Chuck Collins: Healthcare costs, not taxes, are the big hit on businesses

Members of the House GOP were in a hurry on May 4 to pass their bill to gut Obamacare. They rushed it through before anyone even had a chance to check its cost or calculate its impact on people’s access to insurance.

Their urgency, however, had little to do with health care. The real reason for the rush? To set the table for massive tax cuts.

Indeed, the House health plan would give a $1 trillion boon to wealthy households and pave the way for still bigger corporate tax cuts to come, as part of the so-called “tax reform” they’re pushing.

Meanwhile, dismantling the Affordable Care Act will cause up to 24 million people to lose their health coverage, according to the non-partisan Congressional Budget Office. (Though even that estimate is based on the less extreme version of the bill that failed to pass in April. The new plan may be even worse.)

Why would a GOP politician support an unpopular bill that fewer than 20 percent of voters think is a good idea? Why risk angry constituents showing up at town hall meetings?

Put simply, to please their wealthy donors and Wall Street corporations. For complex legislative reasons, repealing Obamacare’s taxes on the rich first will make it easier for them to slash corporate taxes next.

As the “tax reform” debate begins, prepare for sermons about how cutting taxes for rich and global corporations will be great for the economy. Slashing the corporate tax rate, we’ll be told, will boost U.S. competitiveness.

But if Congress were really concerned about the economy, policy wouldn’t be driven by tax cuts. The real parasite eating the insides of the U.S. economy isn’t taxes, billionaire investor Warren Buffett explained recently, but health care.

In fact, taxes have been steadily going down, especially for the very wealthy and global corporations. “As a percent of GDP,” Buffett told shareholders of his investment firm, the corporate tax haul “has gone down.” But “medical costs, which are borne to a great extent by business,” have increased.

In 1960, corporate taxes in the U.S. were about 4 percent of the economy. Today, they’re less than half that. As taxes have fallen, meanwhile, the share of GDP spent on health care has gone from 5 percent of the economy in the 1960s to 17 percent today.

These costs are the real “tax” on businesses. As any small business owner can tell you, health care costs are one of the biggest expenses in maintaining a healthy and productive work force.

Yet the GOP bill will weaken healthcare coverage and regulation, which will increase costs and hurt U.S. companies.

U.S. employers, remember, must compete with countries that have superior universal health insurance for their citizens and significantly lower costs. While health care eats up 17 percent of the U.S. economy, it’s around just 11 percent in Germany, 10 percent in Japan, 9 percent in Britain and 5.5 percent in China.

No wonder Buffett concluded that “medical costs are the tapeworm of American economic competitiveness.”

Buffett observed that the House healthcare bill would give him an immediate $680,000 annual tax cut, a break he doesn’t really need, while only allowing that tapeworm to bore deeper.

For all its limitations, the Affordable Care Act has expanded coverage and the quality of life for millions of Americans. It’s also put in place important provisions to contain exploding health care expenses, slowing the rise of costs.

The GOP plan to reduce coverage and deregulate health care will take us in the wrong direction. That’s a pretty poor bargain for yet another tax cut for the richest Americans.

Chuck Collins is a senior scholar at the Institute for Policy Studies and a co-editor of Inequality.org. He’s the author of the recent book Born on Third Base. 


Chris Powell: ACA a mistake, GOP bill is worse



The Affordable Care Act, better known as Obamacare, lost last week at the hands of the Republican majority in the House  because it didn't work well.

While it extended coverage to millions of people, for many the coverage was not so affordable. It failed to cover millions more and failed to enroll millions of young people whose premiums were necessary to the scheme's solvency. As a result it exploded premiums even without covering everyone. Cynics suspected that Obamacare was  planned to fail like this to become an inducement for the country to adopt a "single-payer" medical insurance system.

But the Republican "repeal and replace" legislation really isn't even insurance at all. It would reduce premiums mainly by eliminating coverage, giving states discretion to allow medical insurance policies to exclude treatment for serious ailments and to jeopardize coverage for the millions of people already afflicted with something.

The Freedom Caucus of House Republicans, which the new legislation was designed to placate, is celebrating only the freedom to be devastated medically and financially by catastrophic illness.

The Republicans in the House seem to know this, for they rushed the bill to a vote without waiting for an analysis by the Congressional Budget Office. Some Republicans admitted that they voted on the bill without even reading it, which was a Republican criticism of Democrats back when the Democratic majorities in Congress hastened to enact "Obamacare".  

But maybe the Republican bill is meant only as a pose -- to show that the party, at least in the House, can keep its "repeal and replace" pledge and advance legislation supported by President Trump. For Republicans in the Senate don't seem to be taking it seriously. Instead they say they will revise it or offer their own insurance bill. Since Democrats control 49 of the Senate's 100 seats, the outcome will be determined by moderate Republican senators.

