For McCain, the Devil Is in the Details
by Andrew Romano*



Call it the McCainian Law of Inverse Proportionality: the more the Arizona senator is forced to talk about specific policies and proposals, the less "straight talk" he seems to conjure up.

Seeing as we've already chided McCain for his hypocrisy on "the specifics"--like when he taunted Obama for preferring "platitudes" to "proven ideas," then delivered an education speech far more platitudinous than what his rival said on the subject four months earlier--we're glad to see that he's spent recent weeks getting down to the nitty-gritty. First came a foreign-policy address in Los Angeles on March 26. Next up was an economic speech in Pittsburgh on April 15. And today he's in Tampa, Fla. to talk health care as part of a week-long "Call to Action" tour. But there's a problem. See, McCain's in a bit of political bind. To beat a Democrat to the White House, he needs to rev up the Republican base (which has long been wary of his maverick tendencies) while somehow managing to simultaneously snag a sizable swath of the swing vote (which has long been open to his charms). Torn between these conflicting goals--and cognizant of the need to actually, you know, say what he plans to do as president--McCain has recently come down with a nagging case of electoral schizophrenia. One moment, he's indulging in political posturing. The next he's demonstrating some common sense. The result? A hopelessly muddled message.
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Take last month's foreign-policy speech. After months of denouncing Democrats for waving the "white flag of surrender" in Mesopotamia, McCain intended to use the address as an opportunity to show off his moderate, non-warmonger side. To that end, he distanced himself from President Bush's unilateralism, affirming that Americans, in the words of the Declaration of Independence, must show "decent respect to the opinions of mankind. He also took a break from saying "stay the course in Iraq" long enough to touch on other important topics, like nuclear proliferation, global warming, free trade and fighting AIDS. So far, so good. But as my NEWSWEEK colleague Fareed Zakaria has already pointed out, the senator couldn't resist kowtowing to hard-core neoconservatives as well. In what Zakaria called "the most radical idea put forward by a major candidate for the presidency in 25 years," McCain proposed that the United States expel Russia and exclude China from the G8--in effect adopting "a policy of active exclusion and hostility toward two major global powers" that "would reverse a decades-old bipartisan American policy of integrating these two countries into the global order... [and] alienate many countries in Europe and Asia who would see it as an attempt by Washington to begin a new cold war." So much for any moderating effect. "[McCain's] speech reads like it was written by two very different people," wrote Zarkaria, "each one given an allotment of a few paragraphs on every topic."

His forays into economics have been equally disorienting. After months of repeating the familiar GOP mantra of fighting pork and extending Bush's tax cuts--and admitting that "the issue of economics is not something I've understood as well as I should"--McCain finally waded into economic waters with a series of three oscillating speeches in late March and early April. In the first, he reassured right-wing skeptics by arguing that the government shouldn't intervene on behalf of borrowers and lenders hit by the housing crisis. But when one of his top supporters, Sen. Mel Martinez, awarded McCain "an incomplete" for his efforts--and others compared him to do-nothing Depressionist Herbert Hoover--the senator changed tack, striking compassionate notes two weeks later in a speech that called on the government to help needy homeowners with loans backed by the Federal Housing Administration. "Let me make it clear that in these challenging times, I am committed to using all the resources of this government and great nation to create opportunity and make sure that every deserving American has a good job and can achieve their American dream," declared Obama Clinton McCain. Predictably, conservatives carped.

McCain's next move? Go to Pittsburgh on April 15 and get specific. But his most noteworthy proposal from that event--a lifting of the federal excise tax on gasoline between Memorial Day and Labor Day--turned out to be exactly the sort of political gimmickry he's long decried. For starters, McCain's tax holiday would begin and end several months before the next president takes office--making it "more of a thought balloon than a plan," according to the Oregonian. What's more, leading economists say the break would do little to lower the prices at the pump, instead producing higher demand, higher prices--and higher profits for the oil companies. In the end, the typical American family would save only about $40 per car. Meanwhile, the cash-strapped federal highway fund would lose $10 billion, politicians would pat themselves on the back and the real problems--namely, our addiction to foreign oil--would remain unsolved. Maverick, indeed.

Today's health-care roll-out was similarly conflicted. McCain has long advocated conventional conservative measures such as tax deductions and malpractice reform, but at the University of South Florida in Tampa this morning he went a step further, proposing a greater federal commitment to the uninsured. Attempting to answer critics who contend that tax incentives alone would slash employer-based coverage and leave workers with pre-existing conditions out in the cold, McCain suggested that the government fund non-profit risk pools to assist Americans who can't afford or qualify for care. The only problem? McCain was so wary of crossing small-government conservatives with his "Guaranteed Access Plan" that he offered few specifics in the speech--"I will work with Congress, the governors, and industry to make sure that it is funded adequately," he said, mysteriously--and didn't mention it at all in a brand-new Iowa ad on the subject (above). Predictably, he chose to highlight his tax credits instead.

The problem isn't that McCain is being dishonest or even disingenuous. He's not. It's that he isn't particularly interested in ideology OR specifics--even though the Republican base requires the former and every rational voter, Republican or not, requires the latter. Rather, he's in his element when waging war for a single--often politically unpopular--cause, like campaign-finance reform, or earmark elimination, or Iraq. In the Senate, McCain is under enormous pressure to vote for the popular "Post-9/11 Veterans Educational Assistance Act," which is essentially a G.I. Bill for Iraq and Afghanistan war veterans. The measure isn't costly, and the company--author Jim Webb and co-sponsors Chuck Hagel and John Warner--isn't offensive. But because the military fears that the bill's incentives would hurt overall readiness by persuading too many active duty soldiers to leave the service early, McCain opposes it. That's exactly the sort of principled, contrarian stand on which he's built his Senate career--and his priceless, well-deserved maverick brand. But running for president will require him to play the (sometimes conflicting) roles of right-wing firebreather and sensible policy wonk as well. So far, his performance hasn't been particularly convincing.

