Wampum

Reasons for Optimism

I noted in a previous post that I was cautiously optimistic about John Kerry’s chances to unseat George W. Bush in the fall. That optimism was based, in part, on the current national polls showing Kerry with a small lead. In addition, I noted that undecided voters are likely to break for the challenger. The fact that most of the undecideds are women made me more optimistic.

Jay Caruso thinks optimism for Kerry’s chances is misguided, arguing that Kerry should be up 8-10 points in the polls. Over at Real Clear Politics, J. McIntyre also thinks Kerry’s chances are overrated:

Now, maybe these people are looking at something different than what I'm looking at, but I just don't see all of this positive news for John Kerry. I see a President that has had a hostile, partisan press beating up on him relentlessly for months now hoping they can drive his job approval into Jimmy Carter territory still standing strong in the high 40's.

I see a Kerry/Edwards campaign that should be ahead today by at least 5 points nationally tied in the polls. I see a lack of appreciation among Democrats and the press for just how unappealing a candidate they are about to nominate.

I would be a lot more optimistic if Kerry had the 8-10 point bulge mentioned by Jay or even the five point spread McIntyre thinks is appropriate. Nonetheless, I prefer a small lead over a deficit any time.

There are a number of reasons for my optimism other than the national polls. For instance, the polling in battleground states seems to favor Kerry. Please consider:

* Larry Sabato’s Electoral Road Map has Kerry leading in every state Gore won in 2000, as well as in West Virginia, New Hampshire, and Nevada.

* The Electoral Vote Predictor has Kerry ahead in all of the Gore states as well as Nevada, Arizona, New Hampshire, Missouri. It also has Kerry even in Tennessee. Tennessee!

* The Election Projection also has Kerry holding all of the Gore states and has him leading in red states such as Florida, Ohio, Nevada, and New Hampshire.

* McIntyre’s own Real Clear Politics has an excellent compilation of polls from seventeen battleground states. That page links to more than ninety polls. George Bush cracks fifty percent in exactly four of the polls. An incumbent polling under 50% is in the danger zone.

* Professor Sam Wang of Princeton has a model to predict the current electoral chances of each candidate based on recent state polling. If the election had been held last Monday, Wang calculates that Kerry would have had an 85% chance of victory (Quick, hold the election tomorrow. The terrorists will not have time to disrupt it.).

Secondly, Kerry and the Democrats seem to have the political momentum. For instance:

* Bloomberg reports:

Kerry … leads 47 percent to 41 percent in states where the November election is likely to be closest, Pew said on its Web site. Bush led Kerry by as much as 11 percentage points last month.

* Betsy R. Vasquez, writing in the Moderate Independent, reports the following:

According to American Research Group's (ARG) Dick Bennett, things are moving in Kerry's direction, in particular in the all-important battleground states.

We asked Mr. Bennett if would it be accurate to say that there is no battleground state in which Kerry is trending negatively. Mr. Bennett agreed that is the case with regard to the states ARG has been tracking. He attributes Kerry's positive movement to three things.

Mr. Bennett told us, "Kerry has benefited by (1) a shift of independents to him from Bush, (2) becoming stronger among Democrats so that he runs about the same among Democrats as Bush runs among Republicans (and this give Kerry a slight advantage because there are slightly more Democrats), and (3) some softening among Republicans in Kerry's favor."

* As Kos notes, Democrats are three for three in Special Elections for the House since 2002.

* The Democrats seem to have offset some of the traditional GOP fundraising advantage.

Third, George W. Bush has failed to make inroads with Hispanics, despite a four year effort undertaken by Karl Rove. Perhaps the more important point is that Bush has lost ground with Florida’s Cuban-American voters. As Barry Ritholtz of the Big Picture writes:

Cuban American voters in Florida continue to be a potential problem for President Bush in the upcoming election.

Not in the sense that incumbent won’t garner a majority of Cuban votes cast in Florida; He is presently polling somewhere between 60-65% of Floridian Cuban Americans. But compare those numbers with the 82% of this voting bloc Bush won in the 2000 election.

A near 20% drop in support in a demographic representing 400,000 voters in a crucial state represents a swing of potentially 80,000 votes. That’s quite significant in a state the President won last time around by a mere 537 votes.

Fourth, Bush has lost support since his post 9/11 surge. It is more difficult to regain a vote that one has lost than to persuade a voter who has never had an opinion.

Finally, there is the point made by Slate’s Chris Suellentrop:

Even a casual viewer of Hardball knows that the first rule of an election that involves a sitting president is that it's a referendum on the incumbent. This election, however, has turned out to be the opposite. It's a referendum on the challenger. Kerry probably isn't responsible for this turn of events, but he's benefiting from it: The referendum on the incumbent is over. President Bush already lost it. This presidential campaign isn't about whether the current president deserves a second term. It's about whether the challenger is a worthy replacement.

J. McIntyre’s argument is that Bush is in pretty good position because the voters are likely to find Kerry unacceptable. Maybe so, maybe not.

I am optimistic because George Bush has in fact lost the initial referendum. Lyndon Johnson lost the incumbent referendum and withdrew. Richard Nixon won the referendum and was reelected. Jimmy Carter lost the referendum but remained close until the voters decided that Reagan was acceptable. George H. W. Bush lost both the incumbent referendum and the election. Ronald Reagan won the incumbent referendum and had a second term. So did Bill Clinton.

Where is the example of an incumbent who lost the referendum but won reelection because of the failure the other candidate? Other than perhaps Harry Truman, it seems that incumbents who lose the referendum lose the election.

That makes me optimistic.

Oh Vunderbar, lets him and him fight (again)

Picking on that bastion of high-minded reportage ... el WaPo, we have in today's copy this

US-appointed interim Iraqi Defence Minister-Puppet Hazim al-Shaalan warned of invading Iran if it did not stop interfering in his country's internal politics. "I've seen clear interference in Iraqi issues by Iran," the Minister-Puppet said in an interview with The Washington Post in Baghdad on Monday.

So, what country offered to hold Muqtada al Sadr in safe keeping until a real Iraqi court could try him for the offenses charged (murder 1), effectively ending in mid-April the Seige of Fallujah, in the full light of day, and paid for it with the assassination of a senior member of its diplomatic staff in Baghdad? Even the Texas Daily Online carried that story, but not a mention from our heros at the incomperably upmarket WaPo. The answer is worth 50 US KIA, and 250 US wounded, and half the butcher's bill among the hostiles and the collateralized civilians.