Congress's objectives should remain the unachieved objectives of "Obamacare" -- getting basic coverage for everyone efficiently, preserving substantial choice among policies and insurers, socializing the burdens of catastrophic illness, lifting the insurance burden on business, and taking advantage of the progressive income tax system.

This might be accomplished in part simply by extending Medicare coverage to all catastrophic illnesses, those causing annual expense of more than $100,000. If achieving these objectives costs a little more money, the country's constant and stupid imperial wars in Afghanistan, Iraq, Syria, Libya, and elsewhere might be liquidated. Call it "America first."

Ask more from Indian tribes -- and MGM

Connecticut's casino Indian tribes are distributing a video attacking MGM for wanting to make money by drawing Connecticut residents to its casino under construction in Springfield. The tribes say that with their proposal to build a casino in East Windsor to intercept Springfield gambling traffic, they want to save jobs for Connecticut and revenue for state government. Of course the tribes want money as much as MGM does.

State government, collapsing financially, should want money more than all of them. But state government assumes that the only way of getting more from the tribes is to give them the "interceptor" casino, though their only real asset is the state's own property, the casino monopoly the state has given them in exchange for a share of their slot machine revenue.

State government has more options than the "interceptor" casino. It should tell the tribes that they must pay more for their monopoly from the state, and it should ask MGM how much it would pay the state every year not to authorize an "interceptor" casino.

Chris Powell is managing editor of the Journal Inquirer,  in Manchester, Conn.

James P. Freeman: Michael Dukakis: The last traditional progressive

Beaming over the convention of the consonant caucus, the speaker uttered what would be the second most memorable line in the 1988 presidential race: “This election isn’t about ideology, it’s about competence…” This dramatic statement was later bested by George H.W. Bush’s “read my lips…” tax pledge.

Atlanta’s Democratic National Convention that July proved to be, in retrospect, the last stand for Michael S. Dukakis, the last traditional progressive. As progressivism gallops to a new beat of populism, modern-day revivalists should look to Dukakis as their godfather.

He is last major living link to the progressive forefathers. Born in Brookline in 1933, he was also born into the first progressive era of Presidents Roosevelt, Wilson and Roosevelt. It would mark the first time the republic would rely upon government, not self-sufficiency, for sustenance, emblematic of modern times.

Citizens needed progress up from the Founders’ ideas. A strong central government, believing in its boundless abilities, could master public and private affairs, thereby delivering happiness. The Constitution was inelastic; its limitations were to be disdained as impediments to the very progress government sought to engineer. Politics became a science.

Dukakis’s long career in public service is writ large with progressive themes. In 1965, as a young Massachusetts state representative, he introduced a measure to legalize contraceptive use for married couples, an early imprimatur of his activism. For the commonwealth’s conservative Catholic bloc in the House, however, voting on birth- control laws written by Protestants in the 1890s proved to be controversial and complicated.  Boston's Cardinal Richard Cushing, remarkably, advised its members in the legislature: “If your constituents want this legislation vote for it. You represent them. You don’t represent the Catholic Church.” The bill passed.

Arguably, this episode — more than John F. Kennedy’s 1960 election to the presidency — helped convert a majority of Catholics from Republicans to Democrats in Massachusetts. Suddenly, it seemed, culture impacted Catholic politics as much as theology. Those majorities remain intact today. Dukakis was elected to the first of three  terms starting in 1974 and he remains Massachusetts’s longest-serving governor.

His first attempts as a reformer were rebuffed and he lost the 1978 primary. Not nonplussed, he was reelected in 1982 with an even more robust belief in government’s efficacy.

He originally opposed the initial concept of the Central Artery/Tunnel project in Boston but expanded its scope to accommodate business and government interests. Boston’s Big Dig cost nearly $4 million a day at its peak. Initially a $2.2 billion expenditure in the early 1980s, final estimated outlays are $22 billion, to be paid off in 2038. The administration of this public-private partnership exposed a skewed risk-reward model (socializing losses, privatizing profits).

Under his leadership, after delays and denial for exemption, Massachusetts was found to be in violation of the landmark Clean Water Act. Every day 100,000 pounds of sludge and 500,000 gallons of barely treated wastewater were dumped into Boston Harbor. A federal court, not political epiphany, ensured the cleanup.

Former EPA Administrator Michael Deland said that the commonwealth’s willful disobedience was “the most expensive public policy mistake in the history of New England.” Raw sewage stopped flowing into the nation’s oldest harbor in September 2000.

