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June 23, 2009

Health Care's 'Third Rail'

A political ‘third rail’ is an issue that’s so highly ‘charged’ that it’s pretty much political suicide to touch it. Literally speaking, the third rail that’s used to power trains carries hundreds of volts of electricity, resulting in electrocution and likely death for anyone who touches it. Some of the best known ‘third rail’ issues are, of course, Social Security reform, tax increases and gun control, but now I think we can add to the list: ending the tax exemption on employer-provided health benefits.

This topic showed up on my radar screen again today for two reasons. First, today’s New York Times Op-Ed by David Brooks brings this hot-button issue into full view. Here’s a brief excerpt, but it’s important to read the whole article:  “On May 12, the Senate Finance Committee held a hearing on health care reform. There was a long table of 13 experts, and a vast majority agreed that ending the tax exemption on employer-provided health benefits should be part of a reform package. Skip to next paragraphThey gave the reasons that experts — on right or left — always give for supporting this idea. The exemption is a giant subsidy to the affluent. It drives up health care costs by encouraging luxurious plans and by separating people from the consequences of their decisions. Furthermore, repealing the exemption could raise hundreds of billions of dollars, which could be used to expand coverage to the uninsured. Democratic Senator Ron Wyden piped up and noted that he and Republican Senator Robert Bennett have a plan that repeals the exemption and provides universal coverage. The Wyden-Bennett bill has 14 bipartisan co-sponsors and the Congressional Budget Office has found that it would be revenue-neutral.” 

Unfortunately, as Brooks continues, the Wyden-Bennett bill isn’t gaining traction among congressional leaders or in the Obama Administration…a variety of strange-bedfellow lobbyists have made it clear that this direction is a ‘third rail’ for them.

The second reason for this issue to rise to the surface for me came in a report from the National Issues Forums community on “Coping with the Cost of Health Care.” This is the title of the most recent NIF issue guide on health care, and the report summarizes the responses of forum participants across the country. As a researcher and writer in NIF work myself, I know full well how difficult it is to create an issue guide that includes the most important and urgent parts of a public dilemma for effective, small group conversations. What was striking to me today, however, was the apparent absence of the tax exemption on employer-provided health benefits in the issue guide and/or in the report. Let me be clear…I’m not trying to find fault, and I haven’t scoured the report, but I’m pretty sure that if this topic had been addressed in the forum it would have created enough of a stir to be included as a major finding in the report.

Here’s my guess: some topics—like this exemption on health care benefits—are so deeply embedded in our psyche that they are generally not questioned…at least not until the problem grows dire enough to look everywhere for ways to pay for truly inclusive health care. When these topics are eventually brought into the open…whoa! You know immediately why it could be considered to be a ‘third rail’ issue. If, however—and here’s the big IF—if we really, really want to find solutions to our most difficult problems, we’ll be willing to address every highly charged topic that has even the most remote chance of making a contribution in the conversation…no-holds-barred! As long as we’re willing to let political-correctness censor the way we talk about issues, we’ll have to settle for mediocre public discourse and ineffective public policy.

For those who are interested in more on this topic, here are a couple more links:
U.S. Senator Ron Wyden…website info on “Healthy Americans Act”:
http://wyden.senate.gov/issues/Health_Care.cfm
NIF Report on “Coping with the Cost of Health Care”
http://www.nifi.org/stream_document.aspx?rID=14664&catID=6&itemID=14663&typeID=8

 

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June 19, 2009

Less and Less Equal

As budget cuts hit home for more and more citizens, the dismantling of what I’m calling our ‘equality infrastructure’ is becoming more obvious, and small groups in our communities are starting to show us how our culture will shift in the months and years to come. Each state has a different revenue profile, so some states will have greater cuts than others. Each county has unique demographics, employment and housing stability, so some counties will have greater cuts than others within each state. Some school districts, towns and cities have a greater vulnerability to the current financial crisis, so some of them will have greater cuts than others. Now we need to add the reality of income distribution to this picture…some citizens have the capacity to weather this economic storm with very little disruption, while others have zero flexibility. Our ‘equality infrastructure’…imperfect as it is…will be eroded, and the gaps in our society will grow.

While driving home a couple of evenings ago, I was listening to a talk-show commentator, Gene Burns, on KGO radio in San Francisco. Mr. Burns read an article about a small group of concerned parents in one of our SF Bay Area school districts where they were creating a fundraising effort to significantly reduce the affects of recently announced budget cuts. His question to his listeners hit the ‘equality infrastructure’ point from the community-response side…some neighborhoods and communities can do this while others cannot. He directly addressed the value of equality in education for the good of our whole society. As I shared in a previous post, when we are eventually ‘starting over’ in recreating some new manifestation of our disappearing ‘equality infrastructure’, we will most certainly have some wide gaps in our society…in housing, health, education, employment, etc. Some of the old inequality standards will still be present, but it’s likely that some new ones will need to be included as we learn about equality in the 21st century.

