Wednesday, August 30, 2006

Who's Getting Paid in the Health Care Industry?

When the answer to that question is "everyone," the next logical question is: "Who's getting paid the most?"

We often focus on how much money is going into the US health care industry, which allows little time to consider who exactly is taking all that money out of it.

When you offer up the question of who's getting paid the most in the health care industry, a flurry of finger pointing between the suspects ensues. Insurers point to hospitals, who point to doctors, who point to insurers, and so on.

But according to a recent report in the Denver Business Journal, the biggest winner in the health care industry is Big Pharma. At least, that is, when you break it down by profit margins.

Pharmaceutical companies have averaged around a 17 point profit margin over the past decade, whereas other industry players can usually expect somewhere between 3 and 6 percent. However, it should be noted, some hospitals have been raking it in lately, posting margins into the teens in some areas.

A few other notable points from the Denver Business Journal report:
  • As hospitals merge, it becomes increasingly difficult for the more disbursed insurance industry to negotiate with them.
  • When insurers do merge, their administrative costs cut in half.
  • The more uninsured people there are in the country, the higher health care costs become for everyone in the system. (Tie that one in with the latest Census Bureau report on the rising number of uninsured in the US to get the full effect.)
Talk about writing on the wall.

Tuesday, August 29, 2006

The Misapplication of State Standards

An educational study by the right-wing Fordham Foundation is getting front-page coverage in the Journal-Sentinel this morning.

The study says that Wisconsin standards are too broadly written.

Yep, that's about it. Evidently that's a charge worthy of above-the-fold coverage in the biggest daily in the state.

Fordham tries to say that standards = expectations, which is way off the reality of what happens inside the classroom. Teachers do not simply stop teaching when students have "mastered" the standards devised for their particular grade level, nor should they.

At the most standards should be guideposts used to frame what takes place inside the classroom. And in this sense, broadness is a desirable quality for state standards.

The question really comes down to who we want controlling what goes on inside the classroom. Should that control be localized within the community or centralized at the state/national level?

It's my feeling that students, teachers, parents, and local communities should have the most influence on what takes place inside the classroom each day.

The state and the feds are there to ensure everyone has equal access to an education and that discrimination is not taking place -- whether in the structure of the school or the content of the curriculum -- but that accountability should not stretch into dictating teaching and learning on a daily basis.

Unfortunately the standards movement has flipped that accountability on its head over the past fifty years (although the real push has come in the last thirty years) to mean that students and teachers are somehow accountable to the state, rather than just the reverse. And the manner in which this accountability exists is standardized tests, which find their basis in strictly written state standards.

This, in effect, strips the classroom of local control. And it also has a negative effect on academic freedom, which I write more about here.

And in case my theoretical argument about educational structure doesn't convince you that the Fordham Foundation's study should be taken with a huge grain of salt, then perhaps a look at how Wisconsin matches up with other states in terms of actual performance will do the trick.

In response to the Fordham study, the DPI argues that Wisconsin consistently ranks as one of the top states in the country on college entrance exams. The Fordham study authors retort that a better assessment of student performance is really the National Assessment of Educational Progress reports that come out on an annual basis.

It really amazed me that the Fordham authors pointed to the NAEP reports as evidence to back up their study. Here's why.

Out of the fifty states plus the District of Columbia, there were 9 that received a grade of B- or higher in the Fordham study.

California = A
Indiana = A
Massachusetts = A
New York = B+
Virginia = B+
Georgia = B+
Arizona = B-
Alabama = B-
South Carolina = B-

Wisconsin was given a D- in the Fordham study.

Yet, when we take a look at the NAEP reports (here, here, and here) on student performance for 2005, Wisconsin ranks higher than all of the nine states listed above except Massachusetts (Wisconsin is tied with Virginia for second place, and, just as a note, NY doesn't participate in the NAEP analyses).

So while the Fordham study alleges Wisconsin has low expectations because of its broadly written standards, the NAEP reports show the Badger State has far better student performance than the states Fordham found to have high expectations.

Something's not right there -- and by something I mean the Fordham study.

The broader charge made in the JS article that Wisconsin needs to do more to close the gap between high income and low income student performance, along with the performance gap between white students and students of color, holds water.

But that is true for states across the country, and when you break down the numbers in that way it starts to get into issues that are beyond just educational policy in scope -- the issues of financial and racial disparities cut to the heart of nearly all of our economic and social policies.

In terms of overall student and school performance, however, Wisconsin is doing quite well, regardless of how Chester Finn and others at the Fordham Foundation read our state standards.

UPDATE: Xoff uncovers how inverting the rankings on student performance and calling it a study is par for the course when it comes to the Fordham Foundation.

Monday, August 28, 2006

Focus on the Family Focuses on Wisconsin

This must have been what Julaine Appling meant in July when she said: "We believe that when we need big bucks in 'Vote Yes,' we're convinced we'll have what we need."

Focus on the Family is coming to Wisconsin this week to help push the proposed marriage and civil unions ban, and the group brings with it annual revenues of nearly $138 million.

Focus on the Family was founded in 1977 by James Dobson and stands as one of the largest Religious Right organizations in the country.

The first Focus on the Family event -- co-sponsored by Appling's Family Research Institute of Wisconsin -- is a free training session for "Christian leaders" that will be held tomorrow in Milwaukee. The topics at the session will range from how homosexuality is a choice to how badly same-sex couples want to destroy marriage in Wisconsin.

If it wasn't clear before Focus on the Family joined the fight that this effort is about more than just "protecting marriage," the entry of Dobson's group into the foray just about seals the deal.

Dobson has been known to liken gay rights advocates to Nazis and his group frequently compares gay and lesbian people to pedophiles. Focus on the Family is also a major proponent of the so-called "ex-gay therapies" that I write more about here.

So if you're wondering why that now infamous second sentence of the amendment goes as far as it does, a look at Focus on the Family will give you a feel for the ideology that spawned it.

In short, amendment proponents are playing offense, not defense.

Friday, August 25, 2006

The Inefficiency of the Embryonic Stem Cell Ban

There's an article appearing in the most recent edition of Forbes that's worth mentioning. It deals with embryonic stem cell research, specifically how it has been funded thus far in the US.

Opponents of the research like to claim that private funds are still allowed to go into the research, and therefore that's enough to keep it going.

In a sense, this is true. The subtitle of the Forbes article, however, puts a big qualifier on the end of that claim: "Billionaire cash has kept embryonic stem-cell research alive--just barely."

Just barely is right, and there's no telling whether simply keeping the research alive is going to be enough to eventually translate into making the research viable in humans.

As the Forbes article points out, no major medical treatment has ever been developed without significant federal government funding. And while some federal funding has gone toward embryonic stem cell research to date, it's highly questionable whether it's a significant amount.

Every year the National Institutes of Health (NIH) pumps $20 billion into the biotech field for research. Of that total, 10 percent goes toward stem cell research. Out of that 10 percent, only 1/5 goes toward embryonic stem cell research.

In other words, a paltry two-tenths of a percent of the NIH research budget currently goes toward embryonic stem cell research, in spite of the fact that researchers agree it holds the most promise for curing a wide array of medical ailments.

This, however, is really just half the story. These funding restrictions also take a negative toll on researchers in the biotech field -- that is, those willing to take a chance on embryonic stem cell research. As the Forbes piece notes, "Without the NIH imprimatur, some young scientists are reluctant to stake their careers on embryonic stem cells."

But even for those who are willing to risk the inconsistency of private funding to head into the embryonic stem cell field, there's always a fear that lines will be crossed between their research studies that can accept federal funding and their embryonic stem cell research that cannot.