Dukakis in 2009 reflected on “two of the biggest projects in history at the time.” The harbor restoration — mandated, mind you — “came in on time and 25 percent under budget.” Of theBig Dig, he said: “We all know what happened with the other.”

The difference? “It was about competence of the people running the projects…”

Few remember that Al Gore (not the elder Bush) first raised the weekend-furlough matter during the presidential primary. Dukakis vetoed a bill in 1976 that would have denied murderers, like Willie Horton, such freedom. The program was ultimately abolished after questions were raised about criminal rehabilitation.

Before there was Obamacare and Romneycare there was Dukakiscare. He signed into law the nation’s first universal healthcare insurance program in 1988. A tiny Republican minority quietly disrupted its funding, leaving it an obscure footnote to history.

At 82, still residing in Brookline,  still a  progressive sanctuary, Dukakis leaves a lasting legacy. He has affected the lives of more residents in Massachusetts than anyone in a century. Clearly, that is a triumph of ideology over competence. As government at all levels struggles with executing competent stewardship, people should look at Dukakis in another light. He at least addressed competence as a core competency.

New-fashioned progressives have abandoned it.

James P. Freeman is a New England-based writer for the New Boston Post. and a former columnist with The Cape Cod Times.


Chris Powell: Worthless educations; yes, exploit working-class fears


From President Obama to Connecticut Gov. Dannel Malloy, elected officials are boasting aboutimprovements in high school graduation rates. But last week even The New York Times acknowledged that it's a fraud. For higher graduation rates are comingmainly at the expense of educational standards, since, while graduation ratesare up, "measures of academic readiness for college or jobs are much lower."   

"The most recent evaluation of 12th-graders on a national test of reading andmath found that fewer than 40 percent were ready for college-level work," TheTimes reported. "College remediation and dropout rates remain stubbornly high."   

Recent testing of Connecticut high school students and state government’s ownmost recent survey of college freshmen show the same thing: Most students arenot mastering grade-level work but are promoted and awarded high school diplomasanyway, and most freshmen in the state university and community college systemsrequire remedial high school math or English or both.   

That's because Connecticut's educational policy now is formally one of socialpromotion. Promotion and graduation require no actual learning. Rather, onlysimple attendance is required. Promotion and graduation are left to thediscretion of local school boards, which have lost the nerve to enforcestandards that measure learning.     

Students and parents may be fooled by this dumbing down of education butemployers are not. While students eventually find out, leaving college withdegrees in politically correct fluff like "women's studies" and incurringcrushing student loan debt only to find themselves qualified to be only cashiersand burger flippers, by then it's too late. The education racket has taken theirmoney, and their futures, in the guise of protecting their self-esteem, whichshatters soon enough anyway.   

If mere higher graduation rates are the objective, Connecticut should distributehigh school diplomas with birth certificates. Actual education will requireimposing standards and measures of learning -- serious testing -- and riskinghurt feelings earlier.  

NO WORKING-CLASS HERO: President Obama complains that presidential candidateDonald Trump is exploiting the fears of the working class, and of course Trumpis. But those fears are entirely valid, since living standards for mostAmericans have been declining for several decades. Somebody should exploit those fears politically.     

To some extent the Obama administration has tried to assist the working class.  That's how the national medical insurance scheme dubbed "Obamacare" was meant, though increasingly it seems to be failing, driving up costs while leavingpeople with deductibles so high as to make it prohibitive for them to use theirinsurance.   

Meanwhile mergers and acquisitions in the economy have exploded, fueled bygovernment’s suppression of interest rates and the preferential access that bigbusiness has to capital. By one estimate mergers and acquisitions in the UnitedStates this year reached a record $2.5 trillion in value. These combinationsdiminish competition and thereby drive costs up and employment down. The ObamaJustice Department's Antitrust Division has slept through them.

FOOL, BRITANNIA: Trump wants to use religion to prohibit certain people fromentering the United States, whose anthem nevertheless identifies it as "the landof the free and the home of the brave."   

Responding to a petition protesting Trump, Britain's home secretary, Theresa May, says she might bar the presidential candidate from visiting thatcountry because she has the authority to exclude people who are not "conduciveto the public good." That is, she might keep people out for being controversial.    One of the U.K.'s several anthems says: "The muses still with freedom found/  Shall to thy happy coast repair." But soon those muses may be admitted only ifthey sing the right tune. 

Chris Powell is managing editor of the Journal Inquirer, in Manchester, Conn. 

Chris Powell: Our Humpty Dumpty courts

MANCHESTER, Conn. From all the cheering and hissing that greeted the Supreme Court's decisions about the Affordable Care Act -- "Obamacare" -- and same-sex marriage, it seemed as if the issues before the court were elections or even football games, not judicial matters.

