2019, after 10 years of the Republican plan, CBO estimates that ...17 percent of legal, non-elderly residents won't have health-care insurance. The Republican alternative will have helped 3 million people secure coverage, which is barely keeping up with population growth. Compare that to the Democratic bill, which covers 36 million more people and cuts the uninsured population to 4 percent.
But maybe, you say, the Republican bill does a really good job cutting costs. According to CBO, the GOP's alternative will shave $68 billion off the deficit in the next 10 years. The Democrats, CBO says, will slice $104 billion off the deficit.

The Democratic bill, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan (...)The Democrats, constrained by reality, produced a far better plan than Boehner, who was constrained solely by his political imagination and legislative skill.

This is a major embarrassment for the Republicans. It's one thing to keep your cards close to your chest. Republicans are in the minority, after all, and their plan stands no chance of passage. It's another to lay them out on the table and show everyone that you have no hand, and aren't even totally sure how to play the game.

Democrats in the House should take the GOP health care reform plan proposal and bust them upside the head with its CBO score over and over and over again on the floor of the House. Its time we had more Democratic members of Congress calling bullshit on this fools and putting it up on YouTube for all the world to see.

Counter Point

Ezra Klein highlights MIT economist Jon Gruber's counter point to the insurance industry's propaganda piece put out yesterday to try to derail health care reform.

Hey AHIP, 1994 called and they want their dirty tactics back.

Ezra Hits Grassley For Parsing His Words

Do Republicans think nobody is watching them while they are shoveling all this bullshit?

Consider The Game Changed

If liberals and progressives, both in Congress and as regular citizens, do not scream this information out loudly and repeatedly until somebody pays attention, then we don't DESERVE a public option in health care reform. Its all right there for the taking, but we have to actually get the word out.

From Ezra Klein:

According to Congress Daily, the CBO says attaching the public plan to Medicare rates will save even more money than originally thought:

In a bid to wrangle concessions from the Blue Dog Coalition on healthcare reform, House leaders Thursday released CBO estimates for liberals' preferred version of the public option that show $85 billion more in savings than for the version the Blue Dogs prefer.

Rep. Stephanie Herseth Sandlin, D-S.D., a Blue Dog co-chair, said any possible new momentum toward a public option tethered to Medicare rates is, in part, "because of the cost issue" and the updated CBO score.

The original House bill required the public plan to pay providers 5 percent more than Medicare reimbursement rates. But as part of a package of concessions to Blue Dogs, the House Energy and Commerce Committee accepted an amendment that requires the HHS Secretary to negotiate rates with providers. That version of the plan will save only $25 billion.

In total, a public plan based on Medicare rates would save $110 billion over 10 years. That is $20 billion more than earlier estimates, a spokesman for House Speaker Pelosi said.

There is absolutely no way for someone who calls themselves a fiscally conservative Democrat to argue against a public option at this point. And if they try it exposes them for the corporatist hypocrites that they really are.

Ezra Klein PWNS Joe Lieberman

Every Democratic strategist going on cable news this week should read this Ezra Klein post about Joe Lieberman's lame recession excuse against doing health care reform now because I can promise you that they will be hit over the head with what that asshole said yesterday on CNN.

Second, health-care reform is scheduled to begin in 2013, by which time we will almost certainly be out of recession, and if we're not, we have bigger problems. Lieberman might be uncommonly pessimistic about our prospects for growth, but that would imply support for health-care reform, as it will pump a trillion dollars into the economy and thus stimulate demand.

Third, the costs of reform largely manifest in the later years of the decade, namely 2015-2019, by which point we may or may not be in recession, but if we are, it will probably be a different recession than the one we're in now.

There is, in other words, no connection between whether GDP growth is slightly negative in the third quarter of 2009 and whether we should spend money between 2013 and 2019 building a universal health-care system. When people say we shouldn't do health-care reform because of the recession, they're saying something about their preferred approach to health-care reform, not to recessions.

Oh yeah, and by the way, FUCK JOE LIEBERMAN!

That is all.

Give That Man A Standing Ovation

Megan McCardle is an idiot. The thing about it is pretty much any reasonable person who reads her work on a regular basis would agree with me on that. And yet for some reason she is elevated as some kind of up and coming writer for the right. Now the truth is the right wing really doesn't put that much of a premium on their writers actually making sense. But it still baffles my mind that she even has a job writing for a major publication. I have even seen a few liberal and progressive writers have good things to say about her.

Well Ezra Klein is not having it. This smackdown of her nonsensical screed against health care reform is epic! That is going to leave a mark and it should. I am to the point where it actually offends me that she can be that bad at her job and most people refuse to say so. For that reason Ezra Klein gets major props for speaking truth to power even though they used to be pretty good friends as DougJ pointed out.

Times Have Changed

Ezra Klein has an EXCELLENT post up about the differences between where we were as a country back in 1994 when Bill Clinton tried to push health care reform and where we are now. I don't think anyone else has really spoken out on how managed care has taken over between then and now and why that matters in the current health care debate. Excerpting it wouldn't do it any justice so please just click the link and check it out, then pass it on to your friends and family.