This hesitancy, in addition to the general lack of funds, has allowed European and Asian countries to forge ahead in the research, leaving the US behind. According to Roger Ashby, who runs a small firm in NY that funds stem cell studies abroad called StemCell Ventures, "In America scientists are always looking over their shoulders and wondering if they are breaking a law."

As a result, the embryonic stem cell research in the US has become highly inefficient -- which, ironically, is often the charge people make when the government gets involved in ventures. Such is not the case in the risky biotech market, however, where the consistency of public funds acts as a leveling force.

Due to the federal funding restrictions on embryonic stem cell research, scientists across the country have been forced to build two separate labs to ensure they are not breaking the law with their research.

We're also seeing this happen right here in Wisconsin. The new Institutes of Discovery in Madison is being forced to split into two buildings -- one that will house privately-funded research and one that will support publicly-funded research.

Dividing research like this has a severe impact on the efficiency of the research. According to Harvard University researcher Douglas Melton, half of his budget for embryonic stem cell research "goes to redundant lab gear and overhead he wouldn't need if it weren't for the NIH rules against stem-cell funding." That is significant.

Echoing this sentiment is Johns Hopkins researcher Douglas Kerr, whose team of scientists made headlines back in June when it found a way to re-grow the circuitry necessary to move a muscle, thereby allowing rats suffering from paralysis to walk again.

Kerr says that with proper government funding, a treatment could be ready for human trials in five years. As it stands, though, it will be much longer because of the funding restrictions imposed by President Bush and the GOP-controlled Congress, including Mark Green.

"I am stuck. It is amazingly frustrating," Kerr explains. "All I see are paralyzed patients. They have been following this work and I have to tell them I cannot do the experiments."

The Forbes article also discusses the significant state commitment to embryonic stem cell research that was recently made in California. And researchers are flocking to California biotech labs because of it. The article mentions that similar funding commitments have been discussed in a number of other states, including Wisconsin.

Would they continue to be discussed if Mark Green is elected this November, or will he force Wisconsin biotech labs to toil under the same type of inefficiencies he voted for while in Congress?

Thursday, August 24, 2006

Lobbyist Distorts Health Care Reform

Dan Schwartzer has a column up today at WisOpinion that outlines what he views to be two opposing ideas for health care reform: "government intervention" and "a private market solution."

Schwartzer is a lobbyist for the Wisconsin Association of Health Underwriters (WAHU), which is described in the column's byline as "an association of professionals who work directly with consumers in the financing of their health care." This is a fancy way of saying WAHU is special interest group made up of agents who sell private health insurance.

So it's really no surprise that Schwartzer champions health care reform that maintains the current structure of multiple privatized insurance companies over a consolidated payer system.

I'm not going to fault him for doing his job, but how he goes about doing it is concerning.

To make his point, Schwarter vacillates between framing insurance companies as blameless entities caught in the middle of increased demand & greedy providers and spinning tales about how government-based solutions to the health care crisis will inevitably lead to government-run health care.

The idea that insurance companies don't contribute at all to the cost of health care in the US is ludicrous. Administrative costs -- which amount to 1/3 of the total cost for health care in the US -- go almost entirely to feed the myriad of private insurance companies competing in the US system.

A simplified consolidated payer system would streamline care to the point that these costs could easily be cut in half, which is the case for single-payer countries that still manage to afford universal care for their citizens.

Plus, consolidating payers would greatly increase the negotiating power of the payers in the system. The success of consolidating and centralizing payers was proven right here in Wisconsin when the state health insurance plan was revamped a few years ago.

By moving under a single payer for prescription drugs, the state of Wisconsin has been able to save "tens of millions of dollars" in just two years, according the administrator of the plan. Wisconsin is now serving as a model for other states who want to do the same.

The charge about government-run health care is as old as it is weak. The government is not interested in controlling people's health care -- what government needs to do is step in to simplify the process and ensure that all citizens have access to affordable and quality care. This is simply not happening in the privatized system in the US today.

Schwarter makes the charge the if the government intervenes in the health care crisis, it will surely lead to rationing as a means for cutting costs. This is ridiculous charge on its head considering that with over 40 million uninsured and countless more underinsured in the US today, the privatized American health care market already rations more than any other system in the industrialized world -- and our costs still are by far the highest!

As health policy expert Michael Holt explains: "So yup [rationing] happens here too, and instead of doing it by some defensible way — like looking at the cost-benefit analysis for a population — that an economist ought to commend, we do it on the basis of whether or not you can afford it."

But even beyond that, there's no evidence that a consolidated payer system in the US (or in Wisconsin, for that matter) would even need to resort to rationing. The claim is nothing more than a scare tactic used to drum up opposition to fundamentally rebuilding our health care system.

Critics like to point to rationing in countries like the UK and Canada, but they ignore that there's no evidence of significant rationing in consolidated payer countries like France, Germany, Japan, Switzerland, and Holland.

Again, I don't blame Schwartzer for his column. He's just doing his job.

And I don't expect this to be the last we see of him and other emissaries from the health insurance sector. The time is ripe for comprehensive health care reform in Wisconsin and the US as a whole -- the recent Commonwealth Fund survey showing that 75 percent of Americans think the health care system needs to be fundamentally rebuilt shows at least that much.

That means the time is now for those who benefit from maintaining the structure of the traditional system for health care in the US.

Raising the Bar on Stem Cell Opposition

The Journal-Sentinel is fronting an article today about a medical breakthrough with embryonic stem cells that allows researchers to grow embryonic stem cell lines without destroying embryos.

Rather than extracting stem cells directly from the embryo, which destroys the embryo, the new technique only takes a single cell from the embryo and subsequently coaxs it to grow into a colony of stem cells. Since single cells are already taken from embryos during in vitro fertilization without any noticeable harm to the viability of the embryos, this procedure averts the issue of destroying embryos for research.

And this is what leads the JS to report that the new procedure "could significantly reshape the ethical and political debates that have long entangled the research."

Great news, right? Wrong.

Upon hearing of the discovery, President Bush suggested that he still wouldn't be willing to lift restrictions on federal funding unless no embryos were used in the process, which is different from his previous expectation that the research simply not destroy embryos.

So, in other words, Bush will only support embryonic stem cell research that doesn't involve embryos. Yeah, you read that right.

The important question for Wisconsin, of course, is whether Mark Green agrees with President Bush.

Green has said in the past, as Bush did, that he merely opposes the use of public funds for research that destroys embryos. Since this research does not destroy embryos, does that mean he's willing to support it with public resources -- or is he going to raise the bar on his opposition like the president?

The research, it should be noted, is still far from viability. The JS reports that issues remain, such as the need for animal ingredients during the growth process and the inability to conduct genetic testing during the process.

Nevertheless, the breakthrough raises the important question for Wisconsinites of exactly where Mark Green stands on embryonic stem cell research. We know Doyle supports it whole-heartedly -- and with him at the helm, breakthroughs like this one will only strengthen the state's commitment to the research.

Can we say the same about Mark Green, or is his position going to continue to slide every time a breakthrough occurs that negates his previous concern?

Does Green agree with President Bush that the only embryonic stem cell research worthy of state support is essentially no embryonic stem cell research at all?

Wednesday, August 23, 2006

Does Van Hollen Know Something We Don't?

From the JS DayWatch blog earlier today: "A statement released by Green's campaign, however, did not provide any details on how Green would tackle crime in the city, nor did it provide a measuring stick for success, such as a particular reduction in the murder rate or crime rate."

From the JS PoliticsWatch blog a little later today (emphasis mine): "Republican attorney general candidate J.B. Van Hollen praised Republican gubernatorial candidate Mark Green for his plan to reduce crime in Milwaukee and said the two share an approach to working with law enforcement to fight dangerous crimes in the state's urban center."