=====================================================
Andrew Romano Biography: Andrew Romano was named Associate Editor and Political Blogger in December 2007. He travels with the 2008 presidential candidates covering the daily roadshow for his blog, Stumper, and reports on politics for the National Affairs section of the magazine.

Prior to his current assignment, Romano was a junior reporter in Newsweek's New York headquarters contributing to the magazine's National Affairs coverage. Since April 2006, he has campaigned with Al Franken, interviewed Paul McCartney, profiled the Howard Dean alums in charge of John Edwards' and Barack Obama's Internet campaigns, revealed how MySpace and police officers are working together to solve crimes, pieced together the story of a cannibalistic New Orleans murder-suicide, discovered the U.S. military recruiting at paintball events and memorialized the Virginia Tech victims.

Previously, Romano had been a reporter-researcher in the magazine's Information Graphics department, where he conceived, reported and wrote "Swing State Watch," a weekly snapshot of the 2004 presidential contest. In addition, he tracked down and interviewed 30 of John Kerry's high-school classmates for a probing 2004 cover profile of the Democratic presidential nominee. He joined Newsweek as an intern in June 2004 after working as a stringer for New Jersey's Trenton Times.

Romano graduated summa cum laude and Phi Beta Kappa from Princeton University in 2004 with an A.B. in English and a certificate in American Studies. A native of Medford, N.J., he lives in Brooklyn, N.Y.

Op-Ed Columnist
McCain’s Compassion Tour

By GAIL COLLINS
Published: April 26, 2008

John McCain — this is the guy, you may remember, who’s going to be the Republican presidential nominee — has been visiting the poor lately. Appalachia, New Orleans, Rust Belt factory towns. This is a good thing, and we applaud his efforts to show compassion and interest in people for whom his actual policies are of no use whatsoever.


Gail Collins* | Photo by Tony Cenicola/The New York Times

McCain’s special It’s Time for Action Tour was in the impoverished Kentucky town of Inez on Wednesday, so he was unable to make it to Washington to vote on the Lilly Ledbetter Fair Pay Act. This is the bill that would restore workers’ ability to go to court in cases of pay discrimination.

But McCain was not ducking the issue. After all, this is a man who told the folks in Youngstown, Ohio — where most of the working single mothers cannot make it above the poverty line — that the answer to their problems is larger tax deductions. He is fearless when it comes to delivering unpleasant news to people who are probably not going to vote for him anyway.

So McCain made it clear that if he had been in Washington, he would have voted no because the bill “opens us up for lawsuits, for all kinds of problems and difficulties.”

How much straighter can talk get? True, this is pretty much like saying that you’re voting against the federal budget because it involves spending. Still, there is no denying that a bill making it possible for people who have been discriminated against to go to court for redress would open somebody up to the possibility of a lawsuit.

Lilly Ledbetter was a supervisor at a Goodyear Tire plant in Gadsden, Ala., for almost 20 years — the only woman who ever managed to stick it out in what was not exactly a female-friendly environment. When she was near retirement, she got an anonymous letter listing the salaries of the men who held the same job. While she was making $3,727 a month, the lowest paid man, with far less seniority, was getting $4,286.

“I was just emotionally let down when I saw the difference,” she said on Friday.

The company declined Ledbetter’s offer to settle for the difference between her earnings and that lowest-paid man’s — about $60,000. A jury awarded her $223,776 in back pay and more than $3 million in punitive damages.

Goodyear appealed, and the case arrived at the Supreme Court just as President Bush’s new appointees were settling in. The court ruled 5-to-4 against Ledbetter, saying that she should have filed her suit within 180 days of receiving her first paycheck in which Goodyear discriminated against her.

The fact that workers generally have no idea what other people are making when they start a job did not concern the court nearly as much as what Justice Samuel Alito, writing for the majority, called “the burden of defending claims arising from employment decisions that are long past.” In other words, pay discrimination is illegal unless it goes on for more than six months.

Ledbetter did not even get her back pay. And Goodyear billed her $3,165 for court-related costs.

The bill being voted on this week would have made it clear that every time a woman like Ledbetter got a check that was lower than those of the men doing the same job, it triggered a new 180-day deadline. That was the status quo before Alito and John Roberts arrived on the scene. But the sponsors needed 60 votes, and they only got 56. “I would never have believed this in the United States of America,” said Ledbetter, 70, who watched from the Senate gallery.

McCain’s vote wouldn’t have made any difference. But his reaction does suggest that on his list of presidential priorities, the problems of working women come in somewhere behind the rising price of after-dinner mints.

Having delivered his objections to the Ledbetter bill this week, McCain went on to tell reporters that what women really need is “education and training, particularly since more and more women are heads of their households, as much or more than anybody else. And it’s hard for them to leave their families when they don’t have somebody to take care of them.”

Maybe George Bush isn’t all that incoherent after all.

Was McCain saying that it’s less important to give working women the right to sue for equal pay than to give them help taking care of their families? There have been many attempts to expand the Family and Medical Leave Act to protect more workers who need to stay home to take care of a sick kid or an ailing parent. “We’ve never gotten his support on any of that agenda,” said Debra Ness, the president of the National Partnership for Women and Families.

We also have yet to hear a McCain policy address on how working mothers are supposed to find quality child care. If it comes, I suspect the women trying to support their kids on $20,000 a year are going to learn they’re in line for some whopping big income-tax deductions.

Let them eat dinner mints.

======================================================

*Gail Collins Biography: Gail Collins joined the New York Times in 1995 as a member of the editorial board and later as an op-ed columnist. In 2001 she became the first woman ever appointed editor of the Times editorial page. At the beginning of 2007, she stepped down and began a leave in order to finish a sequel to her book, "America's Women: 400 Years of Dolls, Drudges, Helpmates and Heroines." She returned to The Times as a columnist in July 2007.

