“Our World Would Be Unrecognizable”

Coffee Brown, University of New Mexico, Talk Radio News

Sen. John D. Rockefeller IV (D-W.Va.), Chair of the Committee on Commerce, Science and Transportation, opened the first of a planned series of hearings into practical responses to climate change with, “Dr. Killen, when does climate change become irreversible?”

Dr. Timothy Killen, National Science Foundation, replied that accommodation was becoming more important than prevention. Killen said that present models are imperfect, they show a range of possibilities for each question, but the possibilities are all about how much our world is changing, not whether it is. The overall pattern of warming and increasingly erratic and extreme weather is certain, with floods and droughts occurring back to back in the same places. One other thing the models have in common, is that the changes are already more severe and rapid than predicted, he said.

This is partly because methane gas wasn’t part of earlier models, Killen said. He confirmed that methane is 30-40 times more potent as a greenhouse gas than carbon dioxide. Methane is sequestered in huge amounts in permafrost. So far, only superficial permafrost is melting and releasing the gas but, if it all melted, “Our world would be unrecognizable,” he said.

Rockefeller said this is the 11th plague on man. “The science is overwhelming… The time for arguing whether carbon emission is a factor which affects the health of the earth, or whether our sea level is rising from global warming, is and must be over.”

Sen. Kay Bailey Hutchison (R-Texas), Ranking Member, asked about research into weather control. Killen indicated that we could begin such studies, with better tools than in the past.

No one among the senators or the panel questioned the reality or significance of climate change, the discussion was about what could be done.

Killen recommended specific areas of further research in order to improve computer modeling of the effects of any changes. He thought science would then yield better answers in “ten or so years.” In the meantime, we should plan for regional climate change, the local details of which were not yet predictable, rising and more acidic oceans, water scarcity, extreme weather, reduced biodiversity, crumbling ecosystems, and substantial impacts on human health.

Sean Dilweg, National Association of Insurance Commissions, recommended both insurers and government create incentives for people to drive less and use clean energy. Insurers are presently looking into other recommendations.

Sen. Mark Warner (D-Va.) suggested “something like EnergyStar on steroids.” A symbol that consumers could look for as a sign that their purchases were part of the solution.,

The Colorado River might carry 20 percent less water by 2050, Katherine Jacobs, Arizona Water Institute, said. There is a great need, she said, for the public and policy makers to be more aware of the science around climate, and to make that science part of important decisions.

Her recommendations also included plans to adapt to now-unavoidable changes, as well as defining the problems around users’ concerns, matching the timing and scale of information to decisions, and establishing credibility of sources in the minds of the public. She submitted several more technical recommendations to the committee as well.

By far the most pro-active panelist was Frank Alix, Powerspan Corporation. His company makes carbon scrubbing and sequestering equipment for coal plants. Still at the prototype stage, their equipment can remove 90 percent of the carbon from coal plant exhaust, pressurize it into liquefied form, and pump it into vast natural underground spaces, where it is expected to remain. Alix estimated that, with full implementation, total carbon emission could be reduced to about 5 percent of what it is now, for about $40 a ton.

Alix said the fastest path to adoption of the scrubbers would be a carbon tax.

Republicans Challenge Obama Budget

Coffee Brown, University of New Mexico, Talk Radio News


Speaking on behalf of both House and Senate Republicans, Sen. Lamar Alexander (R-Tenn.) and Rep. Mike Pence (R-Ind.) presented a joint Republican rebuttal to the president’s budget. Calling it, as Pence said, ”In a very real sense, a blueprint for the future,” they didn’t like it.
Spence said that Republicans would “collaborate…to both challenge the assumptions and the content of the president’s budget, as well as offer positive, substantive alternatives for responsible growth.” He said the budget spends “unprecedented amounts in new ways.”
“According to independent estimates, the government may have to hire 250,000 new federal bureaucrats just to pass out all the money,” he said, and, “This is the largest tax increase in history.” Adding that it would mainly affect small business owners filing as individuals.
Pence went on to say that the new energy tax would cost every American up to $3,125 per year.
He also said that this would be the highest level of borrowing ever.
Alexander stated that, “The question before the American people is whether the American family can afford the Democrats’ spending, the Democrats’ taxing, and the Democrats’ borrowing. And we’ve got four weeks to make that case, starting with this week.”
“This budget doubles the debt in five years, and it triples it in ten years,” he said, adding, “and there’s talk of a second stimulus package.”
Both men agreed that across-the-board tax cuts would be preferable to spending for stimulus.