Do the rest of us get to hear this plan?

Carrie Lynch has more on Green's race to become the next Tony Mandarich.

Kathleen Falk's First TV Spot

It was just a matter of time before Democratic AG candidate Kathleen Falk took advantage of her funding lead to pump out a campaign ad.

You can see the ad here.

It's quite good. The spot highlights her time as an Assistant Attorney General, and also how she has emphasized law enforcement in her current position as Dane County Executive. At the end of the ad, Falk points to identity theft, gang violence, and drug violence as three areas she would target if elected.

It's a very straightforward, positive, get-to-know-you spot, which seems pretty typical for an opening ad.

J.B. Van Hollen is the only other candidate with a TV ad out, which makes sense considering Falk and Van Hollen lead the four AG candidates in campaign wallet size. As of July 30, Falk had $607,000 in the bank, Van Hollen had $417,000, Peg Lautenschlager had $238,000, and Paul Bucher had $85,000.

The Van Hollen spot is similarly positive and also serves as an attempt to introduce the candidate to voters. Although the Van Hollen ad doesn't explicitly mention any issues that he'll target if elected, as Falk does, which could be a result of how largely unknown Van Hollen remains around the state (only 11 percent have an opinion of him, according to a recent WISC-TV poll).

Falk is a little better off in the recognition department (33%), which possibly allows her to focus less on herself and dive right into the issues in her campaign's opening ad.

But what also jumps out at me as a difference between the two is that Falk personally and directly addresses the audience in her ad, while Van Hollen relies on a voiceover throughout his ad.

It seems somewhat minor, but perhaps it will have an impact. When you're trying to introduce yourself to people, I imagine a personal message plays better than a voiceover.

The GOP's Piecemeal Approach to Health Care Reform

President Bush signed an executive order yesterday mandating that federal agencies do more to keep beneficiaries apprised of the cost and quality of their health care.

Here's how the Washington Post describes it: "The executive order requires four federal agencies that oversee large health-care programs to gather information about the quality and price of care, and to share that information with one another and with program beneficiaries."

Fair enough. This sounds like a good order.

But then we get to this part of the article: "During a roundtable with medical and business executives, Bush touted the executive order as well as other initiatives that he believes could harness market forces to slow the skyrocketing cost of medical care."

The "other initiatives" are Health Savings Accounts and what's called Association Health Plans (AHPs), which allow small businesses to poll their resources across state lines to purchase health care.

I covered the limited promise of HSAs last week, so I'll touch on AHPs briefly now.

AHPs sound good on paper, but the trouble with them is that they geographically disburse payers in such a way that actually reduces their bargaining power rather than increases it, which defeats a primary purpose of health care pools.

Plus, AHPs would encourage the selection of healthier populations to get better premium rates, thus leaving the less healthy populations to toil alone in the traditional health care market that would subsequently see an increase in premium costs to cover the risk associated with insuring individuals who tend to require greater medical attention.

Even the nonpartisan National Small Business Association opposes the GOP-approved AHPs:

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Despite [the] good intentions, we are concerned that AHPs are not only a non-answer to the real issues driving cost, but will exacerbate the problems small businesses face. The primary focus and cost savings of AHPs is through circumventing state laws and rating rules. AHPs threaten to greatly worsen the market segmentation and risk-aversion that currently characterize the small group health insurance market, which are at the root of the health care crisis uniquely faced by smaller firms. AHPs might be good for small business associations (like NSBA) who want to run them, but NSBA believes that they will not be good for the small business community at-large, whose interests we are bound to represent.

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The AHP bill pushed by the White House and the Republican leadership is also opposed by over 1300 local and national organizations, including the National Governors Association, the Republican Governors Association, the Democratic Governors Association, 41 state AGs, the National Small Business United, and many others.

More importantly, the idea that piecemeal initiatives like AHPs, HSAs, CDHPs, and medical malpractice caps are going to solve the health care crisis in the US is ludicrous -- it's also all the GOP has to offer on the issue.

And this is where we get to the heart of what's wrong with Bush's order for price transparency.

There is nothing inherently troublesome with the order, but the broad promise Bush makes that it will somehow contribute to a significant drop in the cost of healthcare is a problem.

First, price transparency does nothing to address the massive administrative costs that are associated with the US health care system, which are in many ways the root cause of why our health care costs so much more than the health care in other industrialized countries. Nearly one-third of the total cost for US health care goes to administration, while the number is half that in nations like France, the UK, and Canada that offer universal care.

Second, as I pointed out last week, price is a moving target when it comes to health care. Due to the fragmented nature of the health care system, bills for a single procedure can come from a variety of places: hospitals, doctors, labs, etc. Plus, since every patient is different, it's nearly impossible to predict the exact cost of a procedure prior to that procedure taking place. Unexpected complications can take place that require additional or different procedures than the one that's initially planned. Take, for instance, a pregnant woman who goes into labor. For most women, the initial plan is to have a vaginal birth, but sometimes a cesarean section becomes necessary, which will greatly increase the cost of the delivery. And there are many other factors along the way that are even less common and, therefore, can't be predicted in an up-front price.

The bottom line is that the US health care system requires comprehensive reform, not piecemeal initiatives.

And the majority of Americans recognize this. According to a recent Commonwealth Fund survey, 75 percent of respondents think the US health care system needs to be fundamentally rebuilt, while only 20 percent think minor changes to the system will suffice.

Why are the people running this country in that 20 percent?

Tuesday, August 22, 2006

White House Solution to "Stay the Course" Conundrum

Fire Rumsfeld.

Foreign policy journalist Laura Rozen says (via TPM Muckraker) that move might be in the works.

The White House -- and, subsequently, the GOP as a whole -- has been backed into a corner on Iraq policy lately. Rove & Co. thought the "stay the course" line would be seen by the public as a sign of Republican resolve, but it ended up being viewed largely as an indication that more of the same is in store as long as the GOP stays in charge.

Giving Rummy a pink slip could help the White House chip away at that perception -- and, if it goes down, it'll certainly happen before the midterm elections.

The only trouble, as Rozen points out, might be finding someone who's willing to take the job.

The Other "Vote No" Campaign

I want to quickly draw attention to a group in Wisconsin that's fighting against the advisory death penalty referendum that will be on the ballot this November.

The name of the group cuts right to the chase: No Death Penalty Wisconsin. Their new website is here.

The group boasts backers that range from the Wisconsin Council of Churches to the Wisconsin Coalition Against Domestic Violence to the ACLU of Wisconsin.

Here are the top twelve reasons the group cites for voting against the death penalty:

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1) Risk of Killing Innocents - hundreds of people on death row have been released/exonerated. Four were exonerated only after they died awaiting execution.

2) DNA evidence is not infallible - sloppy lab work and ill-trained staffs have lead to many cases of contaminated evidence. 11 people in Oklahoma have been executed based on contaminated DNA evidence.

3) Death penalty is not an effective criminal deterrent- Crime had not gone down since capital punishment was reinstated in the late 1970s. Moreover, states without the death penalty have much lower murder rates. The South accounts for 80% of US executions and has the highest regional murder rate.

4) Death penalty is racially and economically biased - African Americans account for over 40% of the death row population and are only 12% of the total US population. Most people on death row are poor and uneducated and often cannot afford quality legal assistance.

5) The Death Penalty Costs More - Death penalty cases cost far more than life without parole. All of the appeals, expert witnesses, and lab tests mean that death penalty cases can cost up to of 90 million dollars. Some US counties have gone bankrupt because of a single death penalty case. Wisconsinites need to consider Milwaukee County, the county with the most murders cases, and thus the most potential death penalty cases. Milwaukee County is already on the brink of bankruptcy. The death penalty could cost the state's most populous county millions that would otherwise be going to social services that county residents (many of whom are in poverty) desperately need.