Before joining the Times, Ms. Collins was a columnist at New York Newsday and the New York Daily News, and a reporter for United Press International. Her first jobs in journalism were in Connecticut, where she founded the Connecticut State News Bureau, which provided coverage of the state capitol and Connecticut politics. When she sold it in 1977, the CSNB was the largest news service of its kind in the country, with more than 30 weekly and daily newspaper chains.

Besides "America's Women," which was published in 2003, Ms. Collins is the author of "Scorpion Tongues: Gossip, Celebrity and American Politics," and "The Millennium Book," which she co-authored with her husband, Dan Collins. Her new book is about American women since 1960.

McCAIN & BUSH: IS THERE REALLY A DIFFERENCE?

Sen. John McCain has long promoted the idea that he is a “straight-talking maverick” who challenges his party and stands up to his president. However, despite the media misrepresentation, McCain has not strayed too far from President George Bush’s line, especially on issues important to working families. McCain is not running for a term of his own; he is running on an extension of the agenda laid out by
Bush in his first two terms: tax cuts for the rich, privatizing Social Security and outsourcing jobs.

McCAIN VOTES WITH BUSH

McCain Voted with the Bush Administration 89 Percent of the Time.

Since President Bush took office, McCain has supported Bush’s positions 89 percent of the time. McCain’s support of Bush’s policies reached as high as 95 percent in 2007. [Congressional Quarterly Voting Study, 110th Congress]

SHARES BUSH’S ROSY VIEW OF THE ECONOMY

Bush: Economy Is Inherently Strong. “I believe we can find common ground to get something done that’s big enough, effective enough so that an economy that is inherently strong gets a boost to make sure that this uncertainty doesn’t translate into more economic woes for our workers and small business people,” Bush said in the Cabinet Room. [Associated Press, 1/23/08]

McCain: Underpinnings of Economy are Strong. “I still believe our fundamental underpinnings of our economy are strong, but it’s obvious that we are facing challenges which will require actions such as the Federal Reserve took today.” [“Lou Dobbs Tonight,” CNN, 1/22/08]

* McCain Says Economy Is Strong (Video)

http://thinkprogress.org/2008/01/23/mccain-economy-strong/

WANTS TO MAKE BUSH’S TAX CUTS FOR THE WEALTHY PERMANENT

Bush: Make Tax Cuts Permanent. During his weekly radio address, Bush said, “To keep our economy growing, we need to ensure that you keep more of what you earn, and Congress needs to make the tax cuts permanent.” [Presidential Weekly Radio Address, 1/7/06]

McCain: Make Bush Tax Cuts Permanent. “I think it’s very important that we make the Bush tax cuts permanent. I voted to make them permanent twice already.… And if we don’t make the tax cuts permanent, then they will experience what amounts to a tax increase.” [Republican Presidential Debate, MSNBC, 1/24/08]

* McCain Voted for Tax Cuts for the Wealthiest Americans at the Expense of Working Families. McCain voted for a $60 billion tax cut bill benefiting families with incomes $100,000 or higher. The tax cuts would follow equally drastic cuts in spending on programs vital to working families. [S. 2020, Vote #26, 11/18/05]
* McCain Waffled on Tax Cuts. (Video)


McCAIN WANTS TO PRIVATIZE SOCIAL SECURITY

Bush: Fix Social Security Through Private Accounts. “As we fix Social Security, we also have the responsibility to make the system a better deal for younger workers, and the best way to reach that goal is through voluntary personal retirement accounts.” [President Bush’s State of the Union Address, 1/28/08]

McCain: Only Solution to Fix Social Security Is Private Accounts. “There is only one solution if Social Security commitments are to be honored without breaking the backs of the next generation: bold reform— genuine reform—that allows workers to invest some of their Social Security savings, privately, in higher-yielding accounts.” [Cato Institute]

* McCain Voted for Bush’s Social Security Privatization Plan. In 2006, McCain voted for the Social Security Reserve Fund. The GOP proposal would shift Social Security’s annual surpluses into a reserve account that will be converted into risky private accounts. [SCR 83, Vote# 68, 3/16/06]

McCAIN SUPPORTS BUSH ON PRIVATIZING AND OUTSOURCING JOBS

Bush: Outsourcing Makes Sense. In 2004, the president’s economic report to Congress said, “When a good or service is produced more cheaply abroad, it makes more sense to import it than to make or provide it domestically.” [InformationWeek.com, accessed 2/26/08]

McCain: Global Economy Results in Outsourcing. “I’m not going to bring back a lot of these jobs. I can’t because with a global economy they’re headed the other way,” McCain said. [Technology Daily, 12/4/07]

* McCain Supported Bush Administration’s Plan to Privatize and Outsource Federal Jobs. McCain voted to support Bush’s efforts to privatize federal jobs. The Bush administration has led a major effort to outsource and privatize hundreds of thousands of federal jobs, including those of 350 workers at Walter Reed Army Medical Center. [H.R. 5631, Vote# 234, 9/6/06]

Paid for by the AFL-CIO Committee on Political Education (COPE) Political Contributions Committee, www.aflcio.org, and not authorized by any candidate or candidate’s committee.
Copyright © 2008 AFL-CIO | American Federation of Labor - Congress of Industrial Organizations

McCain’s Health Care Plan: Increases Taxes, Decreases Coverage

by Seth Michaels, Apr 29, 2008

Today in Tampa, Fla., Sen. John McCain gave an address his advisers claimed would “unveil” his health care proposal—but he essentially offered the same tired proposal he’s been touting for months. Most policy analysts agree this plan won’t cut costs, won’t cover more people and won’t fix the real problems in the health care system.