That has been the problem with appellate courts for some time now, their tendency to act as unelected legislatures, deciding policy, decisions properly cheered or hissed, rather than interpreting constitutions and laws, a dispassionate undertaking quite separate from policymaking.

In the "Obamacare" decision, even Chief Justice John Roberts, writing for the court's majority sustaining the law, acknowledged that it was full of "inartful drafting" requiring the majority to reach for "context" elsewhere in the law so that "established by the state" could be construed to mean "established by the state or federal government." To prevent a vast, new edifice of government from collapsing abruptly under its flaws, the court's majority decided that the law didn't really mean what it said.

Those gratified by the Obamacare decision did not seem to worry that the court's conclusion -- that laws don't always mean what they say -- might someday be invoked to their disadvantage.

As for same-sex marriage, public attitudes have changed dramatically in its favor.

Laws against same-sex intimacy long have been invalidated as invasions of privacy, based only on arbitrary religious objections, and there is little in marriage that same-sex couples have not been able to arrange through ordinary contract law.

Much if not most of the argument against same-sex marriage arises only from those arbitrary religious objections, which aren't really arguments at all.

As a practical matter lately the issue has been only whether all governments and commerce should have to ratify homosexuality.

But the weakness of the argument against same-sex marriage as policy has nothing to do with whether the Constitution requires states to authorize it. Further, equal-protection claims for a constitutional right to same-sex marriage are themselves weak, since no person or class was being denied the right to marry. Everyone was free to marry someone of the opposite sex, even if sexual identity itself lately seems to have fallen into question.

The same-sex marriage case may have been a good example of the conflict between the two major schools of constitutional law, the "originalist" and the "living constitution" schools.

The originalists hold that constitutions must be interpreted to mean what they meant at the time of their enactment, or else they aren't really constitutions at all.

The advocates of a "living constitution" hold that constitutions should be adapted to new circumstances without formal amendment through the democratic process, the adaptation done by judges, largely unelected.

Through the years political liberals and conservatives have inhabited both schools, but small-d democrats tend to favor the originalist school, while totalitarians everywhere favor the "living constitution" school, for reasons that Lewis Carroll, in "Alice's Adventures in Wonderland," explained as well as anyone has explained them in the 150 years since:

"When I use a word," Humpty Dumpty said in rather a scornful tone, "it means just what I choose it to mean -- neither more nor less."

"The question is," said Alice, "whether you can make words mean so many different things."

"The question is," said Humpty Dumpty, "which is to be master -- that's all."

The "Obamacare" and same-sex marriage decisions suggest that Justice Dumpty would feel right at home on the Supreme Court.

Chris Powell is managing editor of the Journal Inquirer, in Manchester, Conn.

Don Pesci: Of Gruber, abortion and crime rates



As many students of politics know, there are two kinds of truth: political truth and all other varieties. Political truth, unlike scientific truth, need not be connected verifiably with objective reality. Political truth sometimes dresses up in the robes of science, but bad science also leaves objective reality behind at the altar.
Jonathan Gruber of the Massachusetts Institute of Technology (MIT), the Cassandra of Obamabots, was one of the architects of Obamacare who, unlike many proponents of President Obama’s “Affordable Care Act,” went off script and, in venues he may have thought were off record, simply laid out the truth about Obamacare in such unvarnished terms that even those over-friendly to President  Obama in the media could not easily misunderstand Mr. Gruber’s essential message – which was: Obamacare, right from the get-go, was intentionally misleading. More importantly, he noted, it was of necessity misleading. The sales pitch of the used car salesman who wants you to buy the lemon on his lot, likewise and for much the same reasons, is misleading.
The press spotlight having been focused on Mr. Gruber and the Obamacare warts, media sleuths have now discovered that Mr. Gruber has also told the inconvenient truth about abortion. In a paper co-written during the Clinton administration and printed in the National Bureau of Economic Research (NBER), “Abortion, Legalization and Child Living Circumstances,” Mr. Gruber, along with two other co-authors, wrote:
“Legalization of abortion in five states around 1970, followed by legalization nationwide due to the 1973 Roe v. Wade decision, generates natural variation which can be used to estimate the effect of abortion access. We find that cohorts born after abortion was legalized experienced a significant reduction in a number of adverse outcomes. Our estimates imply that the marginal child who was not born due to legalization would have been 70% more likely to live in a single parent family, 40% more likely to live in poverty, 50% more likely to receive welfare, and 35% more likely to die as an infant. These selection effects imply that the legalization of abortion saved the government over $14 billion in welfare expenditures through 1994.”
Mr. Gruber also touted a positive link between abortion and a precipitous drop in crime rates among “cohorts,” by which term Mr. Gruber means to indicate single parents, the poor and welfare recipients – or, to put the matter bluntly, the underclass, mostly African American and Latino city dwellers, all of whom are fortunate enough to live in close proximity to abortion mills.
A more recent report published in the National Bureau of Economic Research in 2000, “NBER Working Paper No. 8004, probes the connection between legalized abortion and recent crime reductions:
“We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly 18 years after abortion legalization. The 5 states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater crime reductions in the 1990s. In high abortion states, only arrests of those born after abortion legalization fall relative to low abortion states. Legalized abortion appears to account for as much as 50 percent of the recent drop in crime.”
The  Center for Disease Control and Prevention's Abortion Surveillance report has found that between 2007 and 2010, nearly 36 percent of all abortions in the U.S. were performed on black children, even though blacks make up only 12.8 percent of the population. Another 21 percent of abortions were performed on Hispanics, and an additional  7 percent on other minority races. More than half of all babies killed by abortion between 2007 and 2010 were minorities.