6) The US is one of the world's leading executioners, putting us in a group with countries like China, Iran, Saudi Arabia, and Vietnam.

7) The US is one of the few democracies and the only nation in NATO to use the death penalty.

8) Wisconsin has recently enacted tougher sentencing requirements for murder cases, and also, life without parole guarantees no further crimes will be committed.

9) The current method of lethal injection used on death row prisoners is so inhumane that even veterinarians don't use it to put animals to sleep.

10) It is a violation of medical ethics for doctors to assist with executions.

11) Human Rights Watch, Amnesty International, American Civil Liberties Union, the National Association for the Advancement of Colored People, and many other political and human rights groups oppose the death penalty.

12) The death penalty is opposed by many major religious groups including most Jewish and Christian denominations.

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There are reasons on there for just about every position on the ideological spectrum. But, to me, reasons 1-3 are the most potent. For more details on point #3, check out this May post by Paul Soglin.

Mark Green's Press Release Politics

After a Journal-Sentinel article yesterday left question marks about what Mark Green would do to the gas tax as governor, the Green Team released a press statement pointing to a November 2005 pledge by Congressman Green to lower the gas tax by two cents.

Clear now? Not really.

Here's how the JS explains the effect of the two-cent cut in a follow-up article today (emphasis mine):

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In his statement Monday, Green said he would stand by a November 2005 pledge to eliminate a 2-cents-a-gallon gas tax used to clean up leaking underground fuel tanks and for other environmental programs. The remaining 30.9 cents a gallon goes toward transportation.

Trimming the 2 cents would leave no revenue source for those programs. It also would mean $273 million in bonds would have to be paid off with other funds. Green's campaign would not say how he would pay off the bonds or fund the programs. Together, the bond repayment and programs cost $79 million a year.

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Dan Leistikow, a Doyle aide, hits it on the head: "It's pretty clear [Green]'s trying to govern by press release and blow a huge hole in his budget."

But the hoopla doesn't stop there. Here's Green's campaign manager Mark Graul on the situation: "Mark Green is not saying he's going to raise the gas tax. In fact, the only thing he has said for sure is he wants to lower it by two cents. . . . He will say categorically that he will not raise the gas tax unless it is accompanied by some other kind of relief for Wisconsinites."

So Green hasn't said he's going to raise gas tax, he has said he's going to lower it, but he's not against the possibility of raising it.

Follow that?

Maybe we'll get another press release today to clear it up.

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Side-Note: Check out this post for another example of Green's preference for press release politics.

UPDATE: Xoff has more on how the hoopla described above speaks directly to Green's qualifications for governor.

Monday, August 21, 2006

An Unscripted President Bush

Little can be as enjoyable for a lefty -- or as concerning for a righty -- as an unscripted President Bush.

Here's some of the transcript from a Bush press conference today:

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BUSH: The terrorists attacked us and killed 3,000 of our citizens before we started the freedom agenda in the Middle East.

QUESTION: What did Iraq have to do with it?

BUSH: What did Iraq have to do with what?

QUESTION: The attack on the World Trade Center.

BUSH: Nothing. Except it’s part of — and nobody has suggested in this administration that Saddam Hussein ordered the attack. Iraq was a — Iraq — the lesson of September 11th is take threats before they fully materialize, Ken. Nobody’s ever suggested that the attacks of September the 11th were ordered by Iraq.

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Nobody's ever suggested that the attacks of September the 11th were ordered by Iraq.

Nor did the reporter in his question -- he asked what Iraq had to do with the terrorist attacks on September 11.

And Bush nailed it with his first answer: Nothing.

Think Progress has the video here.

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UPDATE: TPM Muckraker has more on Bush's claim that his administration never said Iraq ordered the terrorist attacks on September 11. While this is technically true, they point out that the White House has suggested on numerous occassions that Saddam Hussein was involved in the attacks.

Seems the White House has now changed its stance on that. Will its defenders do the same?

Health Care Crisis Becoming a Middle Class Issue

The nonpartisan Commonwealth Fund recently released the results of a survey on health care in the US.

Perhaps the most eye-opening aspect of the survey was that it showed health care is becoming an increasingly difficult problem for middle class families.

According to the results, nearly half (48 percent) of middle income respondents ($35K - $50K per year) reported having serious difficulties paying for health care. The difficulty decreases as income increases – which is to be expected – but 1/3 of families with incomes between $50K and $75K still reported a problem paying medical bills, as did one in five with incomes over $75K.

This bodes well for Dems heading into 2008. The left has been looking for a way to court the middle class in the same way the GOP did in the 1980s with taxes, and comprehensive health care reform appears to be its best shot.

The Commonwealth Fund survey found that a whopping 75 percent of respondents say that the US health care system needs to be fundamentally rebuilt, whereas just 20 percent say only minor changes will suffice. This went for insured and uninsured respondents.

Notably, however, Republican respondents were more likely than Democrats to back minor changes over comprehensive reform (35 percent to 11 percent). Nevertheless, that shows that even a majority of Republican voters back comprehensive reform.

Unfortunately for the GOP, the current Republican leadership -- which has controlled the federal government for the past five years -- has shown its complete unwillingness to address health care reform on a large scale.

This leaves a significant opening for the Dems on the national level, and in some states like Wisconsin, which features a stark difference in the way the two candidates for governor perceive the need for reform of the state’s health care system.

No Need to be Coy, Congressman Green

Lines like this one are becoming familiar over the course of this year's gubernatorial race: "Doyle staked out his position on transportation, and Green gave hints of his... ."

It must have been tough for the Journal-Sentinel to print, which is probably why the article found itself on page 5 of the Metro section.

Doyle has pledged to not raise the gas tax if re-elected, Green did not say what he would do with the gas tax if he is elected.

Doyle offered a proposal to increase the vehicle registration fee from $55 to $65, Green did not say whether or not he supports such a move.

Green did offer up that he might shift $700 million from the state's general fund to the transportation fund, but -- and here's the kicker -- he wouldn't say how (or if) he would fill the hole that move would create in the general fund, which is the primary fund for education, health care, law enforcement, etc.

Overarching everything that Green says on the budget is his support for a TABOR-type amendment and his promise to not run again if the so-called tax burden goes up on his watch.

Supporting TABOR will only get Green so far since -- in addition to it being a highly unpopular measure -- the soonest it could be enacted is after the 2009-2011 budget is passed. That means the amendment can have absolutely no impact on the two biennial budgets the winner of the Doyle-Green race will need to craft.

And the tax burden pledge puts Green in the tough position of needing to cut revenue somewhere if he chooses to make a move like raising the gas tax or the vehicle registration fee. For instance, if Green did move $700 million from the general fund to the transportation fund, there's no way he could replace the hole without breaking his pledge -- or drastically reducing revenue in some other fund.

In essence, the pledge puts him under TABOR-like restrictions with the only potential savior being an enormous rise in state personal income over the next four years.

It will be interesting to watch the Doyle-Green debate on public finance that's planned for September 15 in Waukesha.

I have a feeling we'll hear about Green's tax burden pledge quite a bit that evening (he'll keep his support for TABOR under tight wraps...unless, that is, he's courting a special interest) -- I just hope someone puts him on the spot about exactly what that soundbite means for public finance in Wisconsin.

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UPDATE: Now Green says he'll cut two cents from the gas tax -- the two cents that's used to fund clean-ups for leaking underground fuel storage tanks at stations. Talk about taking a bad political move and making it worse.