McCain wants to address our nation’s health care crisis by merely shifting costs around—and millions of people would pay higher health care costs as a result. McCain would tax health care benefits as income and push more people out of group insurance pools and into the often-predatory private market. In short, McCain would increase our taxes and ensure fewer of us could afford quality health care.


AFL-CIO union members in Florida were on hand as McCain spoke to ask him to change course and offer some real answers on health care.

Yesterday, McCain met with a father and son at a Florida hospital and listened to the father’s story of his struggle to pay for his son’s health care. But McCain didn’t mention that his plan would leave that nine-year-old boy without coverage. How’s that for straight talk?

Economist Roger Hickey, co-director of the Campaign for America’s Future, says McCain’s health care proposal shows little comprehension of the issue. Indeed, Hickey says, the proposal is “a dangerous fraud” and based on a theory “contradicted by the facts.”



McCain’s health care plan, as it currently exists, wouldn’t lower costs or expand coverage. Instead, through changing the tax system for health benefits, it could result in many employers cutting off health benefits altogether.

The massive upheaval that would result—millions of families losing their health coverage on the job and then having to try to find an insurance company that would sell them a new policy that would cover their families—that’s not an unintended consequence of his proposal. That chaotic loss of health security is exactly what McCain intends to happen. He wants us all to buy insurance not as part of a group—like an employee group or a co-op—that can negotiate for better coverage at lower premiums, but as individuals, at the mercy of the private insurance companies.

And get this: McCain wants to abolish the regulations that currently exist in most states that require companies to insure people with pre-existing conditions, provide benefits that don’t exclude some medical conditions, and prevent them from charging huge premiums for crumby benefits.

McCain’s plan is exactly the wrong answer to give working families at a time when health care premiums have been rising 10 times as fast as income. The nearly 27,000 responses to the online AFL-CIO 2008 Health Care for America Survey earlier this year shows the problem goes beyond the millions of people who lack insurance. The more than 7,000 who took time to write comments made it clear that many more of us are at risk of losing coverage or being denied care. Working families, even those with insurance, already are paying high costs and having trouble getting the medical care they need.

Who really wins in the McCain health care plan? The insurance and pharmaceutical companies whose lobbyists fund and staff McCain’s campaign. Those special interests couldn’t have written a better plan than McCain’s, which would roll back regulations that protect consumers from denials of coverage and excessive premiums. And to top it off, his corporate tax cut proposals would give the top 10 insurance companies nearly $2 billion.

The AFL-CIO is making health care a major part of the campaign to turn around America. Unions are greeting McCain around the country this week to ask for real solutions on health care. Union members and leaders have attended meetings about the health care crisis around the country, and next month, union members will distribute more than a million fliers at worksites and set up phone banks to get the word out on the issue of health care. On May 17, thousands of union members will walk door to door to educate and mobilize working families on how they can make sure the next president makes implementing a real health care plan a top priority.

The New Republic

The Folly of McCain-Care by Jonathan Cohn

His great new plan isn't new or great. And it still wouldn't help Elizabeth Edwards get decent insurance.

Post Date Tuesday, April 29, 2008

A few months ago, when John McCain decided to address the public's anxiety about unaffordable medical care, he gave the sort of speech we've grown accustomed to hearing from Republicans over the years.

Let's encourage people to drop their employer insurance and shop for coverage on their own, he said, since that will create a vibrant market in which people can find better bargains. And since some people will still have trouble paying for insurance, let's give them a tax credit that would help offset the cost.

A big problem with this scheme, as critics like me pointed out, was that it wouldn't do much for people who were already sick. Insurance companies generally won't offer coverage directly to people with "pre-existing conditions," since they represent such bad financial risks. (It turns out people with medical problems need medical care!) So buying insurance on their own really isn't an option.

In just the last few weeks, this issue has started to become a political liability for McCain, thanks mostly to Elizabeth Edwards, who--in addition to being a well-known cancer patient--is also a well-known policy wonk. Edwards has given a series of speeches in which she has pointed out that neither she nor McCain himself, who is a three-time melanoma survivor, could buy individual insurance under his plan, since insurers would disqualify both of them for pre-existing conditions.

McCain bristled at this suggestion, vowing recently to ABC's George Stephanopoulos that "we're not leaving anybody behind." His advisers echoed that sentiment, saying Edwards didn't fully understand the proposal--and that, in short order, they'd have more to say on the subject.

Apparently that's what McCain was doing earlier today. In a speech at a Florida cancer hospital, McCain acknowledged that people with pre-existing conditions can't always buy insurance on their own. But, he says, that doesn't mean these people will be left to twist in the wind.

Instead, McCain is offering people like Edwards what he calls a "Guaranteed Access Plan." But unlike all those awful big-government entitlements the Democrats are promising--you know, the ones that (supposedly) make you wait in long lines and cut off access to high-technology treatments--McCain says his plan will let the states handle the problem by working hand-in-hand with private insurers to offer insurance for people with pre-existing conditions.

It will be the best of both worlds, McCain promises: Affordable, available insurance, but through private carriers and without the heavy hand of Washington.

It all sounds very lovely--unless you know something about health care policy, in which case it sounds absolutely preposterous.

More than 30 states already have programs almost exactly like the one McCain just sketched out. They are called "high risk pools," and the idea is pretty straightforward: Private insurers agree to sell policies directly to individuals, even those with pre-existing medical conditions, as long as the state helps to subsidize the cost.

But the whole reason conservatives like McCain prefer this approach to liberal schemes for universal coverage is that it involves minimal government regulation. As a result, private insurers have enormous leeway in dictating the terms of coverage. And one place they use that leeway is by setting high prices. A few years ago, a Commonwealth Fund study found that, on average, state high-risk pools offered coverage that was two-thirds more expensive than regularly priced coverage. In some states, the high-risk coverage was actually twice as high as regular coverage.

