The MountainGoat Report

Walt Minnick's Pictures of Injustice

This is Margaret from McCall.  She lost her home, her business and her husband all in the same year.  She couldn't afford health insurance and still pay her rent, so she let her health insurance lapse.  Then came the medical emergency which required a life-flight transport to Boise.  Four surgeries later she owes thousands of dollars in medical bills she doesn't know how she's going to pay.

She was one of the more than 130,000 Idahoans without health insurance living in Congressman Walt Minnick's district as the nation battled over health care reform.  Congressman Minnick said he couldn't vote to make health insurance more accessible for people like Margaret because we couldn't afford it.

Seven months later Congressman Minnick asked the House leadership to give this guy a tax cut.  This guy is Senator Jim Risch who happens to be Roll Call's 15th wealthiest Member of Congress.

The tax cut for him and the other wealthiest two percent of Americans will add about $750 billion to the deficit over ten years.  Not only that, but Congressman Minnick said if he can't give Jim Risch a tax cut, he doesn't want Margaret, or anyone else to have one either.

Jim Risch deserves a tax cut but we can't give Margaret access to affordable health care...or a tax cut?

Something is horribly wrong with this picture, Mr. Minnick.

Suicide Prevention Chair: Idahoans Are 'Really Hurting'

The poor economy is taking a toll on Idahoans in many ways.

From the Idaho Press-Tribune, [emphasis added]:

Reported suicides in Idaho shot up by 22 percent from 2008 to 2009, according to figures compiled last month by the Idaho Department of Health and Welfare. And the chairperson of the Idaho Governor’s Council on Suicide Prevention said those numbers could get worse. The increase in suicides in Idaho in 2009 (307) from 2008 (251) marked at least the second year in a row reported suicides went up in the state.

The poor economy is a factor, Governor’s Council on Suicide Prevention chairperson Kathie Garrett said.

Idaho has consistently ranked high for suicides nationally and is the only state in the country without its own suicide prevention hotline.

The article goes on to note that calls from Idaho to a national suicide prevention line increased 61 percent from 2008 to 2009 but its operators lack knowledge of local resources available to callers.  A recent Idaho State University study showed that an Idaho hotline could be run for about $100,000 a year, incidentally the same one year amount allocated by the Idaho Health Freedom Act to sue the federal government over health care reform.

Garrett went on to tell the IPT about the substantial suicide increase, "We can’t put our finger directly and say this is the one cause, but we do know we are seeing an increase because of the economy. Unemployment is a stressor, home foreclosure is a stressor. The citizens are really hurting."

Indeed...and hopefully they're not too small to matter.

'Stop This Insanity,' Indeed

It appears that once again the Idaho Legislature, Governor Otter and Attorney General Wasden are a little premature--this time in spouting off about "states rights" and "unconstitutional mandates."  While Idaho's already bare-bones budget is being systematically dismembered due to lack of revenue (some would say, the lack of will to raise revenue), the Legislature passed the Idaho Health FreeDumb Act.

Then Governor Otter proudly declared "a high priority on sovereignty," publicly making a show of signing it into law and curiously becoming semi-notorious for doing so.  (Contrast that with his "cloak and dagger" swearing in... what was that all about?)

Not to be outdone, then AG Wasden (cheered on by "stop this insanity" Otter) announces that he's joined 12 other states in a lawsuit against the federal government and "it will not be inexpensive" to "protect" Idahoans from health care.

Now, it seems all of that is moot . . . or the political grandstanding it appeared to be.

From Senator Ron Wyden (D-OR) discussing a provision of the legislation he authored saying, "You don't have to abide by it -- just set up your own plan." 

It's called the "Empowering States to be Innovative" amendment. And it would, quite literally, give states the right to set up their own health care system -- with or without an individual mandate or, for that matter, with or without a public option -- provided that, as Wyden puts it, "they can meet the coverage requirements of the bill."

Governor Otter, AG Wasden, Idaho Legislature:  Stop this insanity.  We don't have the money to waste on political grandstanding, your 15 minutes of shame or to refurbish your anti-gumment credentials. 

Map of the Uninsured

What does Idaho's 1st District have to gain from health care reform and what will our esteemed Congressman Walt Minnick be voting against today?  Turns out a lot.

Walt Minnick Accuses Democrats of 'Willful Abuse'

If anyone was still holding out hope that Idaho Congressman Walt Minnick would have a last minute change of heart and cast a vote for health care reform this weekend, those hopes can be permanently laid to rest today.

U.S. House Republicans, in a last-ditch effort to derail reform, attempted to scold the Democratic leadership with a resolution condemning the rumored "deem and pass" procedure they dubbed the "Slaughter Solution."  The resolution failed on a 232 to 181 procedural vote with ten Democrats, including Walt Minnick, joining 171 Republicans against a motion to table the resolution.

In part, the resolution reads:

Whereas the Democratic leadership of the House has conducted a calculated and coordinated attempt to willfully deceive the American people by embracing the “Slaughter Solution”; 

Whereas resorting to the “Slaughter Solution” in this circumstance, is being done to intentionally hide from the American people a future vote that Members of Congress may take on the Senate-passed health care legislation;

Whereas the deceptive behavior demonstrated by the Democratic Leadership has brought discredit upon the House of Representatives; and

Whereas the Democratic leadership has willfully abused its power to chart a legislative course for the Senate health care bill that is deliberately calculated to obfuscate what the House will vote on, in an illegitimate effort to confuse the public and thereby fraudulently insulate certain Representatives from accountability for their conduct of their offices.

Walt Minnick joined Republicans in accusing the Democratic leadership of willful deceit, deceptive behavior, willful abuse of power and a whole host of other strongly worded, imagined offenses.