Note that both  Connecticut Gov.  Dannel Malloy and his prison czar, Mike Lawlor, the architect of a bill that awards early-release credits to violent prisoners, have claimed responsibility for a reduction of crime in Connecticut that parallels a national reduction in crime attributed by Mr. Gruber and other economists to abortion. This is the kind of pseudo-science that leaves objective reality waiting impatiently at the altar for a marriage that never occurs. Neither Mr. Lawlor nor Mr. Malloy has yet been so brash to claim credit for the drop in crime rate that has occurred nationwide.


Don Pesci (donpesci@att.net) is a writer who lives in Vernon

David Warsh: Health economist reaps whirlwind from his irony

Irony – the tendency to underscore a point by stating the opposite of what is meant – has been the downfall of many an advocate.  It’s an often powerful technique. In political speech, though, it is prone to backfire, because it can easily be taken out of context. It’s more dangerous than ever in the age of YouTube and opposition research. Accept that “oppo” has greatly damaged the effectiveness of Jonathan Gruber, of the Massachusetts Institute of Technology, the economist who in 2004 framed the financial strategy that, over a twisted course, led to the adoption of the Affordable Care Act, in 2010.   Gruber is a leading healthcare expert, much in demand.  For two weeks he’s been at the center of a firestorm because of three video clips in which he seems to give comfort to enemies of Obamacare.

The story of how investment adviser Rich Weinstein, angered because he was forced to search for a new policy under terms of the ACA (he found one),  turned amateur sleuth, searching through hundreds of online videos, radio interviews and podcasts to find three damaging ones, makes interesting reading. We owe it to reporter David Weigel, of Bloomberg Politics.

The ACA requires those who don’t receive health insurance benefits from their employer or from the government to buy their own insurance, much as licensed drivers must purchase automobile insurance, with government subsidies for health insurance for those who earn less than a certain amount.

According to Gruber, the bill was written in a “tortured” way to avoid describing its mandates as taxes.  He told a health care conference at the University of Pennsylvania last year that ''Lack of transparency is a huge political advantage, Call it the stupidity of the American voter or whatever, but basically that was really, really critical to getting the thing to pass.''


Gruber was being ironic.  Addressing an audience of healthcare professionals, he meant that, for good reasons or bad, in extending insurance to those who couldn’t afford it or even obtain it, that Americans had done the right thing.  Sleuth Weinstein found two other clips in which Gruber seemed to buttress Republican argument that insurance obtained on a federal exchange is not eligible for subsidies because the legislation anticipated that all states would form exchanges of their own. Twenty-four states, all with Republican governors, refused to form such exchanges. The  federal government formulated a marketplace in their stead.

Health Adviser Logged White House Visits,” headlined The Wall Street Journal. “Fallout From Gruber’s Remarks Spreads: Economist’s Comments on Affordable Care Act’s Passage Prompt Vermont to Cut Ties, Michigan Lawmakers to Seek Probe.” .

In an editorial, “The Impolitic Jonathan Gruber,” The New York Times came to the ACA’s defense:

''Republicans are crowing over Mr. Gruber’s remarks because he has been portrayed as a major architect of the health reform. In truth, his role was limited.  He had a big contract with the White House to use his econometric model to calculate the financial and coverage effects of proposed measures.  And he was one of thirteen experts who advised the Senate Finance Committee.  His comments should not be taken as evidence that the reform law was hatched in secrecy and foisted on the public by trickery.''