At those prices, you might think the coverage was spectacular. Not so. While private insurers in high-risk pools are willing to accept people with pre-existing conditions, they're not generally willing to cover expenses related to those pre-existing conditions--at least not right away. Nearly all the plans surveyed had waiting periods of between six months and a year, during which the insurers would not cover care for prior medical problems.

The plans also came with high cost-sharing; that is, beneficiaries were required to pay a sizeable portion of the bill--say, 20 percent--straight out of their pockets every time they received medical service. And, in many cases, the policies had lifetime benefit limits of a million dollars--which is not that hard to hit if you have the kind of serious medical condition that would land you in a high-risk pool in the first place.

To put this in more practical terms, I contacted Karen Pollitz, a research professor at the Georgetown University Health Policy Institute who has done some of the most detailed studies anywhere on high-risk pools and the individual market. Specifically, I asked her to consider what McCain's plan would--hypothetically--do for the person who has given him the most political grief lately: Elizabeth Edwards.

It turns out that North Carolina, where Edwards lives, doesn't actually have a high-risk pool in operation right now. (It hopes to launch one next year.) But neighboring South Carolina does. Pollitz was able to track down published figures with the rates the South Carolina pool would charge a 50-year-old man. (Edwards, a 57-year-old woman, would actually pay more.) And according to those figures, Edwards' most cost-effective option would be to choose a plan that had monthly premiums of $867 for six months, followed by $693 every month thereafter.

That plan comes with a $1,500 deductible; in other words, every year Edwards would have to pay $1,500 in medical bills before the insurance kicked in. After that, she'd have to deal with the cost-sharing until she had spent another $3,500 out of her pocket.

If you do the math, you'll see that means Edwards would end up paying more than $14,000 a year in insurance and out-of-pocket medical expenses. (At least for now. The rates go up in July.)

But wait--there's the small matter of her cancer treatment during those first six months, which South Carolina's pool, like the rest, wouldn't cover at all. (And, no, those expenses wouldn't count towards the deductible or out-of-pocket limits, either.) Given the high cost of cancer care--some drugs cost $10,000 a month--Pollitz says that her expenses could easily reach $100,000, although it'd be less if Edwards is no longer getting intensive, cutting-edge treatment.

Edwards, who is wealthy, can afford to pay those bills. But most cancer patients can't, and as Pollitz notes, "If you have cancer, if you have a tumor growing in you, you can't just let it grow for six to twelve months while you wait for the pre-existing waiting period to run out."

The result is that a lot of people with medical problems will end up deciding to forgo insurance altogether, figuring that the insurance will make it harder--not easier--to pay their bills. And those people will almost certainly do what most people without insurance do: Pay out of pocket until they're broke or cut back on their own medical care to save money, even though it could mean worse medical problems (and even higher bills) down the road.



In fairness, one of the reasons these insurance arrangements charge so much money for coverage is that they are serving a population of people with exceptionally high medical bills--i.e., the people who are "high risk." And states have not traditionally devoted enough money to subsidize them.

McCain has promised he wouldn't let that happen--that he's determined to make sure the insurance is affordable for everybody. But, as many experts have noted, his budget promises are wildly unrealistic: He's vowed to reduce the deficit, and yet, by all accounts, he's promised far more in tax cuts than he might possibly generate in accompanying spending reductions. If McCain's promises to be fiscally responsible are so transparently false, why take promises about his health care initiative on faith--particularly if he's promising to do something states have tried and repeatedly failed to do on their own already?

Come to think of it, why should we even believe McCain takes this issue seriously? His Democratic counterparts, Hillary Clinton and Barack Obama, issued detailed policy proposals more than six months ago--with pages of analysis and explanation, right down to the budget dollars. Those details were a sign of commitment and, on a more practical level, their constant hyping of them represent an investment of political capital.

By contrast, even today's announcement from the McCain campaign--which was supposed to help fill in the many blanks left before--came with only minimal detail and supporting evidence. The actual proposals are still vague, consisting mostly of bland vows to "work with governors" and make sure premiums for people with pre-existing conditions are "reasonable." And while health care is the campaign's focus this week, it's never occupied the place in his agenda that it does in the Democrats'.

In a sense, this isn't surprising. Earlier this year, when I first wrote about the basics of McCain's health care vision, I asked his economics adviser, Douglas Holtz-Eakin, whether the McCain plan had the same ambition as the Democratic candidates' plans. Holtz-Eakin, who has a reputation as a straight shooter, gave me a forthright answer: No. "We are not under the illusion that it will get universal coverage," he said. And that was pretty much the line the campaign seemed to be taking: They might not be covering everybody, but they were helping some people--and doing so in a manner they found preferable to liberal alternatives, which necessarily required the government to become more involved in the deliver of health insurance. It wasn't my view of the world--I think those liberal alternatives have been shown to work very well--but it was an honest and intellectually consistent one.

But with McCain's vow that "we're not leaving anybody behind" and the promotion of this "Guaranteed Access Plan," it seems they're not so ready to concede ambition after all. Maybe it's the sting of Edwards' attacks, which have gotten a lot of media attention. Maybe it's the poll numbers suggesting that the public thinks health care is major voting issue. Or maybe it's the fact that McCain, who has always struck me as more decent than most politicians, has genuinely reflected upon the plight of the medically uninsurable.

Whatever the reason, now McCain is talking like he wants to help everybody. Of course, he isn't ready to give up his market-oriented principles on health insurance; he doesn't realize that, by its very nature, private insurance operating in a regulatory vacuum is incapable of taking care of the people who need medical attention the most. And that's why, at the end of the day, his plan for expanding coverage is every bit as inadequate as the critics have said all along.

Jonathan Cohn is a senior editor at The New Republic. He is also a senior fellow at Demos and the author of Sick: The Untold Story of America's Health Care Crisis--and the People Who Pay the Price.