It's Expensive, Yes, But What is the Cost of Doing Nothing?

Coffee Brown, University of New Mexico, Talk Radio News Service

Dr. Peter Orszag, previously the Director of the Congressional Budget Office, currently the Director of the President's Office of Management and Budget, told the Senate Committee on Finance that the cost of doing nothing about healthcare reform would be fiscal crisis, decreased take-home pay, 46 million uninsured Americans, and an increasing burden on state governments which is already cutting into other services, such as increased tuition costs for college.
"Do you know of anyone in either party who wants to do nothing?" Sen. Chuck Grassley (R-Iowa) asked.
Orszag replied, "No, Sir. That's why I am confident that we can get healthcare reform passed this year."
Grassley said there was not yet any conflict between Republicans and Democrats about healthcare reform, but that that was partly because the president's budget, while "bold", was "not very detailed."

Still, $634 Billion is a lot of money.

Sen. Max Baucus (D - Mont.) said, "Would healthcare reform now lead to substantial savings?"
"Yes," answered Orzack.
"Should we accept short term deficit spending to achieve that?" asked Baucus.
Orzack replied, "The president's budget for healthcare reform is designed to be deficit neutral for the first 5-10 years, then we should begin to see savings. If we could cut one percent per year from medical cost growth, we could realize savings of 20 percent of GDP in 50 years. For forty years, medical costs have risen 2 to 2.5 percent faster than inflation."

The hearing, at which Orszag was the sole witness, turned from general costs to specific strategies.

Baucus asked, "Can we incentivize consumers to be more cost effective?"
"25 percent of beneficiaries use 85 percent of the cost. That's the group to target," Orszag replied.
"Would costs come down if everyone were covered? And how could we do that?" Baucus asked.
According to Orszag, we need to reduce consumer costs, reduce complexity, and encourage enrollment. We can encourage enrollment by subsidies, mandates, and automatic enrollment with an opt-out choice. Social norms need to change, so that people would be as shocked if you had no health insurance, as they now are if you don't buckle your seatbelt. the key to that is massive public awareness campaigns, he finished.

Grassley said he was concerned that Medicare Advantage might be cut too sharply under the new budget. Physicians might opt out of Medicare if reimbursement is too low.
Orszag said that Medicare Advantage was targeted because it paid substantially more than basic Medicare.

Expansion of the public sector would place new pressures on the private sector.

"Would a public plan undermine Obama's promise that people who prefer to can stay with their current plan? Would Obama support a plan that would 'crowd' 18 million people off private plans onto public?" Grassley wondered.

Sen. Maria Cantwell (D - Wash.) was also concerned about proposed cuts: "We've found medical homes, home care, and Medicare Advantage to be cost effective, but they face cuts under the new budget."
"Evidence strongly favors integrated care...Long term health care is in the budget...Competitive bidding should reflect local costs," Orszag replied.
He pointed out later, however, that the budget office had found that home care typically had much higher profit margins than other sectors of healthcare, and had been targeted for that reason.

Public funding means public accountability.

Orrin Hatch (R - Utah) said, "A Federal Reserve-style medical board would be a disaster, leave standards of care to the specialty boards. Keep these decisions in the private sector. We should not be be setting prices."
"Those problems are common to all the models. Both public and private systems must change," Orszag said.

Sen. Baucus closed the meeting by pointing out that time is of the essence, and the Senate must move quickly.
"We have our sleeves rolled up; we're ready to go," said Orszag.

What Do Geeks Dream Of?

Coffee Brown, University of New Mexico, Talk Radio News



TechAmerica is a trade union representing more than 1500 technology companies that have reached a consensus on priorities for their portion of the Recovery Act.

Christopher Hansen, CEO of TechAmerica, stressed repeatedly that his membership places their emphasis on investment in innovation, and on “Not just employment now, but companies which will benefit America for decades into the future.”