What country has been targeted by several thousand irregular forces stationed in Iraq, and now temporarily held in Camp Ashraf? As recently as a week ago David Ignatz wrote about this in the WaPo. Again, no corrolation from our brave heros at the incomperably upmarket WaPo.

What country has been openly putting money and intelligence operatives in Iraq since the Fall of Baghdad, South, Central, and North? Hardly a state secret, and again, no corrolation from our brave heros at the incomperably upmarket WaPo.

Note: The hyphenation "-Puppet" did not actually appear in the original WaPo copy.

Note also: Any blogger who can prove that s/he has pied (or poured a drink on) any WaPo gliteratti in the next five days either in the Fleet or at a hospitality gig wins a year of hosting at Wampum's facility in Bangor, Maine. Cream is preferred, but key lime will also do just fine. We'll pick up the tab on the pie too.

You may have already won ...

True to form, the WaPo is taking this moment to attempt to transform bloggers blogging about real lives lived and politics participated in, or observed by, card-carrying non-members of the punditocracy, into a "spontanious" WaPo media event. Which blogs go better with a red tie, which go better with a blue tie, and which go better after you've tied one on. Wow! A contest!

Sack races for embeds, now that would be fun to watch.

in media res (redux)

The most effective press critique of the regime is the one you come back to daily. A Krugman editorial once a week at the Gray Lady simply doesn't cut it. A fawning whoever-is-in-power at the WaPo simply doesn't cut it. Wire service rewrites of administration press releases in all the second tier outlets -- your daily paper -- simply doesn't cut it. Getting lucky once each war in a monthly with Seymor Hersh is simply not enough.

There is one media outlet that has been onto the moronitude of the Bremmer-phase of the Occupation of Iraq. If more Americans had access to this media outlet, MoveOn.Org's DVD distro last Fall on the Iraq War would not have been "news". Michael Moore's indy distro this Summer on the Iraq War would not be "news". People would not have to read Juan Cole for news that simply isn't available elsewhere, or to decode what passes for news that does make it everywhere.

Al Jazeera was thrown out of the NYSE for its "irresponsible" coverage of Bush's War on Iraq. Al Jazeera was rocketed in Baghdad for its coverage of Bush's War. During the fantastically stupid Seige of Fallujah, getting the AJ film crew tossed out of Fallujah managed to be high on Bremmer's list of non-negotiables.

In a nutshell, if the American people have a "friend" anywhere in the media world, and we know it isn't CNN or MSNBC or ... or Eric Altman wouldn't have had a book to write and about a thousand blogs wouldn' t have Nidra Pickler and Bob Novak and ... to kick around, then it, this friend, is Al Jazeera. A flater mirror, or at least one that distorts differently, to hold up against the sea of sameness, mirrors that make small men seem large, and better men seem worse. Or, we could just open up or turn on the Daily Fruit Cake and read-or-watch-as-revealed-truth whatever the NeoCons in the Oval Office, Defense, Justice, and the Treasury (gack!) have to say about things going swimingly in Iraq.

Today Al Jazeera reports that its Fleet Center skybox banner had been replaced with "Strong for America".

I watched John Kerry's baby handling in Ohio yesterday. He'd a six month old boy, size large, and interested in the clip-on-tie mic to manage and he did so quite well for more than a nominal moment of time. John's technique on-camera meets this father's is-he-comfortable-with-children measure, but that's not the only point. The boy's father had told John Kerry how he, an American Muslim, felt about the marriage of theology and politics under the current Bush administration. John promissed that his administration would change this, that he would make that father less afraid for his sons' futures, replace Ashcroft, etc. The great chain of being that runs from "no lynchings of American Muslims" to "no lynchings of Arab satellite media outlets" has so few links any child who can count can count them.

Last Spring I wrote here, quoting defenselink.mil

Mark Kimmitt called Aljazeera, and other Arab media outlets the "anti-coalition media" and advised viewers to "change the channel". He was joined by John Abizaid, who said "It is always interesting to me how Al-Jazeera manages to be at the scene of the crime whenever a hostage shows up or some other problem happens to be there."

Pity he's not eager equal their competency on the ground.

It's now mid-July. What media outlet do you think equals their competency on the ground in Iraq? Its not a question you have to answer, at least not on the record, but it is one I suggest you think about. More Mainers are likely to get killed or wounded in Iraq, carrying out some absurd "looking for WMD" detail, or some horribly pathetic excuse for leaving children and life itself behind, like the last Mainers killed or wounded in Iraq, their lives and limbs wasted to maintain RNC media messages -- that WMDs exist, that the War wasn't the work of idiots, liars and madmen. The "responsible" media continues to hump the wooden leg that getting blown up while looking for weapons of mass distruction is a patriotic duty sane men and women should seek, at least through November, but discreetly off-camera.

Support our troops. Change the channel. Switch off Kimmett, Abizaid, Bremmer, and above all, Bush.

Half Full - National Polls

Are you a political optimist or a political pessimist? I am by nature a political pessimist. Growing up and living in the South, I have been a first hand witness to the slow erosion of the Democratic Party. I suppose that may have colored my view of things.

As we approach the Democratic convention, how is the Presidential race going? Is the information now available to us sufficient to turn a natural pessimist into an optimist? To answer that question, a number of factors should be investigated. This post will focus on the national polls.

There is plenty for both the optimist and pessimist to see in the national polls. The optimist sees that John Kerry has retaken the lead in the Rasmussen tracking poll. The pessimist sees that only a few days ago, George Bush had the lead.

The optimists will note that Kerry leads in a number of national polls:

The USA Today/CNN/Gallup poll has Kerry with a one point lead in a three way race (47-46-4);

The LA Times poll has Kerry up 2 in both a three way and two way race (48-46 and 46-44-3);

Political Wire reports that an Investors Business Daily poll has Kerry up three or two (44-41 in a two way match-up and 42-40-4 in a three way);

The Pew poll (46-44-3) has Kerry up two;

The Marist poll has Kerry up one regardless of whether “leaners” are included (45-44-2 and 47-46-3 with “leaners” included); and

The CBS/NYTimes poll has Kerry up five (49-44).