© The New Republic 2008

Bowling 1, Health Care 0


By ELIZABETH EDWARDS
Published: April 27, 2008

FOR the last month, news media attention was focused on Pennsylvania and its Democratic primary. Given the gargantuan effort, what did we learn?



Well, the rancor of the campaign was covered. The amount of money spent was covered. But in Pennsylvania, as in the rest of the country this political season, the information about the candidates’ priorities, policies and principles — information that voters will need to choose the next president — too often did not make the cut. After having spent more than a year on the campaign trail with my husband, John Edwards, I’m not surprised.

Why? Here’s my guess: The vigorous press that was deemed an essential part of democracy at our country’s inception is now consigned to smaller venues, to the Internet and, in the mainstream media, to occasional articles. I am not suggesting that every journalist for a mainstream media outlet is neglecting his or her duties to the public. And I know that serious newspapers and magazines run analytical articles, and public television broadcasts longer, more probing segments.

But I am saying that every analysis that is shortened, every corner that is cut, moves us further away from the truth until what is left is the Cliffs Notes of the news, or what I call strobe-light journalism, in which the outlines are accurate enough but we cannot really see the whole picture.

It is not a new phenomenon. In 1954, the Army-McCarthy hearings — an important if painful part of our history — were televised, but by only one network, ABC. NBC and CBS covered a few minutes, snippets on the evening news, but continued to broadcast soap operas in order, I suspect, not to invite complaints from those whose days centered on the drama of “The Guiding Light.”

The problem today unfortunately is that voters who take their responsibility to be informed seriously enough to search out information about the candidates are finding it harder and harder to do so, particularly if they do not have access to the Internet.

Did you, for example, ever know a single fact about Joe Biden’s health care plan? Anything at all? But let me guess, you know Barack Obama’s bowling score. We are choosing a president, the next leader of the free world. We are not buying soap, and we are not choosing a court clerk with primarily administrative duties.

What’s more, the news media cut candidates like Joe Biden out of the process even before they got started. Just to be clear: I’m not talking about my husband. I’m referring to other worthy Democratic contenders. Few people even had the chance to find out about Joe Biden’s health care plan before he was literally forced from the race by the news blackout that depressed his poll numbers, which in turn depressed his fund-raising.

And it’s not as if people didn’t want this information. In focus groups that I attended or followed after debates, Joe Biden would regularly be the object of praise and interest: “I want to know more about Senator Biden,” participants would say.

But it was not to be. Indeed, the Biden campaign was covered more for its missteps than anything else. Chris Dodd, also a serious candidate with a distinguished record, received much the same treatment. I suspect that there was more coverage of the burglary at his campaign office in Hartford than of any other single event during his run other than his entering and leaving the campaign.

Who is responsible for the veil of silence over Senator Biden? Or Senator Dodd? Or Gov. Tom Vilsack? Or Senator Sam Brownback on the Republican side?

The decision was probably made by the same people who decided that Fred Thompson was a serious candidate. Articles purporting to be news spent thousands upon thousands of words contemplating whether he would enter the race, to the point that before he even entered, he was running second in the national polls for the Republican nomination. Second place! And he had not done or said anything that would allow anyone to conclude he was a serious candidate. A major weekly news magazine put Mr. Thompson on its cover, asking — honestly! — whether the absence of a serious campaign and commitment to raising money or getting his policies out was itself a strategy.

I’m not the only one who noticed this shallow news coverage. A report by the Project for Excellence in Journalism and the Shorenstein Center on the Press, Politics and Public Policy found that during the early months of the 2008 presidential campaign, 63 percent of the campaign stories focused on political strategy while only 15 percent discussed the candidates’ ideas and proposals.

Watching the campaign unfold, I saw how the press gravitated toward a narrative template for the campaign, searching out characters as if for a novel: on one side, a self-described 9/11 hero with a colorful personal life, a former senator who had played a president in the movies, a genuine war hero with a stunning wife and an intriguing temperament, and a handsome governor with a beautiful family and a high school sweetheart as his bride. And on the other side, a senator who had been first lady, a young African-American senator with an Ivy League diploma, a Hispanic governor with a self-deprecating sense of humor and even a former senator from the South standing loyally beside his ill wife. Issues that could make a difference in the lives of Americans didn’t fit into the narrative template and, therefore, took a back seat to these superficialities.

News is different from other programming on television or other content in print. It is essential to an informed electorate. And an informed electorate is essential to freedom itself. But as long as corporations to which news gathering is not the primary source of income or expertise get to decide what information about the candidates “sells,” we are not functioning as well as we could if we had the engaged, skeptical press we deserve.

And the future of news is not bright. Indeed, we’ve heard that CBS may cut its news division, and media consolidation is leading to one-size-fits-all journalism. The state of political campaigning is no better: without a press to push them, candidates whose proposals are not workable avoid the tough questions. All of this leaves voters uncertain about what approach makes the most sense for them. Worse still, it gives us permission to ignore issues and concentrate on things that don’t matter. (Look, the press doesn’t even think there is a difference!)

I was lucky enough for a time to have a front-row seat in this campaign — to see all this, to get my information firsthand. But most Americans are not so lucky. As we move the contest to my home state, North Carolina, I want my neighbors to know as much as they possibly can about what these men and this woman would do as president.

If voters want a vibrant, vigorous press, apparently we will have to demand it. Not by screaming out our windows as in the movie “Network” but by talking calmly, repeatedly, constantly in the ears of those in whom we have entrusted this enormous responsibility. Do your job, so we can — as voters — do ours.

http://www.ourfuture.org/



The McCain Health Plan: Millions Lose Coverage, Health Costs Worsen, and Insurance and Drug Industries Win



By Roger Hickey

April 29th, 2008 - 9:24am ET

Today Arizona Sen. John McCain will deliver what his handlers are hyping as a major address on health care. McCain’s plan is a dangerous fraud.

