Obama Popularity

Why has Obama's popularity plummeted?  He has accomplished a great deal that is not getting talked about.  He is the victim of the press and his opponents (some racist) that keep chanting "Obama Care" is bad.  This seems to stop further thinking about actual consequences.  It reminds of Gov. George Romney whose campaign for the presidency coincided with the Vietnam War.  He went on a fact-finding mission and came back and said he had been "brain washed" by the generals.  Well, we can't have a president who can be brain washed and the press repeated this trope over and over again and Romney's quest for the presidency was over.  The press and many people did not want to know more. 
Culture is a strange animal that is hard to understand.  Words can enter the language, and no matter how misleading, they have a life of their own, albeit pushed along by opinion makers.  Why is not "Affordable Care" is easy to say as "Obama Care?"  But, then the opponents would have to admit that they simply don't want to give aid to the poor--they don't deserve it.

Drug Prices

My sense of moral outrage is being sorely tested.  While Congress is obsessed with the size of the Federal budget, the drug companies are stealing us blind.  Drug company lobbyists spend more than the defense industry. And what do they get for their money? Plenty!  Lawmakers have forbidden Medicare from negotiating drug prices.  The ”US Patient Centered  Outcomes Research Institute is not allowed to consider cost-effectiveness comparisons in its recommendations.” NYT October 13, 2013.  Importing drugs from other countries is prohibited even though they are much, much cheaper.

Health Care Act

There are many things to like in the Health Care Act.
1.Strengthens Medicare by lowering drug costs for seniors and by adding preventative services.
2. Improves insurance coverage for those with pre-existing conditions.
3. Expands coverage by allowing parents to keep their cildren on their policies until age 26.
4. Gives new options to plan and pay for long term services through a voluntary insurance program.
So why are the Republicans so rabid in their opposition? Because many of them have nice coverage through their employers and begrudge it for others. And, because it mandates that everyone must have insurance. But, one of the principles of insurance is that the base must be broad for the average needed care to be supported. This is why group plans have favorable rates.

Super Bowl and the Decline of Western Civilization

We have a society where business firms are willing to spend three million dollars for a 30-second spot on television. At the same time, local governments are hard pressed to provide police and fire protection and some say we can't afford health care for the uninsured. This is sick. I wonder what the equivalent was in the days leading up to the fall of the Roman Empire??

Public Debt Accounting

We are bombarded with media stories pointing out the calamity of a large public debt. We may not be able to grasp trillions of dollars, but we know it is ominous. Political analysts suspect that many voters in the recent election regard the public debt as immoral, and now we must pay for our sins with austerity and reductions in public services, excepting the military, of course. The fear and loathing attached to public debt is a product of poor accounting that treats all public spending as consumption. However, much public spending is a long-term investment in human capital that enhances our productivity.
When a business invests in new plant and equipment, it carries it on its books as an asset. This puts its debt into a proper perspective. The Federal government should keep its accounts the same way. This would help the public avoid misguided efforts to reduce public spending on education, health care, and scientific research.
I owe this insight to William Krehm-- (www.comer.org>

Health Care REform

There is nothing on the table now that can cover the uninsured and keep taxpayer costs reasonable. What would it take? First two key facts. About 25 % of Medicaid and Medicare funds are spent in the last year of recipients' lives. Second, the clever medical researchers will continue to invent ever more costly technologies and drugs to increase life a few more months or years. The nation must face the tradeoff between the ideal and what we want to spend. The only way that we can improve the care of those whose only option now is hospital emergency rooms is to insure them for basic medical care-- no open heart surgery, etc.
Senator Kennedy was diagnosed with cancer, and even with the best of treatment, his life was extended only a few months at a cost of hundreds of thousands of dollars. Those dollars could have paid the annual health insurance for 47 million uninsured.
There could be a list of medical procedures that simply are not available at public expense, such as is now operative in Oregon. The slogan-makers who obfuscate the unavoidable tradeoffs will throw smoke on this suggestion railing about making the the poor and uninsured second class citizens, but of course they are third class now and since few want to pay substantially more in taxes, they will remain such. Here, the unobtainable ideal is the enemy of substantial improvement. It would be nice for everyone to have the latest technology and drugs to extend their lives for a few more months. But, few including seniors during their tax-paying years want to pay for it. And, they know there is no end to ever more costly medical wonders.
Setting aside the scare words of “death panels,” these are the tradeoffs that could improve care for many and not break the bank. A public option that might reduce insurance administrative costs is a good idea, but the bitter debate over it is diverting attention from more essential tradeoffs.
If Obama is to make good on his promise to keep spending near present levels, then he must cap medicare and medicaid spending and divide the pie differently. Cover more people at reduced, less grandiose levels.