The pessimist notes that President Bush has a small lead in both the Fox News poll (even without Nader) and the NBC/Wall Street Journal poll.

The pessimist will also be aware that despite months of bad news and years of poor performance by the President, John Kerry has been unable to open a lead outside the margin of error in any of the polls.

The optimist, however, looks at the internals of the polls and sees that much of the country thinks we are on the wrong track, that the President has a negative net approval rating and that the public is not enamored with Bush’s positions on the issues.

In the end, the national polls look half full to me. There are a couple of reasons for that. The first is that President Bush seems unlikely to win a majority of the remaining undecided voters.

That reason is best expressed by Charlie Cook:

The 45-45 percent tie, with each candidate fluctuating about three points up or down from that point, has been with us since April, though beneath the surface there have been some shifts. While some polls have shown Bush's approval rating on handling the economy to have improved a bit, those gains have been offset by a comparable decline in his approval ratings on handling foreign policy, the war in Iraq and even, to a lesser extent, terrorism.

Last week in this space, I discounted the widely held view that the knotted polling numbers between Bush and Kerry meant that the race itself was even. I argued that given the fact that well-known incumbents with a defined record rarely get many undecided voters -- a quarter to a third at an absolute maximum -- an incumbent in a very stable race essentially tied at 45 percent was actually anything but in an even-money situation. "What you see is what you get" is an old expression for an incumbent's trial heat figures, meaning very few undecided voters fall that way.

A recent survey by Republican pollster Tony Fabrizio (Fabrizio, McLaughlin & Associates: July 6-7, 1,000 likely voters in 19 battleground states), underscores my point. Fabrizio's poll shows that undecided voters in those states have more pessimistic views than all voters in those states. Just 23 percent of the undecideds say the country is moving in the right direction, compared with 40 percent overall. And just 21 percent say the economy is in excellent or good shape, compared with 33 percent of all voters in those states. Those who are undecided are also slightly more apt to disapprove of the job Bush is doing as president, 46 percent to 40 percent.

This is certainly not to predict that Bush is going to lose, that this race is over or that other events and developments will not have an enormous impact on this race. The point is that this race has settled into a place that is not at all good for an incumbent, is remarkably stable, and one that is terrifying many Republican lawmakers, operatives and activists. But in a typically Republican fashion, they are too polite and disciplined to talk about it much publicly.

In a funny way, if this race were bouncing around, it would probably be a better sign for President Bush. It would suggest that there was some volatility to the race and that public attitudes had not yet hardened, and were thus still an eminently fixable situation. The dynamics of a presidential race usually do not change much between July and Election Day. This year, however, the race is much more stable than usual, which is ominous for an incumbent under these circumstances. The bottom line is that this presidential race is not over, but the outlook is not so great for the players in the red jerseys.

The argument that the undecided voters in battleground states are likely to break against Bush is underlined when we consider the gender of those voters. Most of those voters are women. As Common Dreams reports:

Women outnumbered men among undecided likely voters in a number of national polls released recently, including:

-- Women are 65 percent of undecided voters nationwide, according to the George Washington University's Battleground 2004 Poll conduced June 20-23 (n equals 1,000) by Lake, Snell, Perry || Associates and the Tarrance Group. See: (here).

-- Women make up 58 percent of swing voters, according to a June 3-13 survey conducted by the Pew Research Center for People and the Press (n equals 1,426). Swing voters in the survey are defined as registered voters who are either undecided or have said they may change their mind about who they will vote for in the presidential election. See (here).

The gender gap among undecided voters extends into key battleground states:

-- In Pennsylvania, women are 57 percent of the undecided voters, according to a Quinnipiac University Poll of registered voters (n equals 1,577) conducted July 6-11. See (here).

-- Similarly, women are 57 percent of undecided Florida voters, according to a July 13-15 American Research group poll (n equals 600 voters). The firm found a similar gender gap among undecided voters in other battleground states including Michigan (where 62 percent of undecided voters are women), New Mexico (69 percent undecideds are women), and West Virginia (70 percent are undecideds women). See (here).

Having the fate of the election in the hands of undecided women makes me optimistic. Even a pessimist like me is compelled to see the national polling data as half full.

Posted by Dwight Meredith at 05:08 PM | Comments (2) | TrackBack (0)

Maine's ISPs

Two weeks ago I attended what I suppose must be the founders meeting of the Maine ISP Association in Hallowell, just outside of Augusta. One of the issues that I mulled over during the drive up was cable. How do Maine ISPs get access to monopoly physical infrastructure, the basic CATV plant of the municipal video franchisee, whether TimeWarner or Adelphia? How do monopoly municipal franchise "cable broadband" ISPs, co-exist with ISPs offering "dsl broadband", both serving the Palesky-benefiting (southern, lakes, and midcoastal) Maine, or ISPs offering location-indifferent or independent telephone service area restricted dial-up access, and looking to enter those rich monopoly cable markets?

A simple rich-and-poor question, where wealth is created by walls and a history of walls, and the poor would like to raze, or at least lower, the walls, now and in the future. Nothing complex at all.

As it turned out, it really was just Maine ISPs, so the Atlanta and Philidelphia metro franchise and cable plant management companies were absent. It was just a DSL ISP, a big dial-up ISP, and a bunch of small dial-up ISPs, and me. Wampumpeag isn't an ISP. ISPs are our customers, as are hosting companies, bloggers, political campaigns, and anybody or anything that acquires a domain name.

Some hard questions: Should "virtual" ISPs be allowed to join? Should TimeWarer/AOL and Adelphia and Earthlink and Verizon and SBC and ... be allowed to join? Are they facilities based? Are they incorporated in or doing 50% of their business in Maine?

We didn't decide anything, and we comprised something less than most of the 40 or so ISPs that serve Maine, but we got closer to agreement on what the by-laws should be.

Now the reason for this self-serving post is this -- the DSL ISP put its key public policy goal on the table -- a word added to Maine's basic law.
Old

It shall be the policy of Maine to offer internet service everywhere, etc.

New

It shall be the policy of Maine to offer broadband internet service everywhere, etc.

Earlier in the primary cycle I wrote on Lawrence Lessig's blog on the problem Howard Dean's "technology policy" posed. In a nutshell, Dean's policy was broadband-everywhere, wireline and wireless. I won't repeat what I wrote on Lawrence's blog, other than the nutshell of both are suburban delivery systems (race and class), wicked expensive (worldcom bailout), and kept the spam-stupidity-and-cupidity model of the net unchanged. More turds via fatter pipes.

