Friday News Roundup - Domestic
http://thedianerehmshow.org/shows/2011-12-23/friday-news-roundup-domestic
The House of Representatives rejected the Senate's extension of the payroll tax cut on Tuesday and the stalemate continued with days to go before the end of the year; the U.S. economy grew at just 1.8% in the third quarter, down from the original 2.5% estimate; and the latest Iowa polls show Congressman Ron Paul with a slight lead over Newt Gingrich in the race for the 2012 Republican nomination. Sheryl Gay Stolberg of The New York Times, Major Garrett of National Journal and Karen Tumulty of The Washington Post join Diane for analysis of the week's top national news stories.
Guests
Sheryl Gay Stolberg
Washington correspondent, The New York Times.
Major Garrett
congressional correspondent, National Journal.
Karen Tumulty
national political reporter, The Washington Post.
Comments
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A recent comment whined about the fact that anti-capitalist topics come up in every political discussion…here is why:
Because a democracy under rabid corporate/capitalism is eventually reduced to an empty shell and the rise of a corporate/punishing state now looms heavily on the horizon. The market-driven principles of deregulation, radical individualism and privatization penetrate all aspects of our daily life. Americans no longer think, act or desire….we’ve become nothing more than a sickening consumer culture. We laugh at and feel superior to the suffering and hardship of others, “the losers”….the millions of people without jobs, homes, healthcare and increasingly….hope.
This rabid capitalistic ideology that has moved to dismantle the welfare state wants to replace it with the punishing state, an ideology that increasingly turns its back on those individuals for whom prison is the only welfare institutions left in America. If a person is lucky enough to avoid prison they find themselves in one of the emerging tent cities found under bridges and located in other invisible landscapes. The places once used in the past to get rid of waste products…. now used to dump poor working class families.
That is why every discussion comes down to discussions about anti-capitalism, because capitalism destroys everything it touches and every single working person out there is its next victim.
If you don’t understand that, you are not only naïve….you ARE stupid.
No, I said anti-capitalist posts on every political topic.
Instead of just regurgitating the same lame communist dogma slamming capitalism over and over and over. Why don't you take some time and write out your solutions. Personally I think your incapable of an original thought and that in itself is a basis for desiring communism.
Ron Paul has been savagely attacked by his own party relentlessly, his message on foreign policy has been deliberately distorted. People are tired of endless wars and being lied too about curtailing an out of control federal government. His message is the only one being offered that even comes close to offering real change, the others only offer more of the same because they believe the average voter is just too dumb and shortsighted to know what's good for them. Maybe they're right.
Here's a quote from quote from our very humble president Obama last Sunday on 60 Minutes, notice he does not even include President Washington and offers only the possibility that his great successes "might" take second place to great Presidents in his mind. Anyone this full of themselves is completely useless for the problems that face our country or anything else for that matter.
"I would put our legislative and foreign policy accomplishments in our first two years against any president, with the possible exception of Johnson, FDR and Lincoln."
It's my fervent wish that this week's domestic round-up spend no more than 5 minutes talking about the Presidential campaign.
As a physician, I take minor offense at the term "doc-fix".
The need for this ~yearly adjustment goes back to 1997, when politicians voted to allow Medicare growth per beneficiary to increase only as fast as the Gross Domestic Product. They elected to do this by adjusting physician reimbursements. Since the growth in Medicare expenses has been greater than the GDP by ~9%, and physician services account for about 40% of Medicare costs, the proposed physician reimbursements for the coming year are reduced by 9% X (100% / 40%), or 22.5%.
One explanation for the 9% growth difference is that more people are living into their 80's and 90's. As the number and percentage of extreme elderly increase, their Medicare expenditures follow suit.
I hope it therefore becomes evident why physicians dislike the current system. As a group, we are being asked to pay for expenses generated from both our success as well as the success of our public health system in increasing life expectancy.
A little-known fact is that most private insurances reimburse physicians at 140 - 180% of Medicare rates, meaning they pay 40 - 80% more than Medicare pays. Therefore, physicians try to increase the number of privately insured patients they see, and try to limit the number of Medicare patients they see (whether overtly or discreetly). This becomes more important when office expenses, which may run between 25% and 60% of collections, are considered.
This differential is why physicians may limit the number of new Medicare patients they see. The return on investment of time and resources is too small to justify the extra workload. At a certain reimbursement level, it becomes more cost-effective to hire less staff, see fewer patients, and seek other supplemental income, such as nursing home medical directorships or hospitalist work. Those are trends being seen among internists, who see a higher percentage of Medicare beneficiaries.