So…how long will this all take? Unfortunately, an even deeper damage to our ‘equality infrastructure’ won’t even appear until at least next year at this time as this year’s budget cuts and continued increases in unemployment and under-employment create another wave of foreclosures and bankruptcies…further eroding our already fragile property tax base. Some communities will probably be able to sustain their most important local services this year, but only a very few will be able to mobilize the resources to be effectively self-sustaining for the next 4-5 years. This is why many leaders in counties, cities and school districts are worried. On the horizon too, many colleges and universities are projecting huge deficits during the next several years, making a college education impossible for many young people…and taking one of the primary equalizers in our society out of the picture for major part of a whole generation.

I’m proposing that this will be one of the most important topics for deliberation and public conversation in a lifetime for most of us. Here again is the dilemma as I see it: should we rebuild a new ‘equality infrastructure’ using the same blueprints that created the current, fragile system OR should we seek a more sustainable public learning plan with a completely different decentralized foundation OR should we decide together that any future ‘equality infrastructure’ will include only some very basic components that we will do very well? I hope your community is touched gently by this emerging crisis. We know now that ours will not be spared, even though we’re probably not going to experience the worst devastation either. I still feel that this crisis can create a new learning curve in public knowledge and action…if we have the courage to ask the tough questions we encounter as we face the trade-offs involved in making equality sustainable.

 

Posted by deliber8ca at 03:46 PM | | Comments (1) | TrackBacks (0)

June 11, 2009

Inflating a New Bubble?

Yeah, I’m worried! Social and political inertia is incredibly strong in our culture of sound bites and quick solutions…the urge to return to a normal life after a near-fatal illness can lead us to take additional risks where a relapse is highly probable and very dangerous. While numerous voices are signaling their warning, I don’t see or hear any coordinated message about this from the Obama Administration, or the Federal Reserve Bank, or the Congress, or the business media. It appears to me that the public is still just experiencing the Great Recession on an intellectual basis, rather than feeling any real pain…yet. I’d love to be wrong about this, but it appears that we’re dead-set on inflating a new bubble so things can be ‘normal’ again.

Here’s Paul Krugman’s NY Times blog yesterday: “Just a quick note: is it just me, or has the economic news started to darken again? Up through about March, every report was worse than you expected, often worse than you could have imagined. Since then, most reports — although continuing to be bad in an absolute sense — have “surprised on the upside.” But my sense is that in the last few days we’ve been getting reports — Korean trade, Japanese orders, German exports — that are once again surprising on the downside. This thing ain’t over yet.”

Here’s an excerpt from today’s NY Times Editorial on the decision of the Obama Administration to allow many large banks to repay a combined $68.3 billion in bailout money: “Clearly, the way the banks see it, last year’s bailouts meant unwanted public scrutiny and salary restraints, so paying the money back frees them from those burdens. That bodes ill for regulatory reform. The compensation they seek to protect was based in large part on the risky practices that brought the system to the point of collapse. It stands to reason then that if colossal pay and bonuses continue, so will recklessness.”

We’re nowhere close to the end of this economic train-wreck, but the banks and the Obama Administration seem to be on the same message: they want to put Wall Street right back where it was before the crash…with the exception of some carefully negotiated ‘reforms’ where the bank lobbyists have significant influence in the writing process. Sadly, it appears that we have the wrong people in charge of negotiating for the public…they don’t really believe yet that our economic system needs a serious overhaul…and they have too many friends and former colleagues in the financial sector. It makes me nervous when many of the people who helped to create the crisis are celebrating ‘reform’ decisions.

Unless the public demands a full investigation into the economic meltdown before reforms are decided, forces are in play now to simply inflate a new bubble. Here’s another perspective that’s highlighted in many books and articles that seek to understand our 25-year march into the Great Recession. Many believe that we never really recovered from the 1992 recession. Not really recovered. All we’ve done is float a series of bubbles and make things look like they're prosperous, while most people have been lucky to keep their heads above water. As several recent voices have pointed out…if it weren’t for Wal-Mart’s price suppression, the public would have a much clearer understanding of some much deeper economic dangers that are looming just under the surface of the statistical haze. The Federal Reserve doesn’t control inflation…Wal-Mart controls inflation. Our biggest problem is that there’s lots of inflation in our domestic and global markets that Wal-Mart can’t control.