Now the importance of a comment on a blog, even one like Lessig's, is close to zero. It was interesting that one of my technical peers, who is to the far right of Ghengis Khan politically, was on the same page on the feasability of wireless as the rural half of the national broadband service plan and just as sanguine about the economics of the wireline broadband. Still, even two comments, one by (I'll omit my quals), and one by a co-inventor of the wireless technology, amounts to two dry beans when set against the charisma and hunger for change of Dean and the Deaniacs of last Fall.

Where this became more substantial was ironically via the Triballaw list. A sublist was set up, and I ended up spending hours pounding the keyboard on technology issues, starting from my critique of Dean's tech policy and reaching out as if I ran DARPA's ISTO and Commerce's NIST and could put in place the change from mutual assured de-industrialization with China and India to something mutually beneficial.

Other TLers wrote on this and related subjects. A TL contributor at Berkeley put our product in the hands of former Secretary Reiche, who teachs at Berkeley, and who also advises John Kerry on economic issues. Whatever became of our product I've no idea.

I don't expect much. A Maine ISP Association could allow TimeWarner et al, and Juno and the other New Jersy modem pool virtualized business models to join and vote just as if they were facilities-based with 50% of their business in Maine (or New Hampshire or Quebec and the Maritimes), in essense "local". It could also not, and leave TimeWarner and Verizon as "foreign" and above all, monopoly exploiting predatory corporations, and "free" or sub-cost virtual gambits like Juno, to form their own non-Maine ISP association.

Sometime the FCC may hold a locality public hearing in Portland. If they do so, I'll submit comment on the banality of TimeWarner's generic basic cable news-and-entertainment product, and the banality of AOL's generic internet (sort of) access product, relative to the vibrant culture of Maine's low-power radio and low-cap dial-up ISP access products.

Oh. This week I was recruited to participate in a bid to take .net away from Verisign Global Registry Services. This is, at its bottom, a very politicaly activity. The DoC regulates ICANN, sort of. On some issues. If Bush wins in November, in March the ICANN BoD might decide that the monopoly incumbant is the best choice for "competition", rather like the Powell FCC has selected the ILECs over the CLECs on key regulatory issues. If Kerry wins in November, in March the ICANN BoD might decide that the monopoly incumbant is the not the best "competitive" choice, and neither is the monopoly local number portability operator NeuStar, and offer 4.7 million domain name customers to one of the better competing technical and management teams.

Hope springs eternal. I bid .biz (won), .us (won), .org (lost), .cat (Catalonia, not "meow", pending) and some day I'll bid .naa, a pan-tribal sponsored top-level domain. Now I need to go fix a technical problem I caused that has freed the academics, tribal judges and practitioners, law students, and chiefs like my spouse for a brief holiday from Federal Indian and First Nations Law.

Flashback Friday

AT IRAN-CONTRA TRIAL, KERRY SAYS CIA SPYMASTER LIED TO CONGRESS
Steve Power, Boston Globe contributing reporter
July 25, 1992

WASHINGTON -- The US government fired the opening salvo in its case against Clair George yesterday with more than three hours of testimony from Sen. John F. Kerry, who accused the former CIA spymaster of lying to Congress about his knowledge of the Iran-Contra affair. As the prosecution's lead-off witness, Kerry told a US District Court jury that George lied during an October 1986 appearance before Congress when he told the Foreign Relations Committee he did not recognize the name Max...

WHAT BUSH KNEW -- AND WHEN
Boston Globe Editorial
July 21, 1992

The release of previously classified intelligence documents on Saddam Hussein's procurement of weapons before his invasion of Kuwait validates the House Judiciary Committee's request for a special prosecutor to investigate possible lawbreaking by top officials of the Bush administration. Meanwhile, the administration's public relations campaign in defense of its actions does nothing to diminish the need for an impartial investigation...

RECOVERY MAY COME TOO LATE FOR BUSH
Hobart Rowen, The Washington Post
July 26, 1992

Sen. Donald W. Riegle Jr. (D-Mich.) pointed out during the [Alan Greenspan] hearing that real per capita income has declined over the entire three years of the [Bush] administration, the first time that has happened since the Hoover Depression days.

Sen. Paul Sarbanes (D-Md.) said after the Senate Banking Committee hearing: "We've got a serious situation here, but Bush and Greenspan are singing from the ...

FACING PRESSURE, BUSH IS ADAMANT ON KEEPING QUAYLE; A FLURRY OF SPECULATION
R.W. APPLE Jr., Special to The New York Times
July 23, 1992

WASHINGTON, July 22 -- With pressures mounting within his own party for further measures to revitalize his re-election campaign, President Bush denied today that he was even considering the possibility of replacing Vice President Dan Quayle....

FOR BUSH, A HIGH-RISK RESPONSE
Mary Curtius, Boston Globe
July 25, 1992

WASHINGTON -- As he edges closer to another military confrontation with Saddam Hussein, George Bush is acutely aware that its outcome could either boost his sagging political fortunes or hand him a humiliating defeat. A president traditionally benefits from looking decisive on the world stage.

But senior administration officials insist that Bush fears the domestic political fallout if this confrontation results in anything less than Iraqi capitulation to the Security Council's...

U.S.-SAUDI LINKS REPORTED
Special to The New York Times
July 21, 1992

WASHINGTON, July 20 -- Government papers show that the United States and Saudi Arabia have cooperated extensively on oil marketing matters for many years, The Washington Post reports in its Tuesday issue. Such a relationship has been widely assumed to exist, although the countries have long denied it...

DOW TUMBLES IN ANOTHER SHARP LOSS
The Washington Post
July 21, 1992

It was the second straight session in which stocks fell sharply. When IBM came out with weaker-than-expected earnings Friday, the Dow fell 37.01 points. IBM continued to slip today, losing 2 1/8 to 92 7/8 and topping the Big Board actives list.

Wall Street's bearish mood was further soured by sharp losses in London, Tokyo and Frankfurt. Japanese stocks sank 4 percent, German issues lost ...