By the way, your local hospital chain has been buying up local practices by promising to raise their private insurance rates from the 140% range to the 180% range. (Medicare reimbursement is regional and non-negotiable.) In return, the hospitals receive ~4% of ALL collections, AND the physicians steer their patients to that hospital for subspecialty physician consultations and ancillary services, such as physical therapy, radiology, and outpatient surgeries.
The physicians retain the right to refer patients to whatever hospital they want, but when did anyone ever bite the hand that feeds him or her? Consultants that don't join the hospital then lose their referral base, and either are forced to join the hospital or are run out of town.
Hospitals are not really evil (although some administrators may be!). They are just trying to survive. Remember that your local hospital probably has a 15% - 30% self-pay rate. Therefore, for every 5 or so patients that come to the hospital ER and get treated and either discharged or admitted, one person gets treated for free. That includes inpatient care as well. Many of this is written off as bad debt, although some may qualify for Medicaid & the hospital receives their small payment retroactively.
The system is broken. There are ways to fix it. But small alterations to the current system will never work. Lobbyists will always inflate the cost of good ideas by as big a percentage as they can.
I think the real problem in Washington starts at the state level. Voters have become more polarized, and elect state representatives that share their more extreme views. These elected officials then help draw districts which are oddly shaped to give increasing majorities in those areas, often in the name of assuring a minority representative from one or more of these districts. Some state-level lobbying may come into play as well.
This is gerrymandering.
These polarized districts then elect candidates that pander to their district's majority, and ignore the minority. The candidates thus elected are therefore more and more extreme as years go by, and districts become even more polarized.
The result you see in Washington today. A Congress paralyzed by its inability to see the middle ground.
We need a grass roots effort in every state with more than one representative that will promote state constitutional amendments that require all districts to be as SQUARE as possible given total population distribution, ideally drawn along major roads.
We need to give up the minority-majority district idea, and accept that geographic apportionment is representative of a country where geographic apportionment of the states is the definition of our country, the United States of America.
Only then will we see a Congress that can negotiate, compromise, and lead our nation back to world prominence. Without it, I foresee that we will be one of many countries with a dysfunctional form of government, and a permanent stagnant economy.
Dr. John Finch: Thank you for explaining the Medicare caregiver reimbursements from the physician's point of view. I know what you mean.
I've been going with a semi-coherent 90 year old to a specialist. She has a chronic condition. Yesterday the office called to cancel her regular appointment saying she should seek a clinic for care because there was little more they could do for her. I can't help but think they are weeding out Medicare/Medicaid patients because of lowered reimbursement. It was my observation and opinion she was being helped at that practice.
Also, you discuss the hospitals operated as local cartels. I know about this because a physician relative once owned a small private hospital. You don't see those anymore because of the insurance system and cartels. Doctors might not see more income under a single payer system but they would have more freedom of affiliation and more opportunity to treat poorer patients needing their skills. Hypercapitalism, with all this financialization and mergers, is ruining medicine in this country. You seem to agree though you do not explicitly state it. Choosing to become a doctor for the money is actually an insane idea because you must surrender your life to that profession. Outsized reward is justified for doctors but they must also find outsized compensation in job satisfaction.
Mr. Finch, could you comment on end of life care further. We all know much of health-care expenditures come from end of life care to prolong the lives of people who's lives are in essence over. It does not make much sense to spend hundreds of thousands of dollars in treatments to get a couple more months of life if you can call it that at the expense of bankrupting the system. Do you think it's possible to have an adult conversation on the topic of end of life care?
Congressional Reform Amendment
How can Congress be reformed to meet the needs of the people? How can the paralyzing politics be removed? How can corporate, big money influence be removed? Here are some suggestions-
1) All elections shall be publicly funded. No donations allowed.
2) Members of Congress must not profit in any way from their job or influence.
3) Congress participates in all social benefits that are applied to the people. No special benefits.
4) Congress can pass no laws that do not apply to themselves.
5) Congress shall serve concurrent 4 year terms with the president.
6) Congress shall receive no benefits from service after their service has ended.
7) Corporations are not individuals
The simple reason why congress has been in a stalemate since 2010 ….it is being held hostage by an angry white minority of insensitive clods called the Tea Party. The Tea Party is Southern, mainly from rural areas and is part of an ideology that has repeatedly attacked American democracy in order to get its way. It was elected to congress by angry insensitive clods who want to take America back to the Gilded Age though most of them wouldn’t even rank among the members who would benefit most from that horrendous backward change.
The Tea Party caucus has twelve representatives from Texas, seven from Florida, five from Louisiana, and five from Georgia, and three each from South Carolina, Tennessee, and the border state of Missouri. The contingent from California is from Orange County whose political culture was shaped by Oklahomans and other Southerners who migrated there during the Depression. Now….not all Tea Partiers are white, Southern or rural….but that is certainly the ideological center of the Tea Party.
