"The end of insurance companies...is here."

For awhile now I've been following what Rick Unger has been saying about the ACA triggering the end of for-profit health insurance companies as a business model.

This week Mark Bertolini, CEO of Aetna, agreed with him.

It’s not often that you hear the leader of a Fortune 100 company publicly acknowledge the imminent demise of his venerable, profitable business model.

Yet, speaking at the HIMSS12 Conference in Las Vegas, Aetna CEO, Chairman and President Mark Bertolini, said a reckoning for the traditional health insurance model was at hand. “The system doesn’t work, it’s broke today” Bertolini told attendees. “The end of insurance companies, the way we’ve run the business in the past, is here.”

Bertolini said an amalgamation of regulatory, demographic and economic factors were driving this change. The Affordable Care Act in particular, with its ban on medical underwriting, has made the traditional health insurance business model untenable in the long term, he said. Nonetheless, he offered measured praise for the law, even citing the controversial medical loss ratio rules as having a smoothing effect on premium swings. “We got pulled through the crucible against our will and have been reshaped because of it,” he said. “For most of what has already been implemented, it has been a pretty good thing.”

First of all, I'll let Unger fill us in on what "medical underwriting" means.

Underwriting is the process of separating out the healthy from those more likely to be ill and then offering coverage to the good risks while passing on the bad ones.

In other words, the universality of ACA means that insurance companies can no longer pick and chose their customers to maximize profits (ie, no exclusions for pre-existing conditions). In addition, the medical loss ratios - as I've talked about before - require insurance companies to spend 80-85% of their premium dollars on patient care. Together these kinds of regulations are what both Unger and now Bertolini say will mean the end of the for-profit health insurance business model.

For months now the baggers of fire on the left have been shouting about how the ACA was nothing more than a give-away to these companies. Oh my, how much more wrong could they be?

Now we're beginning to see the "long game" play out on where we might be headed with health care reform. Unger says it will eventually lead us to some type of single payer system. But he has this warning...

If you are a single-payer advocate—and it is no secret that I fall within this category—you are likely pumping your fist in the air at this news. After all, when the CEO of one of the nation’s largest health care insurers waves the white flag, it’s got to be a good thing for those who wish to usher in the era of universal coverage.

To you single-payer supporters who are enjoying Bertolini’s perceived capitulation, I would simply say, “chill out.”

While I have long argued that the for-profit health insurance model no longer works, and that some form of a single-payer system is—whether you like it or not— inevitable, the simple fact is that we are no more ready to make single-payer a success in America then we are capable of sustaining the existing for-profit model.

Why?

Because our healthcare cost issues are going to be as damaging and deadly to a single-payer approach as they have been to the for-profit business model.

So we're not there yet but we're on our way. As the saying goes..."the journey of a thousand miles begins with the first step."

Here's what Bertlolini had to say about that:

Reform is not going to stop. It won’t go away.

Thanks Obamacare!

Uncommon courage in unlikely places

I find the story of Dallas County Judge Tonya Parker to be extremely inspiring.

Out lesbian Dallas County Judge Tonya Parker touted her refusal to conduct marriage ceremonies in her courtroom on Tuesday night.

“I have the power, of course, to perform marriage ceremonies,” Parker said. “I don’t.”...

Parker is the first LGBT person elected judge in Dallas County and is believed to be the first openly LGBT African-American elected official in the state’s history. As such, Parker said she takes into account the importance of her position to make members of the LGBT community feel comfortable and equal in her courtroom by “going out of my way to do things that other people might not do because they are not who I am.”...

“I use it as my opportunity to give them a lesson about marriage inequality in this state because I feel like I have to tell them why I’m turning them away,” Parker said. “So I usually will offer them something along the lines of ‘I’m sorry. I don’t perform marriage ceremonies because we are in a state that does not have marriage equality, and until it does, I am not going to partially apply the law to one group of people that doesn’t apply to another group of people.’ And it’s kind of oxymoronic for me to perform ceremonies that can’t be performed for me, so I’m not going to do it.”

The first openly LGBT African American elected official in the state of Texas is a feat unto itself. But to use that position to take this kind of stand takes courage to a whole new level.