Friday, August 18, 2006

A Chat with Bill Richardson

I had a chance to talk briefly with Bill Richardson on the phone today during his visit to Wisconsin.

Richardson's resume is nothing less than outstanding. Here's a guy who served in Congress for 15 years, as US Ambassador to the UN, as US Energy Secretary, as a diplomatic envoy to places like Iraq and North Korea, and as governor in a state that went to Bush in 2004. He was also rumored to be on the short-list for VP in 2000 and 2004.

And -- to top it all off -- he can manage to get Bill O'Reilly to refer to him as "an honest guy."

Richardson has a reputation for being a very personable guy, and based on what I could tell over the phone, he is. He's very smooth with the talking points -- I imagine he's excellent on the stump, but even better face-to-face.

In our 7-8 minute conversation, we mostly discussed economic policy and energy policy, but we also delved quite a bit into Democratic politics in relation to the midterms and the 2008 presidential election.

I won't get much into the details here because those can probably be found in just about every interview Richardson gives these days and on his website.

What I want to discuss a bit more in this post is Richardson's vision. Although often characterized as centrist, my brief talk with Richardson gave me the impression he's really a populist at heart.

Richardson's a broad thinker, but also practical. For instance, on the issue of immigration, he sees it as a discussion about the "national spirit" of the country as opposed to merely an issue of compassion, economics, or law enforcement. While the outcome needs to take into consideration those finer points, it will also help shape the sense of the US as a nation, and that recognition is essential if we're going to find a fair resolution to the issue that can stand the test of time.

But where Richardson's populism really shines through is when he discusses the strategy for Democratic electoral success. Richardson sees the individual states as the best place to ground Democratic policies not only because it's strategically wise, but also because he rightly sees the states as the best place for public policy innovation.

While we have a federal government that's dominated by the GOP, twenty-two states around the country currently boast Dems in the executive office and Richardson -- as chairman of the Democratic Governors Association -- thinks that number is going to increase after November.

These twenty-two states have made impressive strides on Dem issues like stem cell research, renewable energy investments, and public finance reform. And it's these state-tested issues that can be culled together on the national level to formulate a Dem platform heading into the next two elections, as Richardson says, to make the Democratic Party "the party of innovation" and, ultimately, economic growth and competitiveness.

Richardson correctly notes that the Dems can't simply run against Bush -- they need to have an enticing and solid platform of their own, and one that, as he describes it, should be both "optimistic and patriotic."

Another strength that Richardson boasts is his foreign policy expertise. He's served as US Ambassador to the UN under Clinton, and he's also served the country in diplomatic situations on more than one occasion -- most recently in North Korea last October.

And he works this foreign policy angle in beautifully with his expertise on energy (he also served as Energy Secretary under Clinton) to posit some polished talking points on the need for energy independence in order to strengthen national security.

Richardson isn't officially announcing any plans for 2008 until after he wins reelection as New Mexico's governor this November (and the polls show that he will win), but most experts would be shocked if he didn't run. He's got the personality, the resume, and -- from what I can tell -- the message to do it.

I certainly wouldn't mind seeing him on the ticket in 2008 -- and I have a feeling the GOP would.

UW Regent Easily Refutes Charges by Mark Green

UW Board of Regents president David Walsh sent a letter to Mark Green today in response to some of the charges Green leveled against the UW System recently.

Here’s a brief summary, point-by-point:

  • Out-of-state tuition: Green demanded that the UW Regents reverse a decision to decrease non-resident tuition. Walsh points out to Green that out-of-state tuition increases during the 1990s – when Green was a state legislator – helped lead to a reduction of 900 non-resident students from the UW System between 2001-2002 and 2004-2005. And with these students went $13 million in revenue from the system – revenue that could’ve been used to off-set in-state tuition. The modest decrease in non-resident tuition this upcoming year (except UW-Madison, which won’t see any drop) -- which will still leave it three times higher than resident tuition -- is an attempt to recapture those students and that needed revenue.
  • Lawson deal: Green accused the UW System of mismanagement on the purchase of a HR software system that cost $26 million (over five years and including the salaries of UW employees working on the project), which has subsequently been scrapped. Green demanded the managers of the project be held accountable. Walsh points out in his letter: “As you have no doubt been informed, the administrators of that system are no longer employed by the University of Wisconsin System.” Ouch.
  • Faith-based student groups: Green has openly criticized the UW System for supposedly being hostile to faith-based student groups. Walsh points out that the UW campuses each boast numerous faith-based student groups. However, there are certain anti-discrimination rules that regulate all groups on campus, and the organization identified by Green has not abided by those rules. The majority of other faith-based groups on campus, however, do abide by those rules, and thus are allowed to continue their formal affiliation with the UW.
  • Kevin Barrett: Green has asked that the Board of Regents step in and fire Kevin Barrett in spite of the decision made by UW-Madison not to do so. Walsh asks Green if he has any evidence to show that Barrett will not teach his course “in a manner consistent with the rules of the University.” If not, then the Board trusts that students will have the ability to “sift and winnow” through controversial ideas when presented to them in an appropriate manner.
At the end of the letter, Walsh notes that he heard of Green's complaints through a reporter. Part of the release by Green appears in letter format and is addressed to Walsh, but there's no telling if it was directly sent to his office or merely addressed to him through the press release.

If it turns out that Green didn't send a copy directly to Walsh, then it would suggest Green's preferred method of working with the UW is based far more on style than substance.

To be sure, the relatively easy manner in which Walsh refuted Green's charges -- particularly on the Lawson deal and the non-resident tuition issue -- already demonstrates how lacking in substance the charges were to start.

Georgia Thompson's New Position

The other 45,000 civil servants in the state system are going to be so jealous when they hear this.

Apparently Georgia Thompson has been retroactively promoted to the position of "top aide" for Governor Doyle. At least that's what the latest anti-Doyle attack ad by the Republican Governors Association says.

Here's the line: "A top aide to Governor Jim Doyle got a felony conviction for steering a state contract to Doyle campaign donors."

Perhaps one day Georgia Thompson will finally get to meet the person she has evidently worked with so closely over the years.

You can see the ad here.

Thursday, August 17, 2006

Mark Green Continues to Avoid Tough Questions

All politicians like to avoid controversy, but, so far in this gubernatorial race, Mark Green has made side-stepping tough questions a hobby.

The latest avoidance comes on the question of the proposed marriage and civil unions ban, which is the featured "Issue of the Day" in the Journal-Sentinel PoliticsWatch blog today.

Here's the language of the ban: "Only a marriage between one man and one woman shall be valid or recognized as a marriage in this state. A legal status identical or substantially similar to that of marriage for unmarried individuals shall not be valid or recognized in this state."

While I oppose both sentences in the ban, clearly the more controversial of the two is the second sentence. If the ban stopped at the first sentence, there's no question it would pass in November. As it stands, however, the passage is not guaranteed -- and that fact is entirely due to the questionable effects of the second sentence.

Here's Green's response to whether he supports the ban: "I believe that marriage should be clearly defined as being between one man and one woman. So, yes, I support the amendment."

Green completely avoids the second sentence of the ban in his response. He says nothing about the impact of the ban on civil unions -- which a majority of the state supports -- nor does he get into the potential impact of the ban on such things as public domestic partner benefits or any of the other legal protections of marriage for non-married couples across the state.

Doyle's response, on the other hand, takes into account the full language of the ban: "Wisconsin already outlaws gay marriage. This amendment is unnecessary, and was only intended to divide people. Worse, it would make it impossible for some people to make final medical or inheritance decisions for a loved one. Instead of dividing our state, we should find ways to bring people together."