It depends, I guess, on what is meant by “truth.” In truth, Gruber’s role in devising the mandate strategy of the ACA was absolutely fundamental. The idea had originally been proposed in  the early 1990s by the conservative Heritage Foundation as an alternative to Hillary Clinton’s much farther-reaching plans. Gruber dusted it off and broached it in 2004, at the request of then-Massachusetts Gov. Mitt Romney. Romney was in the early stages of preparing a presidential bid.  His plan was adopted by Massachusetts’ s heavily Democratic legislature, with apparent success.

The mandate idea was taken over by the Democrats in the campaign for the 2008 presidential election.  By now a leading expert on its operation, Gruber first advised John Edwards, then Hillary Clinton, and finally Barack Obama on the details of the plan. In early 2010, President Obama relied on Democratic majorities in both the House and Senate to pass the measure into law.

Was it a good idea?  Some Democrats have begun to voice their doubts. Sen. Charles Schumer (D.-N.Y.)  said, last week: “It wasn’t the change we were hired to make.” The party should have found a way to raise wages and create jobs, instead of focusing on the uninsured, he continued, whom he described as “a small percentage of the electorate.”

David Axelrod, a close adviser to President Obama in both campaigns countered (in a another story in the WSJ ), “If your calculus is solely on how to win elections, and that is your abiding principle, it leads you to Sen. Schumer’s position. But that’s precisely why big difficult problems often don’t get addressed in Washington, and why people have become cynical  about that town and its politics.”

The ACA will continue on its perilous course in the courts, this time in King vs. Burwell, a challenge to subsidies for those policies obtained from the federal exchange.  The 2016 elections come after that.

With much rule-changing still to be done before the huge medical sector becomes stable, U.S. healthcare reform is like global warming: Further measures are not a matter of if but when.


David Warsh, a longtime financial  journalist and economic historian, is proprietor of economicprincipals.com

Don Pesci: Do political endorsements matter?


First Lady Michelle Obama has endorsed Democrat Dannel Malloy for re-election as Connecticut's governor. In a picture worth a thousand words, Mrs. Obama was shown on “Capitol Report” being bussed robustly by U.S. Sen. Dick Blumenthal, who no doubt would endorse Mr. Malloy were Mr. Blumenthal a newspaper; some would argue that Mr. Blumenthal  is a newspaper. The winner of the Malloy contest with Republican Tom Foley will become governor of a state first in the nation in progressive governance and crony capitalism and last in almost every other important measurement of prosperity.
Will the first lady's endorsement matter to anyone but hardened Democrats, or to voting age high-schoolers who prefer healthy and pallid lunches to pizza and brownies? Probably not. For politicians, endorsements are little more than shows of party solidarity, and there are few political marriages in the nation more solid than that between Mr. Malloy and President Obama. Indeed, newspaper editorial endorsements in Connecticut’s left-of-center news media also have become highly predictable displays of ideological solidarity.
The lame-duck  president has had some difficulty getting himself invited to campaign soirees elsewhere in the Disunited States. Democrats vying for office in Red States  have tended to shun the president, if only to avoid the falling timbers of Mr. Obama’s foreign and domestic policies. Mr. Obama’s foreign policy is recklessly absurd because all foreign policy but his is constructed around a realpolitik understanding of friends and enemies. Mr. Obama is the first U.S. president who seems incapable of distinguishing between the two. In domestic policy, Mr. Obama should have devoted his energies during his first term to settling market uncertainties occasioned by a ruptured housing mortgage bubble partly caused by Beltway favoritism and the dismantling of the Glass Steagall Acta Franklin Roosevelt measure that that prevented investment banks  from meddling in commercial- banking activities. Instead of attending to the crisis at hand, Mr. Obama created a crisis of his own making by instituting Obamacare, a progressive baby step on the way to universal health care.
Mr. Obama will be appearing in Bridgeport – if, indeed he does make an appearance, a previous campaign appearance on behalf of Mr. Malloy having been called off because of the Ebola crisis – only a few days after Anne Melissa Dowling, Connecticut’s deputy commissioner of the Department of Insurance, announced that  of course she was concerned about insurance-policy cancellations in Connecticut.
“Dowling, NBCConnecticut reported, “says some 55,000 people across the state will have their policies canceled either because it no longer meets the requirements of the Affordable Care Act or because grandfathered policies that didn’t need to meet requirements have simply been canceled by the insurer.”
Even here in true blue Connecticut, some members of the state’s all Democratic congressional delegation have proven resistant to Mr. Obama’s charming attempt to make the world over according to his eccentric predilections.  Congresswoman Elizabeth Esty, for instance, has announced she will not attend Mr. Obama’s prospective campaign appearance of behalf of Mr. Malloy unless the president somehow manages to cross her path in her own district. The lady is very busy attending to her re-election – partly by composing and endorsing killer ads against her opponent, Republican Mark Greenberg, that even The Hartford Courant considered “creatively misleading” and (gasp!) “false.” Mrs. Esty has announced she would not be calling on the president when he appears in Bridgeport, only a hop, skip and a jump from Mrs. Esty's 5th District.  Connecticut is such a small state that anywhere in the state is but a hop, skip and a jump from anywhere else.
The Courant, the state’s largest  newspaper, endorsed Mrs. Esty, the second time it had done so. One of the indispensable determinants that garner Courant endorsements is experience in office, a requirement the paper waived during its first endorsement of Mrs. Esty, who at the time was running against a far more experienced candidate, Republican nominee for the U.S. House in the 5th District Andrew Roraback. The notion that the more experienced candidate for a particular office ought to receive the approbation of voters is, in fact, an argument for the perpetual election of incumbents, except on those rare occasions when the retirement of an incumbent leaves an office vacant. It is a policy, highly suspect in a constitutional republic, that would have stopped the American Revolution in its tracts: King George III, who inherited the British throne at the age of  12, had a much longer and deeper experience running the American colonies than did any of the founding fathers of the country. Most Americans are uncomfortable with perpetual monarchies or unchanging legislatures.
But not The  Courant. The paper’s current endorsement of Governor Malloy is riddled with enough qualifiers to sink a battleship, and this year, as usual, Democrats in Connecticut’s congressional delegation have garnered the paper’s affections; this at a time when Republicans are expected to retain control of the House. Some bean counters expect Republicans to capture the Senate as well. As the whole of New England moves further left, the usual endorsements will increasingly be taken with a ton of salt by voters less progressive than the usual progressive representatives.
Don Pesci (donpesci@att.net)  is a Connecticut political writer.