The association’s top priorities are:

Health: Computerized healthcare, from software to next generation broadband to electronic medical records. “America can still lead the world in medical technology innovation,” Hansen said.

Jobs, education, training,research and development: Hansen acknowledged that maximum benefits now require shorter-term investments, but that we also need to invest now in order to have the scientists and engineers to keep America in front of technology into the future. Josh Lamel, Senior V.P., Federal Government Affairs, added that $400 million had been set aside for high risk, high potential, basic research, “So we’ll be developing technologies that we aren’t even talking about yet.”

Government Management: Modernizing government via technology and technological expertise.

National/Homeland/Cyber security: New technologies for military, intelligence and security.

Green: The group has a strong focus on alternative energy development as a long-term investment.

Immigration: The thrust here was not to restrict but to facilitate immigration for highly skilled people, especially those who are trained in America but are not citizens. Lamel noted that H1B immigration visas have become more difficult to obtain under the new bill.

Broadband: Needs to be faster and more universally available as more and more businesses depend on it. Many jobs become possible in low employment areas if broadband is available.

Trade and patent policies need to encourage innovation, their position paper concludes.

Healthcare Reform: Ain't None of 'Em Pretty, Pick One You Can Live With.

Coffee Brown, University of New Mexico, Talk Radio News
 
 
 At the Alliance for Health Reform briefing, Covering the Uninsured: Options for Reform, Diane Rowland (Kaiser Commission on Medicaid and the Uninsured) said that 15 percent of us are uninsured.
That’s 45 million people out about 298 million. This uninsured figure includes the fact that 81 percent of the uninsured actually have an employed member of the household. These figures are from 2007 and she expects the number to have risen due to the recession.
 Even at 400 percent of the poverty level, 10 percent are not covered.
These rates are not evenly distributed, but tend to be least in the Great Lakes region and progressively worse south and west. The uninsured are about ten times more likely to forego needed medical attention.
Adults without children were the most likely to lack insurance because the eligibility rules are strictest for them even before the recent expansion and extension of SCHIP.
Between 2000 and 2008 the average premium for a family rose from $6,438 to $12,680, with the worker’s share rising from 25 percent to 26.5 percent, for an annual increase of $1,735 per family.
Public support was about two-thirds for healthcare reform both before and after the Wall Street crash, she said.
Ah, but what sort of reform?
Jack Ebeler,  Ebeler Consulting, presented the main alternatives, which he boiled down to tweaking the present system or restructuring it. In the first case, he said, we could go with individual or employer mandates. And/or expand existing public coverage, such as Medicaid, Medicare, and SCHIP. And/or revise regulations affecting private insurance.
The other main approach he described would be to move away from employers, either by going to single payer or by redirecting both responsibility and subsidies away from employers toward individuals.
What we are actually going to get is “mix and match.”
Bradley Herring, PhD, Johns Hopkins Bloomberg School of Public Health, presented some pros and cons of each of the major proposals. There are only four to consider:
Single Payer: HR 676
It would be easy to understand, relatively easy to apply, vs. the others, and would deliver large administrative cost savings. While workers and employers would be glad to be rid of premiums, the increase in taxes, especially for the wealthy, would be substantial.
He described this as a transfer of wealth from the rich to the poor, from the well to the sick, and from the Great Lakes region to the poorer states. He also noted that providers would likely see their incomes fall.
The McCain-Republican vision bets on tax code revisions and a competitive market to control costs and drive enrollment. The downside is basically everything we don’t like now: High risk/high cost individuals are separated from the low-risk/high profit pool. There would also be less consumer protections, less standardization of coverage, and high administrative costs at all levels.
The Obama-Baucus plan adds mandates to the current system and gradually brings public sector insurance into competition with the private sector. Advantage: least change. Disadvantage: least change.
The Wyden-Bennett regulates and subsidizes private markets. This one actually gets more bipartisan support, and the Congressional Budget Office estimates it could break even after only a few years. It was almost no one’s favorite.
And there’s the rub.
Rowland notes that two thirds of the people want healthcare reform. Most of them have a first choice among the four plans, and the status quo is most people’s second choice. Most of those polled would rather keep what we have than accept reforms that are not their first choice.