If Green supports the entire amendment, why isn't he willing to explain why?

JS Reporters Continue Bias Coverage of Gubernatorial Race

In the last ten days, Governor Doyle and Congressman Green have both made tax break proposals.

Doyle's plan is to allow Wisconsin residents to claim a tax deduction for health care premiums that are paid out of pocket. Green's plan is to suspend the sales tax on certain school supplies for one weekend in August.

Here's a rundown of the coverage from the Journal-Sentinel on the Doyle plan:

Title: "Doyle Proposes Health-Care Tax Break"
Subtitle: "Deductions for Health Premiums Would Cost State $50 Million a Year"
Fiscal Impact: "Doyle said the recommended new tax break for health-care premiums would cost the state treasury about $50 million a year, but it would offer the same deduction to about 637,300 families now enjoyed by the self-employed and others who must pay all their health insurance premiums."

Now here's the JS on Green's plan:

Title: "Green Proposes Back-to-School 'Tax Holiday' "
Subtitle: "Sales Tax Break Would Apply to School-Related Items"
Fiscal Impact: "Green estimated that the plan would save taxpayers - and thus reduce tax revenue for the state - between $5 million and $10 million a year."

To sum up, the cost of Doyle's plan gets fronted in the subtitle and highlighted in the second line of the article, while the cost of Green's plan is framed as merely a reduction in tax revenue and couched in a line about saving taxpayers money.

The Doyle article was written by Steve Walters and the Green article was penned by Walters and Greg Borowski, so this isn't merely a difference of journalistic style. The rhetorical framing of the two articles was blatant and undoubtedly purposeful. And the impact is significant.

As Bruce Murphy noted last month: "The Journal Sentinel’s coverage of the governor’s race looks increasingly suspect."

I think it's getting time to ring them up on charges.

Mark Green & the Limited Promise of HSAs

It’s amazing to me that Mark Green has the guts to criticize Doyle on the governor’s health care reform proposals when Green himself has offered little to nothing on the topic.

All Green keeps talking about are state tax breaks for Health Savings Accounts (HSAs), which hardly amounts to a blip on the health care radar in Wisconsin. What’s more, the move would do absolutely nothing to address the growing number of uninsured and the actual cost of care in the state.

It’s also getting tougher and tougher for proponents to find good press on HSAs, which are a signature part of High Deductible Health Plans (HDHPs) or, as they’re often called, Consumer Driven Health Plans (CDHPs).

The idea of CDHPs is that people will get a low premium, high deductible health plan that affords them a HSA to use for the increased out-of-pocket deductible payments.

Since people will be spending their own money for the care, proponents argue, they will be more responsible with the care they receive – seeking out lower cost providers whenever possible, thereby increasing competition and subsequently lowering prices across the board.

According to a recent story in the Chicago Tribune, however, people in these CDHPs are discovering it is impossible to “shop around” for the best provider price, which – as described above – is the central tenet of CDHPs.

The industry newsletter FierceHealthcare explains:

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Healthcare is, by nature, a fragmented industry. One procedure can involve various services from hospitals, doctors and labs, each of which bill separately. This makes an up-front estimate almost impossible. Added to that is the fact that patient's level of health varies: Two patients undergoing the same procedure will be charged different prices based on their particular needs.

At this early stage, CDHPs seem like a Catch-22. Consumers are supposed to comparison shop without even getting a chance to look at the real price tag.

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Adding more pressure to the promise of HSAs is a recent report commissioned by Destiny Health – a company that sells and promotes CDHPs – that suggests most Americans are unwilling to do the necessary homework even when they can manage to get accurate pricing information from health care providers.

According to the findings, less than 40 percent of respondents said they would be willing to “shop around” for care if given the opportunity. And this is coming from a company that’s trying to sell these plans!

People are also showing through their health plan choices that comprehensive coverage is preferred to the uncertainty and risk of CDHPs. As stated in a recent Business Journal of Milwaukee article, while 20 percent of employers in the country currently offer CDHPs, only 5 to 10 percent of eligible employees opt for them.

This trend is in line with findings by the non-partisan Commonwealth Fund late last year that people in CDHPs are significantly less satisfied with them than people who are in comprehensive coverage plans (even those with relatively high out-of-pocket costs).

In the end, Governor Doyle is right: HSAs can be a useful tool as part of broader healthcare reform, but they do not work as a standalone measure. And simply providing state tax breaks on them isn’t a viable answer to the growing health care crisis in Wisconsin.

For example, the health care reform plan proposed by Sen. Russ Decker (D-Schofield) and Rep. Terry Musser (R-Black River Falls) this past spring includes a $600 deductible for families ($300 for individuals). HSAs would be an excellent addition to the plan that would allow people to save their out-of-pocket deductible costs tax-free prior to paying them.

But what makes HSAs an acceptable idea in this plan is that the overall costs of care would be controlled through other facets of the proposal that reduce administrative overhead and increase the negotiating power of payers in the system. Once these costs are controlled, it takes the risk and uncertainty out of the HSA. Plus, the deductible costs are modest in the Decker/Musser plan compared to those in CDHPs, which are a minimum of $2000 for families and $1000 for individuals.

The more Green merely criticizes Doyle on health care reform, the more obvious it becomes that the only purpose in the task is to cover the fact his campaign has nothing meaningful to offer on the topic.

Wednesday, August 16, 2006

Clearing the Air on the State Deficit

Before every biennium, the Legislative Fiscal Bureau examines fiscal commitments for the upcoming state budget and determines how much more revenue will be needed to meet those commitments above the current revenue levels.

How much more revenue will be required above and beyond the current levels has been referred to in the media as a “structural deficit” (and that phrase was repeated on this blog), but that’s actually not accurate. In fact, this figure is simply known as an “advanced commitment” because it involves the cost of future commitments based upon current revenue levels.

Here’s a chart from a recent Department of Administration report that shows the level of “advanced commitments” over the past decade:

(Click image for larger view.)

The 2003-2005 figure (red) represents the “advanced commitments” Governor Doyle faced upon entering office in 2003. The 2007-2009 figure (light blue) is what Doyle or Green will face for the upcoming biennium, which appears on par with figures in the late 1990s, but in fact represents a smaller portion of the state budget as a whole because revenue levels are higher today than they were a decade ago.

Another figure that is being tossed around by conservatives is $2.6 billion, which they claim is the size of the current state deficit. This figure is based upon a special request by State Senators Mike Ellis (R-Neenah) and Robert Cowles (R-Allouez) to add anticipated expenditure increases in school aids, Medical Assistance, and state employee compensation to the advanced commitment figure outlined above.

This $2.6 billion figure has been subsequently compared to the $3.2 billion deficit Doyle faced when he entered office. Republicans, in turn, make the claim that Doyle hasn’t done much at all to help the deficit because it’s only 19 percent less than it was four years ago.

This comparison is flat out false.

As the recent DOA report makes clear, the $2.6 billion figure cited by Ellis and Cowles DOES NOT include expected revenue increases, which amount to $1.9 billion over the next biennium.

The $3.2 billion figure Doyle faced in 2003, however, DOES include projected revenue increases for that biennium.

So, in reality, the $3.2 billion figure should be compared to the current figure of $700 million, not $2.6 billion. And that shows us that Doyle, in fact, decreased the budget hole by nearly 80 percent since taking office.

And to put that into broader perspective, the current $700 million figure – relative to the percentage of total estimated spending, including projected increases – represents the 3rd smallest figure since the 1989-1991 budget.

Considering four years ago the figure was the worst it has ever been in Wisconsin history, the Doyle Administration has made quite a turnaround when it comes to the state budget.

But something tells me the GOP doesn’t want to hear any of that – at least not in an election year that sports an incumbent Democratic governor.