Tea Party members deny global warming, saying that it is not a fact….by a margin of six to ten. By that same margin they say that evolution is wrong, that abortion should be illegal and gay marriage should be outlawed. They are advocates of states’ rights and want to abolish the Department of Education. And most telling, they are more concerned with the federal deficit than they are about CREATING JOBS.
For Americans who are fed up with and tired of a congress that cannot govern, the solution should seem self-evident. Get rid of this band of primitive obstructionists.
If you think what we've seen in government so far since January 2008 is toxic, wait till the battle begins over extending the tax cuts. There will be 62 days between now and Feb 2012 of viscious strategy-making by the right to vilify the President and showing the Democrats to be destroying American values. The goal will be routing Obama and Democrats from power. THAT is the all-important goal. The Tea party anarchists will lead the charge.
On the issue of racial bias in loans and banking, This economy is the result of racism. By holding back anyone you hold us all back. Welcome to the roost.
Teece Bowman:
I am a capitalist, a CEO, and - believe it or not - a job creator. I do not regard myself as either naive or stupid. In my career, my companies (small businesses by most standards - revenues of between M$40 - M$110/yr) have accounted for over 400 new jobs of varying skill levels. We have created unskilled, hourly wage jobs assembling and packaging products, skilled manufacturing jobs in machining and fabrication, and skilled white collar jobs in sales, marketing, finance, operations, executive management, etc. I have created wealth for my investors with returns exceeding 10x of their original capital. I have created long term compensation for key employees by way of equity incentives that has resulted in retirement accounts worth millions of dollars. In the process, we have become reasonably wealthy and, with another liquidity event now imminent, we have made the decision to pull our chips off of the table and enjoy the fruits of nearly thirty years labor.
You believe that I should distribute this wealth with equality of outcome to all my employees. Nonsense. Many (the hourly employees) risked virtually nothing, so their share of the reward should be proportionate. You believe that all, regardless of skill, contribution, motivation, and/or ability should share equally in the fruits of the enterprise. Nonsense. Such distribution is wholly unfair to those that have contributed and given more of their self to the enterprise. You MUST reward loyalty and effort or you will lose these people to those that will offer such reward. You (and the Occupiers) demand your shot at the big time NOW. Nonsense. You MUST earn your shot, learn your career, learn your industry, learn the true depth of your personal skills.
You call the capitalist naive and stupid? May I suggest a mirror....
About the pipeline, I have not heard from anyone, why the oil cannot be transported by rail down to the refineries - or build a refinery right up at the Canadian border. Is there an answer?
feather
I believe Sheryl Gay Stolberg was incorrect when she stated that there has never been a Republican presidential nominee from the libertarian wing of party. Barry Goldwater was the Republican presidential nominee in the 1964 general election and he was a self-described libertarian.
Lady, it's a LOT of oil! It cannot practically be transported by train or truck.
Just as a reminder: CONGRESS is the opposite of PROGRESS
'nough said
I just listened to Karen Tumulty gushing about Newt Gingrich's "teaching generals" and couldn't believe my ears. Does she not remember the infamous videotape of Gingrich teaching students at Kennesaw State College in Georgia? He announced, with his usual blowhard authority, that women can't fight in combat because "after 30 days in the trenches" they "get an infection"!
When that video came out I asked my gynecologist exactly what "infection" Gingrich was referring to. She rolled her eyes and we both proceeded to laugh heartily. But then we wondered, "Why on earth are we laughing when this medieval view of women's menstrual periods is being 'taught' in this day and age?" and we both became angry.
Karen Tumulty, you NEED to see that videotape. Then you'll know what Dr. Gingrich, ob-gyn, is teaching those generals. Maybe you'll stop being so unnecessarily impressed.
StLouis....
Your langauge is punitive.
"You must earn, you must reward...."
I suppose that profit sharing at your company is completely off the table because no one has risked enough. And co-ownership with your employees would be unthinkable because more of the reward should go to you.
Teece:
May I suggest that you READ what I wrote.
Key employees have received significant equity incentives in exchange for allowing me to pay them at a lower scale over a three year vesting period, i.e. by helping me through the times when cash is tight, I will reward you handsomely in the end. When this same program was offered to the hourly employees, I received ZERO takers. ZERO. NOT ONE. So, with my home on the line and everything I own hung out over the edge, we pushed ahead, holding our cash the best we could. After some touch and go years, we finally hit a point where we could basically do no wrong. We became highly profitable and these profits were shared generously and proportionately with those that deserved them - the people that truly sacrificed to make it go. This is not PUNITIVE to the hourly employees; it is incentive reward to all those that sacrificed for the good of the total enterprise.