My hats off to you Judge Parker!

New Guggenheim film about President Obama

Four years ago David Guggenheim produced this short film titled "A Mother's Promise."



Now we learn that the Obama campaign has hired Guggenheim again.

With Hollywood gathering this weekend for the 84th Academy Awards, President Barack Obama has recruited Oscar-winning documentary director Davis Guggenheim to again produce a short film for his campaign.

Obama’s re-election staff in Chicago spent $162,834 on the film last month, according to the January Federal Election Commission filing. Currently in post-production, the film focuses on the president’s first three years in office, according to a campaign official.

The film will be less than 30 minutes long and released in weeks, though the exact date hasn’t been decided, according to the official, who spoke on condition of anonymity. The campaign is still considering how it will be used, the official said.

Beach Books (updated)

One of the fun things about having my own blog is that I get to write about whatever I want to. What that means is that when I get bored with politics (as I am right now), I can write about whatever it is that's on my mind.

In a few weeks I'm going to be taking a trip to the beach where I'll get to spend entire days doing nothing much more than staring at what is represented in the picture up above. That's a little slice of heaven as far as I'm concerned.

In between being mesmerized by that, I'll likely fill my time with reading. So yesterday I did some book browsing and bought a few things to take along with me. Here's what I came up with:

The Healing by Jonathan Odell (yeah, I bought this one last week but I'm saving it to savor)

Great House by Nicole Krauss (if you've never read her first book - The History of Love - please do so NOW)

Restoration by Olaf Olafsson

The Favored Daughter: One Woman's Fight to Lead Afghanistan into the Future by Fawzia Koofi and Nadene Ghouri

I literally can't wait! Pretty impressive list, huh? Do you have any other suggestions? In case you can't tell, I'm mostly interested in historical novels and biographies of interesting (mostly unknown) people.

Update: Added today - Running the Rift by Naomi Benaron.

Why is Santorum so afraid of young people getting a college education?

Here's what Santorum said this week:

On the president’s efforts to boost college attendance, Santorum said, “I understand why Barack Obama wants to send every kid to college, because of their indoctrination mills, absolutely … The indoctrination that is going on at the university level is a harm to our country.”

He claimed that “62 percent of kids who go into college with a faith commitment leave without it,” but declined to cite a source for the figure. And he floated the idea of requiring that universities that receive public funds have “intellectual diversity” on campus.

I'd like to address that one from my own personal experience.

Santorum might put me in that "62 percent of kids who go into college with a faith commitment and leave without it." But there are 2 catches: First of all, I still considered myself a christian when I graduated from college, but the seeds of doubt had been sown. And secondly, I actually went to a private christian fundamentalist college. So whassup?

A friend of mine who graduated from the same college said something very profound about our common experience there are few years ago. He said, "The problem with _______ College (a liberal arts school) was that they were trying to do two mutually exclusive things at the same time...teach dogma and teach you how to think." Nothing I've heard before or since has captured my experience so perfectly. When I left there the questions were beginning to outweigh the power of the dogma. In other words I was beginning to learn how to think for myself.

That's what Santorum is so afraid of when it comes to higher education...that it will teach young people how to think - for themselves.

Questions no one seems to be asking

Listening to a Republican presidential debate, you'd think our country was on a slide towards not only economic but social destruction. Too often folks on the left seem to want to join them in this malaise.

But the truth is, its not just the economy that is slowly improving. There are signs that some of the social issues that have plagued us for at least decades are also improving. But outside "elite" academic circles, no one seems to be noticing...or better yet, asking why.

Here are a couple of examples:

On an issue that came up in the debates last week, you'd never know that teen pregnancy is actually on the decline.

A new study, titled “U.S. Teen Pregnancies, Births and Abortions, 2008: National Trends by Age, Race and Ethnicity” published by the Guttmacher Institute, has found teen pregnancy to be down among all racial groups.

Teen pregnancies are at their lowest rates in 40 years, according to the latest numbers dating 2008 which is when the latest statistics were given.

Conventional wisdom has always believed that when the economy is bad, crime goes up. While that has usually been the case historically, not this time.