He wants voters to think he is going after health care cost inflation. In reality, he wants to dismantle the employer-provided system that now covers over 60 percent (or about 158 million) of non-elderly Americans, forcing millions of us who now get fairly decent health insurance on the job to instead buy whatever they can find on the individual market controlled by unregulated and predatory insurance companies. And he would drive health care costs upward, not downward.

This is truly amazing: McCain and his handlers knew they had to say something about health care. So they turned to their friends (and financial supporters) in the health care industry and the conservative think tanks. And they have adopted the most extreme right-wing ideological approach, premised on the idea that the big problem in health care is that Americans have too much insurance – in their words, we don’t have enough “skin in the game” – and that only when we have to buy health care with money that comes directly out of our own pockets will consumers force doctors, hospitals and insurance companies to become more efficient.

So that’s the theory. But it is contradicted by the facts. Most of us already pay part of our premiums out of our own pockets, and we increasingly have to shell out for co-pays in order to get to see a doctor. The result—in practice—is that most people, even those with good insurance, now think twice or three times about even getting regular preventive health checkups. Having lots of “skin in the game” has meant that millions of Americans don’t get health care they need—and that’s one of the big problems in U.S. health care driving costs up, not down.

But McCain, like George Bush, pays more attention to ultra-conservative theory than he does to the facts. So McCain wants to tax workers’ health care premiums that are paid for by employers. Ask any expert, conservative or liberal, and they will tell you the result will be companies will stop providing health care as an employee benefit. Fortune Magazine quotes one of their experts on the impact of McCain's plan: “I predict that most companies would stop paying for health care in three to four years,” says Robert Laszewski, a consultant who works with corporate benefits managers.

Now keep this in mind: McCain and his corporate advisers don’t dispute this. The massive upheaval that would result – millions of families losing their health coverage on the job and then having to try to find an insurance company that would sell them a new policy that would cover their families—that’s not an unintended consequence of his proposal. That chaotic loss of health security is exactly what McCain intends to happen. He wants us all to buy insurance not as part of a group—like an employee group or a co-op—that can negotiate for better coverage at lower premiums, but as individuals, at the mercy of the private insurance companies.

And get this: McCain wants to abolish the regulations that currently exist in most states that require companies to insure people with pre-existing conditions, provide benefits that don’t exclude some medical conditions, and prevent them from charging huge premiums for crumby benefits. How would he do this? By “giving people the freedom” to buy insurance in other states with weaker regulations. You can bet that most of the big insurance companies are now shopping around for the state that wants to become the corporate headquarters state for the new deregulated health insurance industry – if President McCain wins. Delaware? Mississippi? Arizona?

But, but, but . . . I can hear some people saying, McCain does give people refundable tax credits to help pay for health insurance. And that is part of his package. But his whole philosophy is that too many millions of American’s are getting health care benefits that are too rich, and you certainly can’t say that about the level of tax subsidy he would provide—$2,500 per year for individuals and $5,000 for a family, according to the McCain for President website. Last year the average yearly cost of the most popular type of insurance plan offered by employers hit $11,765, according to a Kaiser Family Foundation study. So the average person with a family would end up paying $11,765 minus the $5,000 tax credit, or $6,765—about double the $3,226 Kaiser tells us the average employee paid for his or her share of premiums.

Again, this is NOT unintentional. McCain and his corporate advisers think it is good for individuals and families to pay more because it makes them think twice before seeking health care, and—in theory—they will shop around for cheaper care. And if they can’t cover the costs of real health insurance with McCain’s tax credit, the insurance industry will sell you lower-cost plans with big holes in coverage or costly co-pays—that is, if you are not already sick and you aren’t too old for them to see you as profitable.

And McCain will be glad to help you invest your tax credit in a Health Savings Account —a savings account coupled with an insurance plan cooked up by his friends in the insurance industry with such high deductibles that it only applies for catastrophic health costs. For those normal trips to the doctor, you just take money out of the savings account until there is nothing left—and then you really reduce health care costs by forgoing the trip to the doctor altogether.

The ultra-conservatives have a name for this combination of tax credits and HSAs. They call it “consumer-directed health care.” A better name is “high-cost health care”—or “insurance company-directed health care.” And although they promote it as saving money for individuals, for our economy and our society, the available evidence shows that it does nothing to reduce health care costs—but it will leave millions of people with worse coverage, more chronic health problems, and higher levels of health cost-driven bankruptcies. And, perhaps most importantly for McCain’s financial backers, it would leave the insurance industry and the drug industry even more in control of America’s health care system than ever before.

The release of this McCain health care plan is an important test for the mainstream media. Health care experts who are “reality-based” will, if asked to comment, tell reporters that there is no evidence that McCain’s proposals will do anything to reduce health care costs, but will the media fall for the McCain spin?

Here’s the story they would like major media to report:

“While Democrats Obama and Clinton, stuck in an endless primary contest, fight with each other over who would cover more of the uninsured, John McCain has been using the luxury of uncontested time to develop a thoughtful plan for bringing down health care costs—the issue voters care most about when it comes to their own family budget worries. And McCain’s plan would attack the health cost spiral by unleashing the power of individual consumers and families in a more competitive health care marketplace, not by using the power of the federal government to either provide health care and not by dictating health insurance arrangements between workers and employers. Expanding consumer choice—and encouraging health care consumers to be wise purchasers of health care, said McCain, is the best way to force the health care system to become more efficient and reduce the burden of health care costs.”

Most honest reporters will note that the McCain will not improve the lot of America’s 47 million uninsured, but they may give McCain credit for focusing more on controlling prices than Obama and Clinton. That might sound “fair and balanced”—but it would be wrong.