Remember how Republicans wailed about the chaos that ending "Don't Ask don't tell" would cause in the military? Current interviews with military personnel have unequivocally shown a complete absence of any "chaos". So too will the claims Republicans make that taxing the rich (1%) will cause economic "chaos". Wake up everyone! Republicans are simply the representatives of the 1% and will say and do anything to stay in power.
Regarding "anti-capitalists": Unfettered capitalism leads to where we are - a corporatist oligarchy that is just a hairs-breadth away from Facism. Look around you! Read and listen to news sources other than FOX. The rest of the developed countries have managed to creat universal health care, have lower mortality rates and higher citizen satisfaction than the US. We USED to lead in those areas - guess when? When taxes on the top 1% were twice as high as they are now. Back when corporations were in fact regulated and PREVENTED from becoming "too big to fail".
Keep this in mind: The most basic human failing encompasses GREED, SELFISHNESS, and ENTITLEMENT. All traits of MOST of the top 1%. Ever wonder if they remember on whose backs their very existence depends on? I have personally spoken with some of those top 1%, and even many in the top 5% who love to say "I made it on my own and no one helped me."
I wince, laugh, and cry at such utter ignorance and hubris.
TB has an axe to grind, obviously there are personal failure issues at work here that are put forward with contemptuous ideas for revenge upon those that succeed through hard work. People suffering from a mental victimization disorder certainly will never accept an apposing idea unless coupled with years of psycho therapy
I was a CEO of a successful company, too. I also shared profits and had a compensation plan that included both earned bonuses and discretionary bonuses to reward those who most reflected the company culture I wanted to create. Over 20 years, my business created almost 400 high-paying software / technology jobs.
Unlike you, I continue to believe that to whom much is given, much is expected. I never earned more than 5 times my lowest paid employee (how much more did you pay yourself over your lowest paid employee?). My business enjoyed the protection of the United States Government and the benefit of all those "pesky" government programs like the interstate highway system, public transportation, the national electrical grid, dams, National Parks, State parks, garbage collection, clean water, etc.
You, unfortnately, have succumbed to the disease that most 1% suffer from: self-righteous entitlement, selfishness from a lack of awareness of proportionality, and simple greed.
I am not as successful as you are, in terms of wealth, but, I am still in the top 5% and damn grateful for the opportunity and the priviledge of living in the greatest country on earth. I view paying taxes as an honor and duty to continue to keep our country financial strong.
For a great read on the corruption/extortion cycle that has taken We-the-People out of any sort of influence in our government read "Republic, Lost" by Lawrence Lessig.
This gives a very insightful look into how our federal government has been taken over by 'special interest', lobbyists and the drive to re-election as well as feasible routes to stop this mess and get the government back to We-the-People.
Diane, you should get this fellow on your show - his ideas are great for both ends of the polarities and the middle (if there is any middle anymore).
ronsonntag wrote: " I view paying taxes as an honor and duty to continue to keep our country financial strong."
Please feel free to write that additional check to the federal government. But leave us out of it. If governments insatiable appetite for funding is allowed to continue as it is now it will devour " the greatest country on earth" in the very near future. The beast must be starved.
I make roughly 2.5 times what our lowest paid employee now makes. I am the lowest paid of the executive staff; EVERY sales rep makes much more than I do. I have always maintained a strong equity stake, as I have always risked my own capital to get the business started, to include using my home to guarantee the revolver at the bank. I have always been the principal inventor of the core technologies and have always licensed them to the enterprise for $1. I have always sought to make my way long term, by the creation of value in associated equity. I have always urged those around me to do the same.
Our book keeper - the gal that does the simple A/P, A/R, GL entry, etc. - will clear (after taxes) M$1 on this current transaction. She made over K$400 on our last deal. She also has been paid less than what she could down the street, but she knows darn well why she is still with us. She too is using this as her ticket out.
Before you speak, it is a good idea to know the facts. Otherwise, when revealed, you look like a fool.
Mountainwomon wrote: "This gives a very insightful look into how our federal government has been taken over by 'special interest', lobbyists and the drive to re-election as well as feasible routes to stop this mess and get the government back to We-the-People."
Your right the federal government with rules created by elected officials in control of the federal government has sold out Constitutional government to the highest bidder, but you cannot blame the people outside the government who play by government rules.
I hope your not confusing "We The People" with "Tyranny of the Majority"
I know EXACTLY what I am talking about. I went 6 months without a salary twice to help keep employees and keep the company afloat.
I noticed that you did not address any of my points about simply being GRATEFUL for what you have enjoyed.
If you hate taxes so much: 1) get off my highways, 2) stay out of my national parks, 3) put your own damn house fire out, 4) pay your own emergency care, 5) process your own garbage, 6) clean up your own water.
RonSonntag:
You seem to harbor extraordinary anger for someone that professes such gratitude. Can you explain the disparity?