Tuesday, August 15, 2006

Taking Steve Nass to Task

I wanted to respond to this ridiculously reactionary piece by Rep. Steve Nass (R-Whitewater) on the UW System, but my spare time energy levels are being sapped by fantasy football preparations.

So I was elated to read this post by Dave Diamond, which hits all of the major points on why the proposals Nass makes are ludicrous, and probably does so in a much more concise manner than something I would put together.

Dave's suggestion for a press release is particularly on target. Check it out.

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Side-Note: I have discussed the new holistic admissions policy for the UW System (except it's not new for UW-Madison) that Nass overblows completely. You can read those here, here, and here.

What Makes Mark Green Extreme

The Green Team has its first TV spot out challenging the “too extreme” label the Dems have pinned on its candidate.

The ad, however, misses the mark on why Mark Green is extreme. Rather than focusing on politics, most of the ad aims at Green’s personal side.

As a person, I have no doubt Green is not extreme – at least not in a bad way. I’m sure he’s a good father and a caring spouse.

But that’s not really the point.

To be fair, the ad does end with Green admitting he’s interested in changing things in Madison, but he doesn’t provide details aside from ambiguously noting he wants to lower the tax burden.

Of course, the devil is in those details.

Back when Tommy was mulling a gubernatorial run in April, I wrote that the effect of a Thompson bid would be to shift power in the state GOP from the far right back to the moderate majority of the party.

Mark Green may or may not be a member of the far right at heart – it really doesn’t matter.

What matters is that the far right – based in southeastern Wisconsin – has been controlling the direction of the state GOP since Thompson left office. Tommy’s strong enough to turn that tide back -- Mark Green is not.

Green needs “the fire-breathing tax-limiting fiscal conservatives,” as esteemed member Charlie Sykes calls them, who control the conservative media around Milwaukee. If they don’t support him, he doesn’t stand a chance of scoring well at the polls in southeastern Wisconsin, nor would he be able to pull in the major GOP donations that flow from Waukesha County. And without those things, he doesn’t stand a chance at beating the incumbent Doyle.

So, in effect, it’s the company that Green must keep that makes him extreme.

Take the failed Taxpayer Protection Amendment. Green backed it throughout the spring, in spite of the fact that moderates in the GOP – who almost entirely hail from outside of southeastern Wisconsin – shot it down when it reached the legislature.

Rather than see that as a sign that the majority of the state isn’t in favor of writing broad and restrictive fiscal policy into the state constitution, Green continues to demonstrate that he would back another incarnation of TABOR in the future. He just won’t say it publicly.

If he didn’t back the next TABOR, you can bet Sykes, Belling, & Co. would turn on him in an instant. Heck, Belling turned on him this past spring simply because the TP Amendment didn’t pass this year, something Belling pinned on Green’s lack of leadership on the measure.

And this isn't the first instance of Green not standing up to party handlers.

Who can believe that Green is actually proud of his fiscal record as a member of Congress? He voted with Bush 93 percent of the time because the White House was running the show, and he wasn’t a strong enough politician to stand up to it.

I mean, who can blame him? He’s giving up his Congressional seat to run for governor this year. If he loses and he had burned his bridges to the top Republican in the country, where would that leave him?

In the end, the issue is not simply whether Green is extreme. It’s that – until he can stand on his own two feet as a politician statewide – he can’t help being as extreme as the state GOP’s current puppet-masters want him to be.

Monday, August 14, 2006

Green Dons Congressman Cap to Warn of Terror in Wisconsin

Do you think Paul "The Pit Bull" Bucher will go after Mark Green for releasing this statement that links terrorism to Wisconsin?

I also like this line from the Green Team in the new Journal Sentinel "Issue of the Day" segment (emphasis mine): "While I believe the death penalty should be rarely used, there are certain evil-doers whose sadistic actions demand the ultimate punishment."

As they say, imitation is the sincerest form of flattery.

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Side-Note: Check out this One Wisconsin Now press release for more on the actual level of terror threats in Wisconsin.

Health Care Reform and the 23rd District: Democrat or Bust

When Rep. Curt Gielow (R-Mequon) announced he was not seeking reelection back in April, I wrote that the Assembly was losing one of its few Republican legislators concerned with comprehensive health care reform.

Gielow co-sponsored the Wisconsin Health Plan (AB 1140) with Rep. Jon Richards (D-Milwaukee), which I discuss in more detail here. I was critical of the plan, but the fact that Gielow was interested in comprehensive health care reform was admirable and something I hope to see continue in the 23rd Assembly District.

When Gielow announced his decision not to run again, some conservatives in the blogosphere celebrated the decision. Here’s what Owen at Boots and Sabers had to say at the time: “This would be great. Surely his district, which is centered around Mequon, can produce a better conservative than Gielow.”

The far right had other reasons to dislike Gielow aside from his emphasis on health care reform. Less than one month after his decision not to seek reelection, Gielow voted against the original “Taxpayer Protection Amendment” (although he did support the less extreme “bar-time” version).

It appears if the 23rd District votes Republican again this November, they’ll get a legislator who will champion writing restrictive fiscal policy into the state constitution. And they certainly won’t need to worry about having a representative who’s focused on addressing the growing health care crisis in the state.

The two right-wingers up for the job are Jim Ott (of WTMJ-TV meteorology fame) and John Wirth.

According to a Journal-Sentinel article this morning, both strongly back the TP Amendment and any other children that may come from the TABOR family this coming legislative session. In fact, Ott even makes the assertion that the TP Amendment wasn’t restrictive enough.

(Side-Note: Although, in fairness, it’s not clear that Ott truly understands what the TP Amendment was proposing – he says it was aimed at limiting government spending, when it actually would’ve restricted public revenue.)

Wirth, for his part, has this to say about public finance: “We ought to have some constitutional limits on taxes and spending at all levels that only could be overridden by referendum.”

Considering Wirth enters the Assembly race as an alderman in Mequon, support for the TP Amendment really makes him the rarest of local officials in the state – although I suppose priorities can change when you become a state rep.

In the end, if constituents in the 23rd District are interested in electing a representative who is concerned with health care reform like Gielow, they’ll need to look to one of the Dem candidates. All three of them – Bill Elliott, Toni Ihler, and Stan Teplin – cite health care reform as their primary focus.

Thursday, August 10, 2006

I Agree with Paul Bucher

I think the Republican AG candidates should do a lot more of these debates.

Perhaps Jerry Springer would be willing to host the next one.

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UPDATE: Owen has a more detailed rundown of the debate for those who are interested. Key quote: "The level of hatefulness between these two men is distasteful."

Public Getting Tired of GOP's Version of the War on Terror

The White House is doing its best to spin the Lieberman primary defeat as a sign that the terrorists will strike again (see Tony Snow say it here, Cheney repeat it here, and then O'Reilly parrot it back here).

The fact is, though, there is no difference between the Dems and the Repubs in terms of willingness or determination to fight terrorism. The difference comes down entirely to how the two sides feel it's best to wage the war against terrorism.

That difference is highlighted in this quote by Josh Marshall on the uncovering of the UK terror plot:

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President Bush just said the events in London are "a stark reminder that this nation is at war with Islamic fascists."

Also a pretty stark reminder that President Bush's War on Terror, the way he's chosen to fight it, is at best irrelevant to combatting this sort of danger. These are homegrown Brits apparently trying to blow up planes over the Atlantic. Good thing we've got a 150,000 or so troops in Iraq to take the fight to them.

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Thankfully, the American people seem to be awakening to this difference.

A recent Washington Post poll asked respondents if they support President Bush's handling of the US campaign against terrorism. Only 47 percent of respondents say they do.

