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What about the proposed cost savings? They, too, are questionable. Most of them consist of reductions in Medicare outlays, which, according to this C.B.O. analysis, would save four hundred and twenty-six billion dollars between 2010 and 2019 compared with current plans. Look a bit more closely, and you find that more than half of the Medicare savings (two hundred and twenty-nine billion dollars) come from cutting payments to providers of services under the regular program; most of the rest (a hundred and seventy billion dollars) come from changing the way payments are set in the Medicare Advantage program. Does anybody really believe that these savings will materialize? For decades now, Congress has been promising to reduce the growth of Medicare outlays, and yet every year they continue to go up. The reasons are straightforward: the population is aging; seniors are politically active; and health-care treatments, particularly for the aging, continue to evolve in complex and costly ways.

To be fair, contained in its reform plan, the White House does have a proposal to address these issues: the establishment of an Independent Medicare Advisory Council (IMAC), which would provide Congress each year with cost-saving recommendations. “By removing some of the political pressure around such reforms,” Romer said in the same speech, “the IMAC would make it easier for improvements to be made year after year.” This statement can only be described as wishful thinking. I hope it will be proved right, but Washington is replete with now-defunct independent bodies and commissions that toiled dutifully, did good work, and made little difference.

So what does it all add up to? The U.S. government is making a costly and open-ended commitment to help provide health coverage for the vast majority of its citizens. I support this commitment, and I think the federal government’s spending priorities should be altered to make it happen. But let’s not pretend that it isn’t a big deal, or that it will be self-financing, or that it will work out exactly as planned. It won’t.

Many Democratic insiders know all this, or most of it. What is really unfolding, I suspect, is the scenario that many conservatives feared. The Obama Administration, like the Bush Administration before it (and many other Administrations before that) is creating a new entitlement program, which, once established, will be virtually impossible to rescind. At some point in the future, the fiscal consequences of the reform will have to be dealt with in a more meaningful way, but by then the principle of (near) universal coverage will be well established. Even a twenty-first-century Ronald Reagan will have great difficult overturning it.

That takes me back to where I began. Both in terms of the political calculus of the Democratic Party, and in terms of making the United States a more equitable society, expanding health-care coverage now and worrying later about its long-term consequences is an eminently defensible strategy. Putting on my amateur historian’s cap, I might even claim that some subterfuge is historically necessary to get great reforms enacted. But as an economics reporter and commentator, I feel obliged to put on my green eyeshade and count the dollars.

Now this I can really appreciate. Cassidy wants the Obama healthcare reform (or transformation to be more accurate) but at least acknowledges that the "deficit neutral" claim is either dishonest, or at least, self-delusional. He makes a strong argument that America is morally obligated to insure all its citizens, and condemns our lack of fiscal prioritization (a view I share to some extent). In a perfect world, Cassidy and Krugman would debate Prager and Krouthammer on the Senate floor before the vote was allowed.

Vegetables are sick – Hunan Liuyang cadmium pollution

November 21st, 2009

(picture: A polluted eggplant)

[Southern Metropolis Daily] In July and August of this year, the Hunan Liuyang cadmium pollution incident caused nationwide concerns. It has been three to months since the incident, chemical plant was permanently closed, the relevant officials were suspended from their positions and affected farmers also received a certain amount of compensation. Recently the photographer went back to Liuyang, to some of the affected areas and shot a set of portraits for the crops. These terminally ill fruits and vegetables tell us the disaster has not yet ended.

 

Vegetables are sick – Hunan Liuyang cadmium pollution

By Southern Metropolis Daily reporter Fang Qianhua

 

 

July of this year my partner Yang Xiaohong and I went to Liuyang in Hunan province together to cover the incident of cadmium pollution. Centered at Xianghe chemical factory which was the source of the cadmium pollution, the fields within 1.5 kilo-meter radius were seriously polluted with cadmium.

At the time, the amount of the cadmium content in majority of the villagers’ body seriously exceeded the standard level. Some of them were very young babies. Apart from this, large tracts of contaminated farmland and crops were too horrible to look at. Those once familiar fruits and vegetables in the field became grotesque and disfigured beyond recognition, making people feel nausea and fearful when looking at them.

November of this year I once again returned back to the polluted areas to investigate and found many farmland were deserted, rarely seen crops. However after walked through many villages we could still see some remaining fruits and vegetables in the corners of the deserted fields. Because they were never cleared away, after a few months of pollution they have become more deformed, more shocking. In order to find crops suitable for the photo shoot, I went there 4 times to couple of the villages to look for those polluted vegetables. To me, these deformed and sick fruits and vegetables are like a group of special patients.

Photography: Fang Qianhua

Video: Qiao Yanjie

For the economy is still in deep trouble and needs much more government help. Unemployment is in double-digits; we desperately need more government spending on job creation. Banks are still weak, and credit is still tight; we desperately need more government aid to the financial sector. But try to talk to an ordinary voter about this, and the response you’re likely to get is: “No way. All they’ll do is hand out more money to Wall Street.”

So here’s the real tragedy of the botched bailout: Government officials, perhaps influenced by spending too much time with bankers, forgot that if you want to govern effectively you have retain the trust of the people. And by treating the financial industry — which got us into this mess in the first place — with kid gloves, they have squandered that trust.

The problem is that the "ordinary voter" is right. How much of the $800+ billion bailout was spent wisely? How many of the so-called saved/created jobs were long term jobs? Instead of creating wealth (which creates long-term jobs) they created short-term jobs; a band-aid on the economy that was destined to expire as soon as the money did.

Opponents of the health care reform bills moving through Congress have seized on the new recommendations as evidence that the government is seeking to put bureaucrats between you and your doctor or that it would ration care by denying coverage for some mammograms that are now covered.

There is virtually no chance that any insurers, either public or private, will deny coverage to anyone based on these recommendations. Government and industry officials have said that explicitly and, in fact, every state but Utah requires private insurers to pay for mammograms for women starting in their 40s.

Somehow "virtually no chance" is not very reassuring. Answer me this: In countries where the government has become the chief insurer, has access to cancer screening increased or decreased?

Democrats' health bills depend on forcing individuals to buy insurance or face severe fines or imprisonment. In 1994, the Congressional Budget Office said forcing individuals to buy insurance would be "an unprecedented form of federal action," adding: "The government has never required people to buy any good or service as a condition of lawful residence in the United States."

This year, the Congressional Research Service delicately said "it is a novel issue whether Congress may use the [commerce] Clause to require an individual to purchase a good or service." Congress has the constitutional power to "regulate commerce . . . among the several states." But a Federalist Society study by Peter Urbanowicz and Dennis Smith judges it perverse to exercise coercion under the commerce clause "on an individual who chooses not to undertake a commercial transaction." As Sen. Orrin Hatch (R-Utah) says, there is "a fundamental difference between regulating activities in which individuals choose to engage" -- e.g., drivers can be required to buy auto insurance -- "and requiring such activities" just because an individual exists.

House Majority Leader Steny Hoyer (D-Md.) says Congress can tax -- i.e., punish -- people who do not buy insurance because the Constitution empowers Congress to tax for "the general welfare." So, could Congress tax persons who do not exercise or eat their spinach?

When asked whether any compulsory insurance purchases are constitutional, House Speaker Nancy Pelosi was genuinely astonished: "Are you serious? Are you serious?" In 1803, in Marbury v. Madison, Chief Justice John Marshall wrote, "The powers of the legislature are defined and limited; and that those limits may not be mistaken, or forgotten, the Constitution is written." He was serious.

Yes, he was serious. And so are we.