The rate of major crimes in the U.S. continues to drop – even during the recent recession and its aftermath – and crime experts aren’t sure why...

According to recently released FBI crime statistics, the number of violent crimes -- murder and non-negligent homicide, forcible rape, robbery and aggravated assault -- reported in the first six months of 2011 declined 6.4 percent compared with the first six months of 2010. The number of property crimes (burglary, larceny-theft and motor vehicle theft) decreased 3.7 percent for the same time frame.

The report is based on information from more than 12,500 law enforcement agencies and shows the continuation of a downward trend in crime that began in 2008.

It’s also part of a broader, longer-term trend: Between 1991 and 2010, the homicide rate fell 51 percent and property crimes dropped 64 percent. Crime rates decreased significantly during the 1990s before flattening out at the start of the new century.

The statistical trend is puzzling and not easily explained.

It seems to me that - rather than wail about how awful things are and suggest that we go back to the 1960's - the pertinent question we should be asking is "why are we seeing these improvements?" Doing so might help us build on the successes.

Now wouldn't that make an interesting topic for a presidential debate?

The wheels of justice grind on. Anyone noticing?

A little less than 2 years ago most of the country was consumed with anger at BP and other companies that were complicit in the Gulf oil spill. Much of that anger was turned on President Obama. I remember at the time being confused about just exactly what it was folks wanted him to do...swim down into the depths of the ocean and personally plug the spill? Of course not. I suspect they just wanted him to erupt in self-righteous anger too.

The truth is, even if he had blown his top about it all (which was never going to happen), it would have accomplished nothing other than perhaps make some people feel better. But now that everyone has gotten over that particular outrage and moved on through several others, I doubt many people will pay attention to the fact that on Monday, the federal trial to hold BP and other companies accountable will commence in New Orleans.

My question is whether or not the people of this country have the staying power to really care about accountability. Or did we just want a Presidential temper-tantrum?

You're Still the One

DOD Goes Green - and why that's important

I've grown increasingly frustrated that so few of the people writing about the dangers of climate change and our need to develop renewable energy sources are noticing what I think its the biggest story in this arena...the greening of our military. So this morning I did a little looking around the internet in order to provide you with some idea of what's going on and why this is so important. Science is definitely NOT my forte. Stick with me - I couldn't get too technical about this even if I wanted to.

Last fall leaders from the 4 branches of our military wrote an op-ed about why the development of alternative energy sources is important for our national security. They also highlighted some of their recent accomplishments.

There are some who say now is not the time to invest in clean energy, given our current economic woes. Some say the well-publicized failure of solar company Solyndra is proof that clean energy doesn't work and that government support shouldn't be an option.

That sort of thinking is short-sighted, misinformed and takes the wrong lessons from one company's failure.

In fact, there may be no better time for our country to increase support for clean energy than now, when our economy is in desperately need of jobs and emerging clean-energy companies are trying to grow — and in doing so, add new employees, many of them veterans.

The military knows climate change is happening and that our current energy posture is a growing threat to national security. Clean energy is a solution we must pursue.

Already, the Navy and Air Force have pledged to get at least half of their fuel from alternative sources. We now have planes and ships that run on fuels made from plants and algae, and bases that get their electricity from the sun and wind.

The Army is working toward a "Net Zero" strategy where bases will consume only as much energy or water as they produce.

Marines at forward operating bases are using portable solar panels to charge communication equipment, high-efficiency LED lighting systems to find their way, and other energy-efficient equipment that increases the mission effectiveness of troops while reducing the need for vulnerable fuel convoys.

All these are positive steps, but more can and must be done. As a nation, we should move forward without further delay.

But the issue goes far beyond improving the operations and security of the military. Here's how the writers at Pike Research introduced their 189 page report on the military's involvement in renewable energy.

The various composite branches of the DOD, as an organization, combine to form the single largest consumer of energy in the world – more than any other public or private entity and greater than more than 100 other nations. Energy consumption is the lifeblood of the U.S. military – and the supporting governmental infrastructure that facilitates and controls it.