That's the lowest the number has been since the Post started asking the question right after September 11. Only one other time, in November 2005, did the number drop under 50 percent.

What's more, as Greg Sargent points out, when asked which political party they trust to do a better job handling the US campaign against terrorism, more respondents stated the Dems (46 percent) than the Repubs (38 percent).

The public simply has had enough of the GOP's version of the war on terror, and they're no longer buying that it's the only way to go.

Bringing It Back on the JS

I have a friend who used to slap us (albeit lightly) in the face when he thought we said something stupid -- and when he thought we really said something ridiculously stupid, he would "bring it back" on us by immediately slapping us again with the back of his hand.

Well, Xoff brings it back on the Journal-Sentinel today for a ridiculously slanted article that appears on the front page this morning concerning Doyle's order to not enforce the minimum mark-up law on ethanol blended fuel in the state.

I was going to craft a response to the article myself, but didn't have time to put one together.

Thankfully, Xoff hits all of the points I wanted to make -- and then some.

Check it out if you haven't already -- it's worth the read.

Mark Green Conceals Stance on Concealed Carry

A commentary up at WisOpinion today reminds me of an issue I've been meaning to raise for some time.

JJ Blonien of the Wisconsin Conservative Digest points out that getting rid of Doyle is the only way to get a concealed carry law passed in the state.

Without getting into all of the issues of whether or not such a law is a good idea, it is interesting that the Green Team has been conspicuously silent about concealed carry so far during this election.

In fact, you can't even find the words "concealed carry" anywhere on Green's campaign website, nor do they appear in any edition of "The Green Sheet" dating back to when the publication started in May 2005.

Why the silence?

A poll by UW-Milwaukee in April showed that 69 percent of respondents oppose the concealed carry law, but proponents frequently argue that survey results depend upon the wording of the question.

It seems, though, the Green Team has evidence that no matter how you frame it, concealed carry is not a winning issue this election year -- otherwise, why not use it?

To dig a little deeper, it may be that Green is trying not to upset voters in Milwaukee and other urban areas (which tend to oppose concealed carry more than voters in rural areas).

If Green is to beat Doyle in November, he needs to do well in the urban locales. He's already well-known in Green Bay, which helps his chances there (although he couldn't even muster 50 percent support in the area in the latest WPRI poll).

But the rest of the state -- including Milwaukee -- still doesn't know him (or at least know him very well) and it's likely he doesn't want arming citizens to be the issue they get to know him by.

To be sure, concealed carry isn't exactly a mainstream Republican issue in Wisconsin. After all, one of the most popular governors in state history -- Tommy Thompson -- opposed the idea since it was first discussed in the state legislature during the mid-1990s. The Doyle Administration is simply following in Thompson's footsteps on this issue.

Perhaps it would be wise for the Doyle Team to inform the voters -- especially in urban areas -- of exactly how this aspect of life in Wisconsin would change under a Green Administration.

Wednesday, August 09, 2006

Would Mark Green Support BadgerCare Plus?

WI Department of Health and Family Services secretary Helene Nelson is visiting different parts of the state to discuss Governor Doyle's BadgerCare Plus proposal.

An article in the Oshkosh Northwestern discusses one of these visits to the Fox Valley yesterday.

The goal of the BadgerCare Plus plan is to expand health coverage to every child in Wisconsin and many currently uninsured adults. The estimate is that the plan will reach half a million Wisconsinites once implemented -- almost 20 percent of the beneficiaries would be children.

And the need is certainly there. According to a Journal-Sentinel article on Monday, an estimated 91,000 children in the state lack health coverage. About 2/3 of those kids could qualify for Medicaid and BadgerCare, but enrollment issues are stopping them -- either because parents aren't aware of the programs or they don't think they qualify.

The BadgerCare Plus plan would simplify the process by merging the family Medicaid, BadgerCare, and Healthy Start programs currently operating in the state. There would only be one set of eligibility requirements under BadgerCare Plus, which makes enrollment significantly easier for families.

In addition, the plan would raise the income ceiling for participants to up to 200 percent of the federal poverty level (FPL) and cover pregnant women up to 300 percent of the FPL.

What's more, due to the administrative streamlining inherent in the plan, it would save an estimated $20 million annually over what is paid now to cover the separate family Medicaid, BadgerCare, and Healthy Start programs.

This savings is similar to the savings realized when the state health insurance plan for state employees was overhauled a few years ago. By centralizing the payers in that system and consolidating the prescription drug coverage under a single payer, the state health insurance plan has become a model for states around the country. Over $14.5 million was saved in negotiations with providers in 2005 alone.

At least one Republican in the state is backing the BadgerCare Plus initiative. State Senator Carol Roessler (R-Oshkosh) applauded the program yesterday. "What is being proposed here," she said, "is collapsing pools of money to make them go a better distance, help more people and make a more effective delivery system."

The question remains, however, whether Republican gubernatorial candidate Mark Green supports the plan.

Doyle plans to include the program in his 2007-2009 biennial budget proposal. Would Green do the same if he's elected?

So far Green has not said anything about BadgerCare Plus on the record. In fact, all he has offered on health care reform thus far is that he supports "private sector solutions" to the growing crisis, which amounts to state income tax breaks for health savings accounts (HSAs already exist and are tax-deductible on federal income taxes).

I think the people of Wisconsin deserve to know where Green stands on the BadgerCare Plus proposal prior to heading to the polls this November.

Fact Checking Mark Green's Spending Figures

Yesterday the One Blog commented on part of an article in the Wausau Daily Herald, but I wanted to follow up today with a question about the state spending figures Mark Green provided to the Daily Herald editors and reporters.

Here's the section in question from the article:

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Gov. Jim Doyle's administration is guilty of fiscal mismanagement, leading to a 20 percent increase in spending in the past four years, Republican challenger Mark Green told reporters and editors from the Wausau Daily Herald on Monday.

Green, a four-term congressman from Green Bay, said state spending must be held closer to the rate of growth or the annual inflation rate, currently at 4.3 percent.

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Like his "plan" for the budget, Green apparently didn't provide any specifics to back-up his claims about the increased spending under Doyle. He should've been asked to provide them.

Here are the state spending figures over the past decade, according to the most recent Blue Book (see page 834):

1994-1995: $18.1 billion
1995-1996: $18.7 billion
1996-1997: $20.1 billion
1997-1998: $21.6 billion
1998-1999: $23 billion
1999-2000: $26.4 billion
2000-2001: $28.2 billion
2001-2002: $31.6 billion
2002-2003: 32 billion
2003-2004: $33.9 billion

Doyle officially took office in January 2003, smack in the middle of FY 2002-2003, which ran through June 30, 2003.

If you consider that FY to be part of Doyle's tenure, then total state spending only increased by a combined 7.3 percent in Doyle's first two years in office.

If you consider the following FY -- 2003-2004 -- to be Doyle's first year in office, I couldn't find any spending figures online that go beyond that FY. I'm sure there are figures for 2004-2005 out there somewhere, but the number for 2005-2006 won't be finalized until fall and the figure for 2006-2007 just started accumulating on July 1 of this year.

Which leads me to wonder, how exactly is Green coming up with a 20 percent spending increase under Doyle?

And, as it happens, in the four full fiscal years prior to Doyle coming into office -- 1998-1999 through 2001-2002 -- total state spending increased by a combined 37.4 percent.

So even if Green can provide figures that show spending actually did increase by 20 percent in Doyle's four years in office (which, again, would be difficult considering those years aren't finished), all that means is that Doyle managed to reduce spending increases by 17.4 percent in his first term in office.

Is that really a case the Green Team wants to make?