U.S. WAS AWARE THE IRAQIS WERE BUYING TECHNOLOGY
By Elaine Sciolino, The New York Times
Juyl 22, 1992

WASHINGTON, July 21 -- A year before Iraq's invasion of Kuwait, American intelligence agencies had amassed evidence of President Saddam Hussein's vast network set up to buy Western military technology, including an Iraqi-owned front company based in Cleveland, according to documents disclosed today by Representative Henry B. Gonzalez, a Texas Democrat...

There's more: Continue reading this post...

Posted by MB Williams at 06:42 AM | Comments (0) | TrackBack (0)

Webster Hubbell, Defensive Medicine, and Health Care Costs

I can think of no member of the Clinton administration more deserving of scorn than former Associate Attorney General Webster Hubbell. Hubbell ended up in jail but his conviction had nothing to do with his performance at the Justice Department or with anything related to Whitewater. Hubbell went to jail for the worst offense a lawyer can commit. He cheated his clients. You can find Hubbell’s plea agreement here.

Hubbell's technique for cheating his clients was not even particularly sophisticated. He ran up hundreds of thousands of dollars in personal expenses and then billed his clients for those expenses, falsely claiming them to be case related. While that may not be a particularly complex scheme, it is particularly despicable.

At the core of the relationship between a lawyer and a client is the idea that the lawyer will promote the interests of the client. When a lawyer puts his own financial gain ahead of his duty to a client, he disgraces not only himself, but also his firm, and the entire profession. I have no use for lawyers such as Hubbell. Disbarment, jail time, as well as personal and professional disgrace are completely appropriate in such cases.

In a round about way, that brings me to the subject of health care costs. The John Kerry web site, citing information from “2000 MEPS Data from the Agency for Healthcare Quality Research projected forward using KFF National Premium Increase” notes that the cost of health insurance for American families has risen from $6,772 to $9,549 over the last four years. Reducing the cost of health insurance has become a big issue.

The centerpiece of the Bush/Cheney proposal to reduce the costs of health insurance is to limit non-economic damages in medical malpractice cases to $250,000. It is obvious that the direct savings from such a proposal would do little to reduce health care costs.

According to the Congressional Budget Office the cost of the entire medical malpractice tort system is about $25 billion. Not even Dick Cheney wants to eliminate all of those costs. As the Vice President said recently:

Obviously, we want to preserve the right of people who have legitimate grievances to be able to go to court and address those grievances. That's as it should be. Nobody is suggesting that somebody who has been harmed by a serious breach of medical ethics, or somebody -- a doctor who has made a serious mistake, that an individual patient shouldn't be compensated for those errors.

According to the CBO, about the best we can hope for in direct savings from a damages cap is a reduction of about half of one percent in health care costs. That would save American families less than $4 per month.

The Bush/Cheney idea is not just to get savings from a direct reduction in costs of the tort system but also to change the way doctors practice medicine. The Republican idea is that limiting damages for pain and suffering will reduce the practice of defensive medicine.

Vice President Cheney defines the practice of defensive medicine as ordering tests or procedures that provide no health benefit to the patients in the hope of avoiding or defeating a malpractice suit. He says:

They'll do everything they can in terms of ordering up tests, whether you need them or not, because they're thinking not necessarily about treating the patient, they're thinking about the pending lawsuit.

The Bush/Cheney argument is that a cap on non-economic damages will reduce the incidence of defensive medicine and save $60+ billion per year in health care costs. That argument is predicated on two assumptions. The first assumption is that there is a lot of defensive medicine being practiced. The second is that a cap on damages will result in a reduction of such practices.

I do not think that a cap on damages is likely to result in significant reduction in defensive medicine. That belief results from my having a very different view of doctors than Bush/Cheney.

My experience with doctors in my family, the doctors who have treated me and my family, and the doctors that I know socially leads me to believe that doctors take the Hippocratic Oath seriously.

The Modern Version of the oath includes the following:

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

Defensive medicine is prima facie overtreatment and, therefore, a violation of the Hippocratic Oath. President Bush and Vice President Cheney may think that doctors routinely violate their oath, but I do not.

Secondly, I believe that doctors, other than a very small minority, abide by a far higher ethical standard than Webster Hubbell.

Defensive tests and procedures are ordered for the benefit of the doctor (to prevent his financial exposure in litigation) and not for the health benefit of the patient (which, by definition, is zero). They are, therefore, expenses of the doctor and not the patient.

It would be completely appropriate for a doctor to raise the price he or she charges for services that benefit the patient and then pay for tests and procedures ordered for the doctor’s benefit out of his or her own pocket (after obtaining informed consent from the patient, of course).

What is not appropriate is for a doctor to order a test for his own financial protection, fail to inform the patient that the test or procedure is of no health benefit, and then bill the patient (or the patient’s insurer) for the expense.

Webster Hubbell went to jail for incurring expenses that benefited him personally, falsely representing that they were expenses of the client, and then billing the client for such expenses. I see no important distinction between Hubbell’s cheating of his client and the practice of purely defensive medicine. A doctor billing the patient for the personal expenses of the doctor is cheating his patients just as surely as Hubbell cheated his clients.

George Bush and Dick Cheney may believe that most doctors operate at Webster Hubbell’s ethical level but I do not.

My belief that the vast majority of doctors abide by the Hippocratic Oath and operate at a higher ethical level than Webster Hubbell leads me to the conclusion that there is not a large pot of money to be saved from eliminating defensive medicine.

Of course, I might be wrong. Perhaps Bush and Cheney are correct in their assessment of doctors. Perhaps doctors do routinely violate the Hippocratic Oath and have no qualms about defrauding their patients. In that event, would the Bush/Cheney proposal eliminate a lot of defensive medicine?

I see no reason why it would. Under the Bush/Cheney proposal, doctors would still be liable for malpractice claims. They would still be called to account for unlimited damages for health care expenses and lost wages caused by negligence. They would still be liable for pain and suffering up to $250,000.

If doctors continued to order unnecessary tests and procedures, they would still be paid for those services. The Bush/Cheney view is that the doctors are quite willing to ignore their oath and commit massive fraud in order to gain financially. Why would a cap on non-economic damages in malpractice cases change their character?

Edit: Usage errors fixed. Spelling changed.