Health Care

Today President Obama is going to have a press conference where he will announce that some pretty big names in the health insurance industry are promising to help with health care reform. Evidently these folks are saying they can help get up to $2 trillion dollars in savings in healthcare over the next decade. While several liberal and progressive voices have come out in measured support for the move Ezra Klein has a post up that I think gets at the heart of the pitfalls inherent in President Obama making a big deal out of this announcement.

Which gets to my skepticism: This is one of those moments when new words are being used to drown out ongoing actions. A major source of potential savings, at least in the administration's estimation, will come from comparative effectiveness review. But the pharmaceutical industry and the device industry -- both of which are represented here -- fought violently against CER when the Obama administration sought to include it in the stimulus. By the end, they had managed to win legislative language stating that comparative effectiveness studies wouldn't include cost-effectiveness and wouldn't be used to make coverage decisions. Another source of potential savings is the public plan, which can marry best practices with federal bargaining power to push down costs. The insurance industry has gone to war against this provision.

What we have, in other words, are promises of future cost containment that exist alongside concrete and continued opposition to the cost containment ideas that are actually on the table. And for good reason. A 1.5 percentage point decrease in health spending is a 1.5 percentage point decrease in medical industry profits. This commitment doesn't contain any examples of concessions that will reduce a participant's revenue streams. Conversely, every time legislators have proposed a reform that will actually cut industry profits -- and thus cut health spending -- the industry has howled in pain and anger. It's hard to sync that with promises to cut spending by $2 trillion over the next 10 years by implementing a set of unspecified reforms.

Indeed, the straight read of today's transaction is rather different. The White House gets messaging help. The health care industry secures, as Karen Tumulty says, "a seat at the negotiating table." The question is what they'll do with it.

The big test is not today. It's a month from now. In June, the Finance Committee will release the first version of its health reform bill. If the bill is what we expect -- something along the lines of Baucus's white paper, or Hillary Clinton's campaign proposal -- and these industry groups not only endorse it but explain how they will save money within its confines, that will be something to celebrate. If they use the credibility they've attained today to unleash a more vicious assault tomorrow -- if they grimly say that they proved their willingness to work with the administration but this legislation and its public plan and its insistence on evidence and its payment reforms sadly proves the administration's unwillingness to work with them -- then that will be a rather less cheery outcome.

All in all I can see how this is a positive development but just like Ezra Klein I am far from being impressed just yet.

Common Sense

For most of this morning Vice President Joe Biden has been villified for a supposed "gaffe" he committed on the Today Show. Here is the video.

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Now this is how the story is being framed.

WASHINGTON (AP) — Vice President Joe Biden says he's advising his own family to stay off commercial airlines and even subways because of the new swine flu.

Biden said Thursday if one person sneezes on a confined aircraft, "it goes all the way through the aircraft." Going beyond official advice from the federal government, Biden said of his family's personal precautions: "That's me."

Now this is the framing even on liberal and progressive blogs and I for one am calling BULLSHIT. What VP Biden said was unquestionably reasonable in the context of advice he was giving to his family on how to avoid getting infected with swine flu and with the caveat he included that he was advocating not taking public transportation if you have an alternate means to get around. I don't think the WHO has raised the threat level to 5 out of 6 just for shits and giggles and in light of that how can it be wrong to say you are telling your family to avoid public transportation where the likelihood of contracting swine flu is much higher? I know I for one wouldn't be advising any family members of mine to take a flight or get on a subway right now. Its a shame that now every time Joe Biden says something that should be common sense for most folks the media rushes to call it a gaffe. I realize the White House made him walk back the statement but that says more about our chattering classes than it does about Joe Biden.

Ezra Klein has a post up similarly dismissing this "gaffe".

But here's the thing: Biden may be right to induce a bit of panic. The United States Travel Association won't think so. It's their profit stream on the line, after all. But epidemiologists are probably quietly relieved by the Vice President's comments.

Last night, I spent some time with Arin Dutta's "The Effectiveness of Policies to Control a Human Influenza Pandemic: A Literature Review." The overview was prepared for the World Bank. In it, Dutta argues that the key variable in determining the spread of an infection is the "base reproduction rate," defined as the number of secondary infections produced by a primary infection. In other words, if one person has the flu, then on average, the base reproduction rate measures how many people will catch the flu from him. Lowering that rate is the key to pandemic response. And lowering that rate requires things like "forcing or urging people to limit contacts, encouraging hand washing or other personal hygiene, or promoting the use of facemasks." Some of it sounds trivial. But it matters. If the reproduction rate falls beneath 1, "the epidemic usually dies out."

snip

Which is why the absolute best case is that Joe Biden did something that's so effective that he looks really stupid. If people actually reduce social contact and cut down on air travel and stay home in response to a single cough, then it's much likelier that swine flu will quickly die out. If it does, we'll all feel a bit foolish over having taken those precautions and late night comics will make fun of Joe Biden and everyone will move on. If we don't, and R jumps up, then we could be dealing with a full blown pandemic and Biden's warning will come to be seen as, if anything, insufficiently alarmist.

This is much ado about nothing and I am dissappointed that some on the liberal and progressive side are getting sucked into playing up this story.