The reality is, McCain’s proposals would greatly increase the number of uninsured Americans, while also doing nothing about health care costs except increasing the number of people who can’t afford good quality health care for themselves and their families. Let’s see if the media gets both parts of the story right.

Veteran White House reporter Helen Thomas asks the White House to reconcile contradictory statements on the approval of and use of torture:



Q The President has said publicly several times, in two consecutive news conferences a few months ago, and you have said over and over again, we do not torture. Now he has admitted that he did sign off on torture, he did know about it. So how do you reconcile this credibility gap?
MS. PERINO: Helen, you're taking liberties with the what the President said. The United States has not, is not torturing any detainees in the global war on terror. And General Hayden, amongst others, have spoken on Capitol Hillfully in this regard, and it is -- I'll leave it where it is. The President isaccurate in saying what he said.
Q That's not my question. My question is, why did he state publicly, we do not torture --
MS. PERINO: Because we do not.
Q -- when he really did know that we do?
MS. PERINO: No, that's what I mean, Helen. We've talked about the legal authorities --
Q Are you saying that we did not?
MS. PERINO: I am saying we did not, yes.
Q How can you when you have photographs and everything else? I mean, how can you say that when he admits that he knew about it?
MS. PERINO: Helen, I think that you're -- again, I think you're conflating some issues and you're misconstruing what the President said.
Q I'm asking for the credibility of this country, not just this administration.
MS. PERINO: And what I'm telling you is we have -- torture has not occurred. And you can go back through all the public record. Just make sure -- I would just respectfully ask you not to misconstrue what the President said.
Q You're denying, in this room, that we torture and we have tortured?
MS. PERINO: Yes, I am denying that.

Mccain vs. Mccain

He seems to think he can magically unite the two main strands in the foreign-policy establishment. He can't.

Fareed Zakaria


NEWSWEEK: May 5, 2008 Issue

Amid the din of the dueling democrats, people seem to have forgotten about that other guy in the presidential race—you know, John McCain. McCain is said to be benefiting from this politically because his rivals are tearing each other apart. In fact, few people are paying much attention to what the Republican nominee is saying, or subjecting it to any serious scrutiny.

On March 26, McCain gave a speech on foreign policy in Los Angeles that was billed as his most comprehensive statement on the subject. It contained within it the most radical idea put forward by a major candidate for the presidency in 25 years. Yet almost no one noticed.

In his speech McCain proposed that the United States expel Russia from the G8, the group of advanced industrial countries. Moscow was included in this body in the 1990s to recognize and reward it for peacefully ending the cold war on Western terms, dismantling the Soviet empire and withdrawing from large chunks of the old Russian Empire as well. McCain also proposed that the United States should expand the G8 by taking in India and Brazil—but pointedly excluded China from the councils of power.

We have spent months debating Barack Obama's suggestion that he might, under some circumstances, meet with Iranians and Venezuelans. It is a sign of what is wrong with the foreign-policy debate that this idea is treated as a revolution in U.S. policy while McCain's proposal has barely registered. What McCain has announced is momentous—that the United States should adopt a policy of active exclusion and hostility toward two major global powers. It would reverse a decades-old bipartisan American policy of integrating these two countries into the global order, a policy that began under Richard Nixon (with Beijing) and continued under Ronald Reagan (with Moscow). It is a policy that would alienate many countries in Europe and Asia who would see it as an attempt by Washington to begin a new cold war.

I write this with sadness because I greatly admire John McCain, a man of intelligence, honor and enormous personal and political courage. I also agree with much of what else he said in that speech in Los Angeles. But in recent years, McCain has turned into a foreign-policy schizophrenic, alternating between neoconservative posturing and realist common sense. His speech reads like it was written by two very different people, each one given an allotment of a few paragraphs on every topic.

The neoconservative vision within the speech is essentially an affirmation of ideology. Not only does it declare war on Russia and China, it places the United States in active opposition to all nondemocracies. It proposes a League of Democracies, which would presumably play the role that the United Nations now does, except that all nondemocracies would be cast outside the pale. The approach lacks any strategic framework. What would be the gain from so alienating two great powers? How would the League of Democracies fight terrorism while excluding countries like Jordan, Morocco, Egypt and Singapore? What would be the gain to the average American to lessen our influence with Saudi Arabia, the central banker of oil, in a world in which we are still crucially dependent on that energy source?



The single most important security problem that the United States faces is securing loose nuclear materials. A terrorist group can pose an existential threat to the global order only by getting hold of such material. We also have an interest in stopping proliferation, particularly by rogue regimes like Iran and North Korea. To achieve both of these core objectives—which would make American safe and the world more secure—we need Russian cooperation. How fulsome is that likely to be if we gratuitously initiate hostilities with Moscow? Dissing dictators might make for a stirring speech, but ordinary Americans will have to live with the complications after the applause dies down.

To reorder the G8 without China would be particularly bizarre. The G8 was created to help coordinate problems of the emerging global economy. Every day these problems multiply—involving trade, pollution, currencies—and are in greater need of coordination. To have a body that attempts to do this but excludes the world's second largest economy is to condemn it to failure and irrelevance. International groups are not cheerleading bodies but exist to help solve pressing global crises. Excluding countries won't make the problems go away.

McCain appears to think that he can magically unite the two main strands in the Republican foreign-policy establishment. But he can't. This is not about personalities but about two philosophically divergent views of international affairs. Put together, they will produce infighting and incoherence. We have seen this movie before. We have watched an American president unable to choose between his ideologically driven vice president and his pragmatic secretary of State—and the result was the catastrophe of George W. Bush's first term. Twenty-five years earlier, we watched another president who believed that he could encompass the entire spectrum of foreign policy. He, too, gave speeches that were drafted by advisers with divergent world views: in that case, Cyrus Vance and Zbigniew Brzezinski. It led to the paralyzing internal battles of the Carter years. Does John McCain want to try this experiment one more time?

© 2008