Military investment in renewable energy and related technologies, in many cases, holds the potential to bridge the “valley of death” that lies between research & development and full commercialization of these technologies. As such, the myriad of DOD initiatives focused on fostering cleantech is anticipated to have a substantial impact on the development and growth of the industry as a whole.

The U.S. military currently spends $15 billion on energy every year. Of that total, the Air Force is the biggest consumer spending $8 billion a year. As these branches pivot to spend more and more of those dollars on renewable sources, they not only have access to more secure sources of energy, they are reducing the military's contribution to global warming and providing the seed that will allow these products to be more available to civilian markets. As Navy Secretary Mabus said recently:

Mabus ran down a litany of programs that by 2020 should render the Navy half as dependent on fossil fuels. “The technology is there, what’s missing is the market,” Mabus said. “We are the market. If the Navy comes, they will build it.”

The various initiatives DOD has underway are too numerous to identify. But they have a web site titled DOD Goes Green that's full of information. Earth Techling is chronicling this story quite thoroughly as well with dozens of interesting articles they've gathered together for easy access. Here are just a few:

The U.S. military’s testing of fuel-cell vehicles in Hawaii is shifting into higher gear as part of a larger effort to encourage hydrogen-powered cars as an alternative to gas cars on the petroleum-reliant islands.

Last December, Navy Secretary Ray Mabus and the Office of Naval Research highlighted five General Motors Equinox fuel-cell vehicles being put through their paces at Marine Corps Base Hawaii—and now the Army says the number of hydrogen fuel-cell vehicles in use by the military in Hawaii is up to 16...

GM is looking forward to moving the program beyond the islands. “Once the key hydrogen infrastructure elements are proven in Hawaii, other states can adopt a similar approach,” said Charles Freese, executive director of global fuel cell activities for GM. “The military is paving the way, demonstrating the practicality and applicability of this technology.”

Virginia-based Skybuilt Power is providing the US Army with portable power-packs, the SkyCase and the SkyPAK. The SkyCase features at least one lithium-ion battery, while the SkyPAK has a fold-out solar array. Power packs like these are part of the Army's attempt to cut down on diesel, and having free and ready power in the field can potentially save lives.

Last year, the US Army began testing portable, trailer-mounted wind turbines that were designed to be part of "renewable energy trailers," which would provide power quickly to military units using only solar and wind power. This would be an alternative to diesel fuel, which is often very expensive.

The US Navy's new monitoring system is powered by microbes. This device, called the Zero Power Ballast Control (ZPBC) is designed to provide power to underwater sensors. The hydrogen gas produced by the microbes provides buoyancy as well.

Two new barracks buildings being constructed at Fort Lee in Virginia are going to be fitted with geothermal heating and cooling systems, which typically use about 20% less energy than conventional heating and cooling systems, and are 40% more efficient than traditional heat pumps during the winter.

As I've said before, all of this is part of President Obama's progressive policy on renewable energy. Too often, it seems to be hiding in plain sight from those on the left who claim to care about these issues and yet aren't noticing the biggest story out there.

Two things the Republicans can't talk about

Did anyone else watch the GOP debate last night in Arizona? I did. And what strikes me as significant is that there are 2 things the Republicans can't talk about.

First of all, there was one word that was obviously missing from the entire conversation...jobs. Other than a passing reference from Gingrich in the beginning about balancing the budget by increasing employment (with not a word about how he'd do that), it never came up.

We all know that lately the economy has been improving. But we still have an 8.3% unemployment problem. In other words, a significant portion of Americans are either un or under employed. But the Republican candidates for President didn't have one thing to say about that last night.

The second thing Republicans can't talk about is the real Obama. Yesterday, E.J. Dionne summarized that beautifully.

They say that President Obama is a Muslim, but if he isn’t, he’s a secularist who is waging war on religion. On some days he’s a Nazi, but on most others he’s merely a socialist. His especially creative opponents see him as having a “Kenyan anti-colonial worldview,” while the less adventurous say that he’s an elitist who spent too much time in Cambridge, Hyde Park and other excessively academic precincts.

Whatever our president is, he is never allowed to be a garden-variety American who plays basketball and golf, has a remarkably old-fashioned family life and, in the manner we regularly recommend to our kids, got ahead by getting a good education.

