Tuesday, April 26, 2005

April 25, 2005

The Law of Unintended (Good) Consequences

No doom and gloom today boys and girls. Today I am a virtual Mr. Rogers, because our neighborhood is about to get a long overdue dose of good stuff.

We all are familiar with the bad side of the law of unintended results. Less recognized are the times when the unintended result is positive. That’s what’s about to happen. And whom can we thank? Surprisingly, George W. Bush & Co.

Yes, they finally did something right – though unintended. You still have to cut through a lot of bad sounding stuff before you find it, but the good stuff is there. It will just take a little more suffering before it arrives in full-flower.

Here are two glimmers among the muck.

Medicaid Cuts
The Bush administration and Republican-controlled congress finally has that thorn-in-their-side “socialist” program, Medicaid, in it’s sights. They are going to cut the federal share of Medicaid to states by enough to virtually kill the program in some states.

Medicare serves roughly 53 million Americans. Some states rely on Medicaid more than other. Tennessee, for example, says the federal cuts will result in more than 320,000 adults, many of them elderly, being cut. Minnesota says it will have to stop insuring 27,000 college students and adults without children.

A single mother of two who earns $3,800 a year will be considered too wealthy to qualify for Missouri Medicaid under the legislation, which is due to take effect this summer. The program pays the bills for nearly 60 percent of all nursing-home residents and finances 37 percent of all births. Because most states have added prescription-drug benefits, Medicaid covers the hefty pharmacy bills for many patients with AIDS, many transplant recipients and many seniors on dialysis or chemotherapy. The program also covers the more mundane medical expenses of low-income working families. (Full Story)

So, why is this seemingly awful news, really good news in disguise? Because things will not turn out the way pro-business conservatives in congress believe. In spite of all the evidence to the contrary, those troglodytes continue to insist that if government programs like Medicaid stop thwarting free market forces the private sector would be able to provide affordable medical insurance and services for everyone. And, for those too poor, faith-based groups would pick up the slack.

Of course that’s pure nonsense -- all of it. Private medical insurers will never insure all comers. When given a choice whom they will and will not insure, private companies will always cherry pick the actuarial pool. They will happily insure those who don't have pre-existing conditions or are statistically unlikely to get hurt or sick. Those who are likely to need medical attention will be rejected.

Many of those rejected by private insurers or too poor to afford the premiums -- I call them Americas "untouchables" -- found refuge in the state/federally funded Medicaid program.

Now, here's the ironic part -- this is one place when conservatives were right, but for the wrong reasons.

Medicaid did distort the medical free market system... by hiding its flaws. Because so many of this growing number of unisurables were picked up by Medicaid no one noticed. Medicaid provided cover for the very private insurers that refused to cover so many Americans in the first place. Medicaid has become a kind of government witness protection program for private insurers.

Let's imagine what the country would have looked like already if Medicaid were not there to hide all these people private insurers did not want. Many are elderly resthome residents, many are working poor with children, many are children. Think Calcutta -- poor mothers on New York sidewalks begging for money to get their kid an operation -- old people dying alone in stinking tenements or in the bushes of Central Park.

Oh, and remember those faith-based organizations that were going to pick up the slack, where would they be? After their charities became swamped by pleas for help these GOP-loving "people of faith,” would quickly reconsider their choice of political parties.

By cutting Medicaid conservatives are shooting themselves in both feet. The private medical/industrial complex they think they are helping will itself turn on them. You see, private companies really don't give a fig whether they get paid by an insurance company or the federal government, as long as they get paid. And, as the uninsurables lose Medicaid coverage these companies will see their own revenues drop. That in turn will create a whole new crop of socially conscious corporate born-agains demanding the government do something to cover "these poor souls."

Still waiting for that good stuff that’s supposed to come from all this Medicaid misery?

Okay, here it is. National, single-payer healthcare.

The US will be the last developed nation in the world to figure out that the private sector can do a lot of things right, but providing universal health insurance is not one of them. Only a single-payer system can (actuarially) absorb risks involved in covering everyone. No other system can. None. No way, Jose.

So, I say cut away fellas. Cut Medicaid and while you’re at it, go ahead and cut Medicare too. You know you want to, so just do it. And raise the retirement age for Social Security while you're at it. Keep those old folks in ill health AND working.

Go ahead. Frist, DeLay... I dare you. I double, double dare you.

It’s a Gas
Here’s another bad-but-good development: $3.00 - $5.00 a gallon gasoline.

As you read this President Bush is having Saudi Princes over to the ranch to beg them to pump more oil, to which our Saudi energy bosses will likely reply, “You want MORE oil?”

Even if Saudi Royal thugs agree to pump more oil gas prices will not go down but will will continue their climb towards $5 a gallon. Everyone (except those raised in Texas) understand that the whole petroleum enchalada has changed. Oil is so yesterday.

First there simply is not enough of the stuff down there any longer -- and there's millions of barrels less everyday. Then there's China and India. Both those over-populated nations have recently bellied up to the oil can demanding their share. Their industries gobble more energy every day. So do their people who want cars and other power-consuming goodies westerners have enjoyed for a century.

Joke's on them. They got to the party late and the key is about to start pumping pure foam. The jig is up for petroleum-based economies. There are maybe ten years left before everyone will have to come up with a new way to run all that stuff.

But conservatives have spent so many years convincing themselves that alternative technologies and fuels were formulas for economic disaster that the only solution they can imagine is to look for more of the black stuff. They remind me of heroin addicts cut off by their supplier. What do they do? Quit? Forget about it. They head straight out to search for a new supplier willihg to pay whatever to keep their feelgood juice coming -- even though they know the stuff is going to eventually kill them.

Gasoline and natural gas prices continue to climb. As they go up and stay up, alternative fuels and technologies will become increasingly attractive. Suddenly automakers, who have claimed for years they had no alternatives to the gasoline engine, will put more electric and fuel-cell cars on the roads. Traffic-chocked US cities will begin to look more like European cities as commuters turn to public transportation or ride thrifty and easy-to-park scooters to work. Neighborhood roofs start to sprout solar panels that convert each home from a power-parasite to a power-producer.

So here again the conservatives had it half-right. Free markets really do work if allowed to do so, just not the way they think. Once the real costs of oil – production costs, scarcity and environmental – are accurately reflected in its price, that price will become too high to bear. When that happens markets move to the next acceptable and sustainable alternatives, and that will not be oil. (Bonus! Saudi Princes will have to either find something new to pimp to the West or go back to herding goats. Poor goats.)

So, patience my friends, patience. Twenty five years from now we may look back at the years 2000 to 2008 as a turning point. And, Bush's policies as the best thing to happen since the last time free markets kicked the props out from under a fraudulent American Dream-fa├žade -- the Great Depression.

Sure there was great suffering during those hard years. But, look what grew from that learning experience -- Social Security, Medicare, Medicaid, and a social conscience.

I have said for months now that you simply can not tell right-wingers anything. Nuance confuses and annoys those folks. So, you have to show them. The fall out from Medicaid cuts, attempts to gut and cripple other social programs like Social Security, and soaring energy costs will show them.

Then, and only then, will they get it. Then and only then, will we get the kind of government Americans really deserve.

Seton Sighting
"I should be packing boxes and moaning about throwing out what I’ve been carrying around for more than two decades, but I’m giving in to the need to use another part of my brain and comment on some of the news stories that have swathed the wires of late." (Full Tale)

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