Prof. Hashem Aghajari

Overnight the retrial of Hashem Aghajari concluded. This time the offenses charged and the guilty verdict brought the penalty down from death to three years (with credit for two years time served) and post-release civil penalties. I wrote about his case in the context of the run-up to the elections in February:

I spent part of yesterday evening reading From ijtihad to wilayat-i faqih: The Evolving of the Shi’ite Legal Authority to Political Power by Abbas Amanat. The "why" is unimportant, though the proximal cause was looking up the press coverage on Professor Hashim Aghajari ...

That's from Part IV of my Iran series. See Al Jazeera for coverage of the re-trial. The AP and Reuters both have comperable copy that has been picked up by some media outlets.

I'm not the only one in East Blog-i-stan to be concerned that a US-Iran War is in the making. Juan Cole's blog, Informed Consent, has Iran in Bush's Sights, which I recommend highly. Wampum's readers are not monkeys who merely imitate, but following the links will expand one's education, so that our readers will not need the linking teacher. That is a redaction of the opening quote that twice cost Hashem Aghajari his life-in-law, and reading Abbas Amanat is highly recommended.

Changing The Tone Update

Number 8 on the Top Ten Ways To Change the Tone In Washington (For the Worse) is Try To Have Political Opponents Arrested.

Dan Froomkin at the Post’s White House Briefing points us to a piece in the Post Crescent for an example from Wisconsin:

Outagamie County Supv. Jayson Nelson might be new to politics, but he already can attest to the price of freedom of speech.

Nelson, who joined the County Board this year, said he got bounced from the VIP list for President Bush’s speech Wednesday at the Resch Center in Ashwaubenon because of inappropriate attire…

Nelson said he was ejected after being caught sporting a T-shirt endorsing the presumptive Democratic presidential nominee, though he said it was fully hidden beneath a heavy cotton button-down shirt…

[T]he female election worker who singled Nelson out snatched the VIP ticket from his hand and called for police, he said.

“Look at his shirt! Look at his shirt!” Nelson recalled the woman telling the Ashwaubenon Public Safety officer who answered the call.

Nelson said the officer told him, “You gotta go,” and sternly directed him to a Secret Service contingent that spent seven or eight minutes checking him over before ejecting him from the property.

Changing the tone for the worse, each and every day.

Say What?

The Post:

Sen. John W. Warner's office acknowledged yesterday that the Virginia Republican arranged for religious activists to use a Senate office building last March for a ceremony in which the Rev. Sun Myung Moon declared himself the Messiah and said his teachings have helped Hitler and Stalin be "reborn as new persons."

Did we really want them back?

A Denny Special

What makes House Speaker Dennis Hastert such a special politician?

The New York Times carries a story that may help answer that question.

Hastert met with 9/11 Commission Chair Thomas Keane and Vice Chair Lee Hamilton about the forthcoming report of the 9/11 Commission. What did they talk about? Not much, according to Hastert:

Mr. Hastert said that during the briefing on Tuesday the commission's chairman, Thomas H. Kean, a former Republican governor of New Jersey, and its vice chairman, Lee H. Hamilton, a former Democratic member of the House, did not offer a detailed summary of the report or its conclusions. "The report's not printed yet," Mr. Hastert said. "We didn't go into detail on content."

How does Hastert intend to use the report? Non-politically, of course:

"One of the things I've said all along is I would hope that this wouldn't become a political football," he said. "I think we ought to take the information in this report and move forward - and how best to reorganize intelligence, if we need to do that."

One might suspect that Hastert would have nothing further to say. But then, Denny would not be so special.

Hastert had to add one comment about a report that he hasn’t read after a meeting in which the report's contents were not discussed so as to make sure the report did not become a political football:

After their briefing, Speaker J. Dennis Hastert and other House Republican leaders held a news conference at which they suggested that the report, which is scheduled to be made public on Thursday, would show that intelligence and law enforcement failures before the Sept. 11 attacks were more the responsibility of the Clinton administration than of the Bush administration.

"The report covers eight years of the Clinton administration and eight months of the Bush administration," Mr. Hastert said...

That is what makes Denny such a special politician.

Big Savings

The Washington Post reports on a Dick Cheney speech in which he blames rising health care costs on medical malpractice suits:

Vice President Cheney, with a swipe at his Democratic trial-lawyer counterpart, yesterday blamed rising health care costs on "runaway litigation" and promoted a $250,000 cap on medical malpractice awards as the central tenet of the White House program to improve access, affordability and quality of care…

"This problem doesn't start in the waiting room," Cheney said in remarks released by the campaign. "It doesn't start in the operating room. The problem starts in the courtroom."

With lawsuits on the rise and multimillion-dollar awards making headlines, physicians and many Republicans say limiting damages is the solution to the broader challenges confronting the U.S. health system.

Would tort reform significantly lower health care costs?

The Congressional Budget Office does not think so. CBO approached the issue by looking at the experience of states that have enacted tort reform legislation. So far, the CBO has been unable to find any such savings:

CBO could find no statistically significant difference in per capita health care spending between states with and without malpractice tort limits.

Let’s assume, however, that tort reform would reduce malpractice premiums significantly, say in the range of 25-30%. If that reduction actually happened, would it lead to significantly lower health care costs? CBO says it would not.

Savings of that magnitude would not have a significant impact on total health care costs, however. Malpractice costs amounted to an estimated $24 billion in 2002, but that figure represents less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small. (Footnotes omitted).

Let’s further assume that the health insurers would pass all of the savings along to the consumer (a fairly dubious assumption). Given those assumptions, how much would the centerpiece of the Bush/Cheney health care initiative save the average American family?

John Kerry’s web site says that the cost of health insurance for families has increased to $9,549 per year or $795.75 per month. If everything goes right and all of the above assumptions prove true, the centerpiece of the Bush/Cheney healthcare plan would reduce premiums by $3.98 per month. Instead of paying $795.75 per month, a family would be paying $791.77 per month. I know you are thrilled.

Wait a minute, what about the savings from the elimination of defensive medicine? The CBO suggests that you not hold your breach waiting for such savings to materialize:

Proponents of limiting malpractice liability have argued that much greater savings in health care costs would be possible through reductions in the practice of defensive medicine. However, some so-called defensive medicine may be motivated less by liability concerns than by the income it generates for physicians or by the positive (albeit small) benefits to patients. On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.