Please forgive this outburst. It’s simply astonishing that a man in his fourth year as our president continues to be the object of the most extraordinary paranoid fantasies. A significant part of his opposition still cannot accept that Obama is a rather moderate politician quite conventional in his tastes and his interests. And now that the economy is improving, short-circuiting easy criticisms, Obama’s adversaries are reheating all the old tropes and cliches and slanders.

The truth is...the Republicans are scared to death of President Obama's actual record. They know that if they deal with him honestly, they lose. And so they lie. And try to convince someone about their "most extraordinary paranoid fantasies." Those were on display for all to see last night. Here are the ones that stood out to me.

ROMNEY: I don't think we've seen in the history of this country the kind of attack on religious conscience, religious freedom, religious tolerance that we've seen under Barack Obama.

SANTORUM: (On Syria) This president has -- has obviously a very big problem in standing up to the Iranians in any form. If this would have been any other country, given what was going on and the mass murders that we're seeing there, this president would have quickly and -- joined the international community, which is calling for his ouster and the stop of this, but he's not. He's not. Because he's afraid to stand up to Iran.

I guess Santorum missed the whole thing about a U.N. vote on the ouster of Assad that was pushed by the U.S. and vetoed by Russia and China.

But the real whopper of the evening came from Gingrich.

This is an administration which, as long as you're America's enemy, you're safe.

You know, the only people you've got to worry about is if you're an American ally.

I have a couple of words for the disgraced former Speaker of the House...bin Laden and Gaddafi. Nuff said.

Blues in da house!

I know that by now all of you have probably seen this video. But it won't hurt to take a look one more time will it?



I watched the whole event on the White House web site last night. If you missed it, please know that this was but an over-the-top ending to an amazing evening of music. It was not only a blast to watch, it was also a real pleasure to see both President Obama and Michelle genuinely enjoying themselves. Here's one taste of the brilliance that has been made available on youtube...Buddy Guy, Mick Jagger, Gary Clark, Jr. and Jeff Beck doing "Five Long Years."

What's up with Mitt?

I remember a couple of months ago prior to the Gingrich surge, Steve Benen caught Romney going on the attack against him. Benen wondered if Romney had some internal polling data that the rest of us hadn't seen yet. Sure enough, a couple of days later the Newt-surge happened and the Romney camp looked prophetic.

I think about that as we see some rather strange things coming from Romney lately. First of all, he sounded almost Keynesian yesterday when he warned about austerity.

"If you just cut, if all you're thinking about doing is cutting spending, as you cut spending you'll slow down the economy," he said.

That kind of statement undercuts EVERYTHING Republicans have been saying for at least the last 2 years.

And then today, he dropped all his talk about President Obama creating divisions via class warfare and talked about fairness progressivity (are Republicans actually allowed to use that word?) in the tax code.

And in order to limit any impact on the deficit, because I do not want to add to the deficit, and also to make sure we continue to have progressivity in our code, I’m going to limit the deductions and exemptions particularly for high income folks. And by the way, I want to make sure that you understand, for middle income families, the deductibility of home mortgage interest and charitable contributions, those things will continue, but for high income folks, we are going to cut back on that so we make sure the top 1% keeps paying, paying the current share they’re paying or more.

One of these might have been considered a rhetorical misstep in which some inner/more reasonable Romney slipped out. But two in two days more likely means something's up.

Could it be that Romney once again has some internal polling that is ahead of the rest and indicates either:

1. Santorum's surge is coming to an end and its already time to pivot towards a general election message, or
2. Mitt's campaign is toast so why bother to keep up pretexts?

I really have no idea. But I do think this is something to notice and keep an eye on.

Republican Platform: Screw Fairness (updated)

In his speech at Osawatomie, Kansas President Obama introduced the word "fairness" into the political conversation.

Now, fortunately, that’s not a future that we have to accept, because there’s another view about how we build a strong middle class in this country -- a view that’s truer to our history, a vision that’s been embraced in the past by people of both parties for more than 200 years.