Adventures at the Andaz

By ROBERT WHITCOMB (This piece originated at www.cmg625.com).


I wandered down to the Wired (magazine) Data/Life conference here on Nov. 5-6 on the suggestion of a Cambridge Management Group colleague. There was a lot of interesting stuff that can help people understand where health care, health-care economics and health-care technology are going. And, perhaps especially, where health-care capitalism is going; how fitting that the conference was held at the Andaz Hotel, on Wall Street.

There was remarkably little talk about Obamacare or even about Accountable Care Organizations.

Personal- and population-health data, behavior modification and neat new devices were in the spotlight, and the attendees saw them as considerably more important than Obamacare in the long run. The confab was sponsored by Poland Spring (healthy product, except that oil is used to make its water bottles), IBM (whose Watson computer, with its impressive analytics ability, seems to hold considerable promise for improving health care) and Withings, which makes self-monitoring health devices. Such self-monitoring was a big theme (and marketing play) of the conference.

The first major speaker, Rushika Fernandopulle, M.D., set the stage by noting that great challenges in improving the bad (for the Developed World) U.S. health-care system outcomes and the system’s bankrupting costs include boosting primary care and moving from focusing on acute care to chronic care of diseases, especially such lifestyle-related ones as diabetes, heart disease and certain cancers. As later speakers made clear, new technology and better date are revolutionalizing, by rationalizing, such care already.

Then there was Dr. David Agus, a sort of rock-star (big on TV) cancer doctor and a pioneer in new technologies for personalized health care. The doctor, wearing blue jeans, said it was important to get back to the focus on being able “to die of old age’’ instead of highly preventable diseases. To do this, let’s make far more use of population-health data – think like a climatologist, looking at the earth from above. And let data be your skeptical guide. (Remember when margarine was said to be less bad for you than butter?) And look at the data associated with inactivity -- for instance, that sitting for five hours every day does as much danger to your health as smoking a pack and half a day, he told the crowd.

And, he said, such seemingly small things as going to bed and getting up, and having meals, at the same times of day can be very health-improving. There are real data about this.

Remember, he said, that 50 percent of our health problems are environmental. And read data showing how statins and a baby aspirin cut your risk of heart attack and cancer. (But a later speaker, Dr. David Newman, raised some questions about claims for the routine use of these substances.)

At the same time, Dr. Agus said, some stuff is over-rated or worse, such as taking supplemental doses of Vitamin D. He noted that America spends more on badly or untested supplements than it does on cancer research. Watch the data, with more and more of it available weekly!

While pressing for more data, and pointing to greater patient access to their own personal health data, he also raised the point that constantly watching these data can cause stress…. (Which another new device will monitor?) Which brings up an issue of the whole conference: We’re all supposed to be monitoring ourselves much of the time. Can that get out of control? Will it lead patients to drive doctors and nurses crazy?