Job losses are only really just starting…school districts, cities and counties are desperately slashing jobs to stay afloat. When all of these cuts are made and the economic consequences of steeply rising unemployment and increased under-employment with more part-time positions and furloughs become reality, that’s when everyone will ‘feel’ the Great Recession. We are in the eye of the hurricane and the next phase is about to hit…and it’ll hit next with the strongest and most devastating force!

Yeah, I’m worried! I’m worried most that we appear to be willing to let social and political inertia make our most critical decisions. As the local damage grows in the next months, I’m hoping that our deliberative communities across the country will decide to step into the public square with opportunities for conversations about reforms that are grounded on carefully researched analysis and on true transparency in public problem-solving. As you might be able to discern, I believe some of the dilemmas uncovered in the economic crisis are actually at the hub of multiple issues…how we face reality, how we investigate carefully, how we talk with each other, how we discover together our foundational values, and how we defy inertia to create long-term solutions that satisfy our basic needs.

Posted by deliber8ca at 10:04 AM | | Comments (1) | TrackBacks (0)

June 09, 2009

A Foundation of Uncertainty

I didn’t think we’d need to deliberate about the public need for the truth, but I guess I was wrong. Hey, everybody…where is our Pecora investigation? As the Great Depression deepened, a full and relentless investigation, led by Ferdinand Pecora, probed into the corporate and political decisions that caused the crisis. Pecora was the chief counsel for the U.S. Senate Committee on Banking and Currency in 1933-34, uncovering a wide range of abusive practices on the part of banks and bank affiliates. The Senate hearings were broadcast on the radio, featuring Pecora’s questioning of corporate leaders. They galvanized wide public support for new banking and securities laws…some of which successfully stabilized our economy for decades. So where’s our fire-in-the-belly for the truth about our current Great Recession?

It seemed very straight forward and natural that a thorough investigation would start almost immediately after the economic meltdown in late 2008. But then the election had our attention, so we couldn’t start then. In the lame-duck days of the Bush Administration, no one wanted to start something that would probably change after the Inauguration, so we waited some more. Now…why are we still waiting? Sadly, it appears that what some of us thought was a foregone conclusion has developed a complexity that may need some significant public conversation. On the surface at least, it didn’t appear that we have deeply-held, emotionally-charged differences in values, concerning our need for an investigation. Underneath, however, the Obama Administration and the Congress obviously have at least a different timeline in mind and at most a completely different concept of public knowledge than many who want answers about the crisis before memories fade and records are ‘misplaced’ or ‘deleted.’

On April 3, 2009, William Black was one of the guests on Bill Moyers Journal…he said about our need to investigate the causes of our current, deepening financial crisis: “What would happen if after a plane crashes, we said, "Oh, we don't want to look in the past. We want to be forward looking. Many people might have been, you know…we don't want to pass blame. No. We have a nonpartisan, skilled inquiry. We spend lots of money on (it), and get really bright people. And we find out, to the best of our ability, what caused every single major plane crash in America. And because of that, aviation has an extraordinarily good safety record. We ought to follow the same policies in the financial sphere. We have to find out what caused the disasters, or we will keep reliving them. And here, we've got a double tragedy. It isn't just that we are failing to learn from the mistakes of the past. We're failing to learn from the successes of the past.”

But wait! The Pecora investigation wasn’t the only successful benchmark for public learning…we learned a lot in the Watergate hearings (1973-74), the Church Committee hearings (1975), the Iran-Contra hearings (1987) and the Keating Five hearings (1991). We even learned in the McCarthy hearings (1953-54) that we didn’t want a vendetta or a witch hunt. Each time, the public got to hear the questioning and the responses…and each time we learned more about the crisis under inspection and about what we as citizens in a democracy wanted in our government.

At present, it doesn’t appear that the Obama Administration sees any importance or urgency in investigating the fraud and cover-ups in the current economic meltdown, or the abuses of power of the Bush Administration Justice Department, or the erosion of constitutional rights after 9/11 or the allegations of a systemic policy of torture. If we were investigating even one or two of these critical issues in our recent past, it would be understandable to not have the time or resources for the others, but we’re not currently committed to any of these public learning curves. So…we’d probably better start talking about the public need for the truth, even when it’s a distraction from current legislative agendas. We can’t create a sustainable future on a foundation of uncertainty.

Posted by deliber8ca at 02:44 PM | | Comments (1) | TrackBacks (0)


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