...It is a view that says in America we are greater together -- when everyone engages in fair play and everybody gets a fair shot and everybody does their fair share.

The word might have been new but the concept was not. As an example, he'd given a speech back in April 2011 about the country's fiscal situation just after Rep. Ryan had released his budget proposal which basically eliminated Medicare as we know it by turning it into a voucher system. Here's what the President said about that:

It’s a vision that says America can’t afford to keep the promise we’ve made to care for our seniors. It says that 10 years from now, if you’re a 65-year-old who’s eligible for Medicare, you should have to pay nearly $6,400 more than you would today. It says instead of guaranteed health care, you will get a voucher. And if that voucher isn’t worth enough to buy the insurance that’s available in the open marketplace, well, tough luck -– you’re on your own. Put simply, it ends Medicare as we know it...

They want to give people like me a $200,000 tax cut that’s paid for by asking 33 seniors each to pay $6,000 more in health costs. That’s not right. And it’s not going to happen as long as I’m President.

In other words...that's not fair.

Of course Republicans have been dancing around this concept of fairness ever since he introduced it. Usually they do that by accusing him of being the one to introduce class warfare (instead of those who want to end Medicare as we know it in order to maintain a tax break for the wealthy).

But now conservative writer Thomas Sowell has just come right out and called President Obama's message The Fairness Fraud.

To ask whether life is fair -- either here and now, or at any time or place around the world, over the past several thousand years -- is to ask a question whose answer is obvious. Life has seldom been within shouting distance of fair, in the sense of even approximately equal prospects of success...

More fundamentally, the question whether life is fair is very different from the question whether a given society's rules are fair. Society's rules can be fair in the sense of using the same standards of rewards and punishments for everyone. But that barely scratches the surface of making prospects or outcomes the same.

People raised in different homes, neighborhoods and cultures are going to behave differently -- and those differences have consequences. The multiculturalist dogma may say that all cultures are equal, or equally deserving of respect, but treating cultures as sacrosanct freezes people into the circumstances into which they happened to be born, much like a caste system.

Mr. Sowell's argument at first is that we should all just accept the fact that life isn't fair...learn to live with it. Never mind that wealthy folks have the money and access to tilt the system unfairly in their direction. We should all just pretend to not notice and accept getting screwed by it all. I can just hear him saying the same thing to those living in slavery...don't rock the boat, life was never meant to be fair (by the way, Mr. Sowell is African American so that one might have not worked out so well for him).

But then he exposes where he's been going with this all along. The dog whistles come out blaring when he suggests that people are poor (or not wealthy) because of their cultural roots. So we've now turned the class war into a culture war. And obviously any culture associated with black or brown skin is the cause of unfairness. He didn't come out and say that. But everyone knows that's what he meant.

I doubt that I have to unpack the racism and classism of all that for my readers here. I simply want to point out that this, my friends, is as clear an articulation of the Republican platform as I've seen. If you want to understand the choice we have in front of us this November - there you have it.

Update: Just in case anyone doubts that this is the Republican platform, take a listen to how Gov. Christie responded when asked about Warren Buffet's call for more tax fairness.

"Yeah, well he should just write a check and shut up," Christie said. "Really. And just contribute. I mean, you know, the fact of the matter is that I'm tired of hearing about it."

Who's getting bonus checks now?

As profits at major manufacturers go up, lets talk about who's getting the bonus checks these days. (hint: its not the Wall Street folks.)

GM Workers: 47,500 members of the United Auto Workers will get up to $7,000 each

Chrysler: 26,000 union workers got checks averaging $1,500 each

Ford: $2,450 to each worker

Boeing: 33,500 workers got checks for $3,500-4,000 each

And its not just the workers themselves that benefit. For example, in the Seattle area (home of Boeing):

Economist Dick Conway told the Seattle Times the payments would inject $217.5 million into the local economy.

Red White and Blues

Watch Red White and Blues on PBS. See more from In Performance at The White House.

You can watch the performance live tonight at 7:15 pm ET on the White House live stream or you can catch it next Monday (Feb. 27th) on PBS. Read about the performers here. B.B. King and Mick Jagger at the White House...oh my!