Even if we do not get direct savings from tort reform or from the elimination of defensive medicine, reduction in malpractice premiums might help keep health care more readily available. The CBO thinks not:

Some observers argue that high malpractice premiums are causing physicians to restrict their practices or retire, leading to a crisis in the availability of certain health care services in a growing number of areas. GAO investigated the situations in five states with reported access problems and found mixed evidence. On the one hand, GAO confirmed instances of reduced access to emergency surgery and newborn delivery, albeit "in scattered, often rural, areas where providers identified other long-standing factors that affect the availability of services." On the other hand, it found that many reported reductions in supply by health care providers could not be substantiated or "did not widely affect access to health care."

Paul Krugman recently wrote with regard to an actual policy debate on health care “I don't see how President Bush will win it.”

With tort reform as the centerpiece of the plan, I think Krugman may be right.

Avner the Eccentric

Avner the Eccentric was being interviewed on local radio a few days ago. I was listening with interest, not because I had a clue as to who Avner might be, or why he was Eccentric, or any particular interest in performance art, mime, juggling, or stand-up comedy. No, I was listening because he was talking about working in Europe, and working up to the politiclally intimate. That point when your friend takes a deep breath and puts his chin in his hand or tilts her head over slightly and asks about you and George Bush [or you and Ronald Reagen]. Avner's reply was this:

We're going to have an election in November, and when we do, I expect I'll vote for Ariel Sharon. [pause] The funny thing is, when you have your next election I expect you'll vote for Ariel Sharon too.

Avner makes his home in Maine, where Ariel Sharon's name never appears on the ballot, and his generic friend makes his or her home in Europe, where Ariel Sharon's also never appears on the ballot.

Both Tom Allen (1st CD) and Michael Michaud (2nd CD) voted in favor of H. Res. 713. Both are Democrats. Both endorse the legislative restatement of the outcome of the legal process at the International Court of Justice as misuse of that Court by a plurality of the United Nations General Assembly for a narrow political purpose. Neither presumably endorse a similar characterization of the Biodiversity Convention, or the Kyoto Convention, or for that matter, the Fourth Geneva Convention, or the Treaty Organization that each rely upon.

Earlier this month I wrote a piece on the actual physical threat to the life of Ariel Sharon. It upset a friend, which was not my intention. I was trying to point out, with so much less humor and clarity, what Avner the Eccentric got across on the radio in the space of two minutes.

Tanks to N in Seattle for the korrection.

The Top 10 Ways To Change The Tone in Washington (For the Worse)

In the run up to the 2000 election, American politics had become rabidly partisan and vituperative. That is perhaps not surprising as the election followed an era in which two of the most polarizing figures in American politics, Bill Clinton and Newt Gingrich, led their respective parties. Some Americans (swing voters, for instance) became fed up with hyper-partisan politics and began looking for a candidate who could bring us together.

George W. Bush tapped into that discontent by promising to be a “uniter, not a divider,” and by promising to “change the tone” in Washington.

How has Mr. Bush done in fulfilling his campaign promise to change the tone in Washington?

After nearly four years of Mr. Bush’s Presidency and two years of Republican control of both houses of Congress, Mr. Bush can truthfully claim to have changed the tone in Washington. He and the GOP have made it far worse.

Miles Benson, in an op-ed, demonstrates the point:

The venomous conflict of the 2004 presidential election, which has pushed leaders to new levels of partisan hostility, has spread to ordinary Americans.

Intolerance of political differences is growing, experts say….

“We've become two warring nations," independent pollster John Zogby agreed. "The same incivility we have been experiencing within Washington in the last decade has spread out and we are seeing it nationally now…

Republican Bill McInturff of the polling firm Public Opinion Strategies uses an "intensity range" to show that attitudes are significantly stronger regarding President Bush than they were concerning Bill Clinton in 1996 or Bush's father in 1992.

When McInturff adds the percentage of Democrats who strongly disapprove of Bush (69 percent) to the percentage of Republicans who strongly approve of him (68 percent), the "intensity range" is 137 percent — almost double the 72 percent range for George H.W. Bush. The range for Clinton (in this case, Republican disapproval added to Democratic approval) was 92 percent.

"It's stunning. I have never in my life seen these kinds of numbers on the level of intensity on both sides," McInturff said. "We are seeing the largest gap in American history in approval and disapproval by party. The level at which people are locking in is without precedent."

Just in case David Letterman is interested, below are the Top Ten Ways The Tone in Washington Has Been Changed (For the Worse):

There's more: Continue reading this post...

Policing the Borders

Medcine Lines

One of the major beefs in Indian Country since the budgetary reshuffling post-9/11 has been that this particular Republican Administration isn't putting increases in law enforcement and border control monies into the hands of tribal governments that abut the US-Canada and US-Mexcio borders. This is a special case of this particular Republican Administration not putting increases in State-targeted federal spending into the hands of tribal governments. The generic modern Republican approach to the Federal-State relationship (block grants, reserved powers, etc.) is present, but the average modern Republican approach to the Federal-Tribal relationship, since Nixon, has been much, much better than this.

The poster-child for the problem are the complaints by the Tohono O’odham Nation that it spends 60% of its law enforcement budget doing work along its 70 mile jurisdiction over the US-Mexico border the INS should either do, or pay for. About 1,500 undocumented immigrants, most from Mexico, cross the reservation every day. The Tohono O’odham Nation Tribal Police can't catch them all, and couldn't take care of them if they could catch them all, for lack of funding by, and cooperation with, the INS.

Now it is well-known that the government of Iran participated in the US Afgan War, providing support to the Northern Alliance against the Talibans, and after the fall of the Taliban Government interdicting large groups of Taliban and al Qaeda cadres crossing the Afgan-Iran border, and now holds over 500 al Qaeda cadres, some of them quite senior in that apparatus, in its prisions. As I mentioned in a recent post, one that caught the eye the spokesman of the Mujahedin-e Khalq (see comments), the US could effect the transfer of those senior al Qaeda cadres from Iranian to some other jurisdiction, say Cuban (or whatever Gitmo passes for) with ease. The US need simply shop the 4,000+ Mujahedin-e Khalq it holds at Camp Ashraf, all but about 70 of whom are already guaranteed amnesty by Iran, the rest are guaranteed that the death penalty will not be sought, regardless of the offenses charged (and there are offenses), off to the Iranian border. However, it choses not to, which sort of makes Iran's bothering to arrest and detain al Qaeda cadres of limited utility to the Iranian state.