It also occurred to me that much of what the conference speakers touted seemed to assume, wrongly, that virtually all Americans can be digital-saavy. In fact, many still don’t have computers and have no idea how to use the Internet. (Going digital is, however, a handy way to lay off more employees and jack up operating profits in the health-care sector and other industries.)

In any case, having much more peer-reviewed data transparency – for medical professionals and patients alike – will be key to improving America’s health outcomes, he suggested.

Then there was David Newman, M.D., of Mt. Sinai Hospital in New York and editor of the very interesting www.TheNNT.com – a data-based site focused on, among other things, on the need to be wary of such panaceas as statins (which, he noted, can give you diabetes). If one has already shown that he or she has heart disease statins can be helpful, but for those who don’t, it can do more harm than good, he said. (The present writer has “severe arterial disease’’ and recently had a triple bypass after many years of taking statins. He’d like more data himself!)

Dr. Newman lauded Affordable Care Act incentives to encourage more skeptical use of stents. He said they’re overprescribed (because lucrative). Indeed, many folks at the conference cited favorably the ACA’s interest in incentives that encourage cost controls that simultaneously improve outcomes. And a more personalized approach to individuals’ risk is needed. We must learn how to better customize treatment.

Beware, he said, of industry-tainted promotion of certain lucrative drugs and procedures.

All in all, he said “Health care has under-treated those without easy access to the system and over-treated those {affluent and/or with insurance} those with it.’’ And what he called “information asymmetry’’ (Iack of transparency) explains much of the medical and economic failures of America’s system.

Ronald DePinho, M.D., president of M.D. Anderson Cancer Center, in Houston, spoke of Anderson’s ambitious plan to sharply reduce some major cancers in the next decade through better use of data (such as using IBM’s Watson artificial intelligence) and public education (e.g., reducing sun exposure amongst children to reduce the likelihood of melanoma later). The idea is to be able to reduce the number of people who go to Anderson and instead be able to diagnose and treat from afar through better data use. Physicians and hospital officials should monitor the Anderson plan carefully. Anderson is, after all, the world’s biggest cancer center.

Martin Blazer, M.D., of New York University, for his part, spent most of his time talking about the beneficial uses of bacteria and the overuse of antibiotics, especially in early childhood. We must, he said, restore our internal “eco-system’’. And we must learn more about our “metabolic pathways.’’ Again, Big Data makes this easier.

Then there were the new medical systems being promoted by some businesspeople. Elizabeth Holmes, of Theranos, talked up her company’s full-service, very patient-friendly laboratory services for drugstores, with only pin pricks needed to get enough blood for full analysis. Theranos has an agreement with Walgreen’s.

Sean Duffy, for his part, talked up Omada Health, which helps patients at risk of diabetes track their behavior through such things as coaching and digital tracking. And Mike Huang talked up Glow, with its mobile app used to predict a woman’s daily fertility cycle, thus, he says, making it easier for couple to conceive. There’s even a financial-assistance program for those who fail to conceive naturally after 10 months!

Life gets more and more intense.

My favorite was Neurotrack, which, as co-founder Elli Kaplan explained, is developing a cognitive test that can detect the earliest neurological effects of Alzheimer’s, thus allowing patients to act to delay its full onset.

Finally, there are devices, discussed in much detail at the conference, with the hope, of course, that venture capitalists there would bite. The conference reminded a little of a car dealership promoting its new models.

Consider David Icke’s company, MC10, which is developing new flexible electronic devices to be worn externally or internally to help diagnoses and therapy. An interesting one is a device to be worn on a football helmet to monitor concussion danger. Then there’s Jawbone, represented by its vice president for software, Jeremiah Robison, like most of the speakers young (and newly rich). It makes wearable devices and audio devices to, among other things, get people to take walks and go to bed to improve their health. (Orwell for president?)

In other words, we and medical professionals will be tracking ourselves every minute. Self-consciousness raised to new levels.

Several speakers suggested that it’s past time to even let the patients, of all people, know what their procedures will cost ahead of time – in the face of secrecy by many health-care institutions and insurance companies, which will fight such transparency all the way because its means they won’t make as much money. Speakers and attendees saw great promise in getting patients to start asking what medical stuff costs. Such questions will change the course of treatment.

The conference made it clear that more transparency was coming with better and better measurement of health-care outcomes. “You can’t improve what you can’t measure,’’ as David Icke of MC10 remarked to the conference.

With wearable health-monitoring devices, much more data and better ways to monitor and analyze it and heightened consumer participation through social media and other new tools, it’s clear that the revolution in health care – and health-care financing -- can only accelerate. It all almost makes the ACA seem inconsequential.

Meanwhile, a bunch of people might become billionaires based on what they learned at the Andaz conference. They’ll be selling stock up the street at the New York Stock Exchange.