There have been individuals and groups of individuals associated with al Qaeda which have committed criminal or quasi-military ("terrorist") acts against Iranian persons and institutions. Naturally, there are a lot more individuals and groups of individuals associated with al Qaeda which are innocent, at least of attacking Iranians an Iraninan institutions.

Finally, it is really, really, well-known that the Afgan-Iran border is about as hospitable as the Sonora Desert that the Tohono O’odham Nation Tribal Police attempt to control.

Except by the editors of Time magazine. The Tehran Times has the following from Foreign Ministry spokesman Hamid-Reza Asefi, on the extent of Iran's borders and the problem of monitoring border crossings:

"It is reasonable that five or six people crossing the border illegally over a period of five or six months may evade our attention. The same happens on the border between Mexico and the United States." "It happened before Sept. 11 and who knew that Sept. 11 was going to happen?"

The good news is that the INS has illegal immigration down to a dozen people crossing from Mexico per year.

Above the fold...

Well, at least on the online version, that is.

Hourly Pay in U.S. Not Keeping Pace With Price Rises
By EDUARDO PORTER
Published: July 18, 2004

The amount of money workers receive in their paychecks is failing to keep up with inflation. Though wages should recover if businesses continue to hire, three years of job losses have left a large worker surplus.

...

Even though the economy has been adding hundreds of thousands of jobs almost every month this year, stagnant wages could put a dent in the prospects for economic growth, some economists say. If incomes continue to lag behind the increase in prices, it may hinder the ability of ordinary workers to spend money at a healthy clip, undermining one of the pillars of the expansion so far.

...

On Friday, the Bureau of Labor Statistics reported that hourly earnings of production workers - nonmanagement workers ranging from nurses and teachers to hamburger flippers and assembly-line workers - fell 1.1 percent in June, after accounting for inflation. The June drop, the steepest decline since the depths of recession in mid-1991, came after a 0.8 percent fall in real hourly earnings in May.

Despite my keen interest in pocketbook economics, I'm not a professional. The closest I come is that my specialty in my field, archaeology, is wampum, used for a few decades in early American colonization as a monetary unit. And while my training may give me a bit of an edge over the average Joe in archival digging, there is no reason that mainstream journalists should have had any problem locating data released every month, in black and white, in the monthly jobs report (Addenda B-3 and B-4.) I first noticed the trend over six months ago, despite working 60 hours a week (at a pitiful wage, I might add):

Another issue I've been itching to talk about has been the stagnating non-exempt hourly rate, which once again, in November indicated that inflation is growing faster than worker bee earnings. From January to July 2003, non-exempt hourly earnings increased by 45 cents. Since July 2003, earnings have grown by a whopping 3 cents. Yet in the meantime, inflation, while not rampant, has still increased significantly more than wages.

The failure of the mainstream press to report such events irritates me to no end, as such laziness plays right into the hands of right-wing pundits who argue that all is well and good with our so-called recovery. While hundreds of thousands of jobs have been added in the past few months, we are still at an employment deficit not seen since the Great Depression, and the paychecks of newly re-employed worker bees are significantly lighter than before they joined the unemployment lines. Middle class Americans, who have seen their quarterly 401K reports make up much of the ground lost after the 2001 collapse of the markets and the equity in their homes (on the brink of a possible price bubble) skyrocket, are generally unaware of the pain felt by their peers on the lower rungs of the economic ladder.

Thus, when the SCLM fails to draw attention to the real costs of the Bush economic plan, consumer confidence rises. As consumer confidence heads up, so do Bush's poll numbers. When James Carville coined the phrase, "It's the economy, stupid," he wasn't bad-mouthing average Americans; the "stupids" were the media, who even back in 1992 often ignored the bread and butter issues voters ultimately depended on to determine how they pulled the lever, not the more sexy blather of "values" spoonfed to political journalists by agents of the Right.

I'm glad that the NYTimes has finally reassigned their economics desk from their previous stint on fashion or Kobe or the Bush twins. It's just too bad they didn't think to do it months ago.

Employees must wash hands after

This is an update to the Got CREMs? post. The Chron is reporting this now as a God damnit pay attention! No, repeat NO RUNNING WITH SCISSORS story. Here is the link. This seems vastly more credible as a story than the run-of-the-national-press coverage of only 24 hours earlier. Intern cooks eye. Tech squirts caustic goo in eye. Tech nearly fries tech. Accident, accident, accident. The Lab at Los Alamos a 35 acre playground chock full of sharps and SCIFs.

Looks like BC04 hasn't authorized the DHS or the FBI or the DoJ to run with this one. Pity. The idea of BC04 trying to do to the Regents of the University of California and the Lab management what the Clinton/Bush Administrations did to Dr. Wen Ho Lee, either to further the Cult of Fear, or the academic status ambitions of the University of Texas (remember the original midnight riders to the HSD authorization bill?) is kind of alluring.

with the Wehrmacht in Poll Land

I have to go to Geneva in September for a technical meeting and the working language is German. Over dishes this morning I was thinking about dropping in on VideoPort and picking up some episodes of Heimat I. That thougt and its similies settled on the 25 page CBS poll I was leafing through earlier this morning when I got early-riser oversight duty. In December 2001 the conduct of the "War on Terror" got 90% approval by the CBS sample population, and 6% disaproval.

September the 1st to October 26th 1939 are the dates of the Polish War, 55 total days.

October 7th to December 7th 2001 are the dates of the Afgan War, 60 total days.

Watching the Democratic left unfurl from that season of a collapse of sanity, when only one of its members could speak against the elected-by-coup Administration's choice of an Afgan War, to the present here in poll land, where now 62% think the Iraq War is not worth the casualties, it has been 34 total months. As I watched the macho text slinging at various blogs, I've wondered, where were these people when the question was real international police or fake multi-national military? At best only 12 in 100 of Democrats and "Lefties" opposed the Afgan War, and 80 in 100 celebrated the capture of Osama Bin Laden and the final distruction of the al Qaeda Group in December 2001.

Someday I'll have to post about the Nacht und Nebel-Erlass. Fortunately, there are no "Ghosts" in US-occupied Iraq, nor were there any in US-occupied Afganistan, nor anywhere else either.

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Blitzkrieg Überraschungsangriffe mit koordinierten massiven Luftangriffen