Yes, it's safe to say that Walt Minnick is not changing his vote.  

That's despite news from the Congressional Budget Office today that the reconciliation bill would cover an additional 32 million people and reduce the deficit by $130 billion in ten years.  Ezra Klein at the Washington Post distilled the merits of the reform bill and the CBO score for conservative Democrats.

If you're a conservative House Democrat, then probably you support many of those policies, too. But you also get the single most ambitious effort the government has ever made to control costs in the health-care sector. According to the Congressional Budget Office, the bill cuts deficits by $130 billion in the first 10 years, and up to $1.2 trillion in the second 10 years. The excise tax is now indexed to inflation, rather than inflation plus one percentage point, and the subsidies grow more slowly over time. So one of the strongest cost controls just got stronger, and the automatic spending growth slowed. And then there are all the other cost controls in the bill: The Medicare Commission, which makes entitlement reform much more possible. The programs to begin paying doctors and hospitals for care rather than volume. The competitive insurance market.

Thirty-two million additional people covered; reducing the deficit by trillions--which core principle is it that Walt's standing on again?  Or maybe there's still not enough "bi" in the partisanship to suit him.  But ooh boy, accusing your own party of willful deceit and abuse of power--that's the sort of bipartisan solution Idahoans are looking for?  There may be more than just a few more Idaho Democrats hoping for the spotted weasel after that.

Uninsured Story Project: Dear Mr. Minnick

How could someone say no to health care reform?  "I think they never had to make the choice between seeing a doctor and putting food on the table," replies Margaret in McCall, Idaho, just one of the scores of uninsured Idahoans living in Congressman Walt Minnick's district and across the state.

Hear the rest of her story via Bill Thomas at Uninsured Story Project:

While Margaret and millions like her are making these unimaginably difficult decisions every day, Congressman Minnick has indicated he would have no trouble being the vote that kills health care reform.

Call Congressman Minnick now; tell him Margaret and millions like her can't wait.

The Vote That Kills

Today the Idaho Statesman reports that Congressman Walt Minnick "would have no trouble being the vote that kills President Barack Obama's health care plan — if it still doesn't include the aspects he'd like to see."  So what exactly are the aspects of health care reform that Minnick would like to see?

Last July, Congressman Walt Minnick crafted what he called " five core principles" that he "would use to evaluate proposals for reforms of our nation’s health care system."  They were:

• First, reforms must be fully funded.
• Second, comprehensive, affordable health insurance must be made available to all Americans.
• Third, no "socialized medicine.” The health care system of insurance must be private – not run by the government.
• Fourth, insurance companies must be required to make insurance available to everyone regardless of age, employment status or preconditions.
• And fifth, reforms must reduce costs, not just expand coverage.

Except, apparently there really wasn't very much "core" in those principles and they've been modified somewhat.

Minnick's spokesman John Foster told the Statesman Wednesday that as Minnick has said in the past, he would like to see tort reform and a better way to control costs throughout the country. He also wants to make sure there is no public option, and that whatever is passed doesn't add to the overall cost of the deficit.

So according to John Foster (who strangely enough was commenting on a policy issue despite having taken a leave of absence to work on the reelection campaign), Minnick's health care reform "core principles" now look more like this:

• First Fourth, reforms must be fully funded.
• First, tort reform.
• Second, comprehensive, affordable health insurance must be made available to all Americans.
• Third, no "socialized medicine.” The health care system of insurance must be private – not run by the government.
• Fourth, insurance companies must be required to make insurance available to everyone regardless of age, employment status or preconditions.
• And fifth, Second, reforms must reduce costs, not just expand coverage.

Notice what's now missing from Minnick's list?  That would be the actual reform--the things that help the uninsured get access to health care.  Not only that, but everything else on Minnick's list, including the latest addition—tort reform, is now included in President Obama's current proposal.

Nearly 45,000 people die each year from lack of health care and Walt Minnick wouldn't mind being the vote that kills health care reform.  Apparently he does not have a conscience.

Update:  This is how Foster responded yesterday evening to The Huffington Post:

"Like his constituents in Idaho, Walt continues to hold out hope that the president will propose a bill that will actually reduce their costs of insurance and be something that they will support. It's not surprising that the liberal Huffington Post wouldn't understand his position," said Minnick's campaign spokesman John Foster.

Minnick Still Says 'No'

News came yesterday that Idaho Blue Dog Congressman Walt Minnick has not changed his mind on health care reform and will vote against it regardless what iteration of the legislation comes before the U.S. House again.  This after months of posturing that turns out to be just that.

Since first voting no on the legislation in November, Minnick indicated in town halls across the 1st District that he hadn't made up his mind how he would vote on a reconciliation package, saying he would have to see what was in the final draft.  He even touted his own "leaner, meaner" proposal that he admitted didn't do much but hey, on the bright side, didn't cost much either and looked remarkably similar to the House Republican plan.

Must be that allegiance to big business thing again.

In other Minnick news, word came Friday that spokesman John Foster was taking a leave of absence from the congressional office to work on the Minnick reelection campaign.  He made sure to emphasize that this was an unpaid leave of absence, which should be noted, is not to say that he's not being paid, just not by the taxpayers.  This is a bit of a change from his predecessor, Wayne Hoffman, lately of FreeDumb Foundation notoriety, who continued to work in both the campaign and the congressional offices of Bill Sali during the 2008 cycle.

Foster did not make clear whether he would continue receiving federal benefits, including health insurance, while on leave, however.   If not and the Minnick campaign operates as it did in the previous cycle, he won't be receiving health insurance through the campaign and his young family would join the hundreds of thousands of Idahoans without employer sponsored coverage or just going without.

My guess is he's keeping his federal benefits. 

Too bad his boss thinks 30 million people without health insurance is acceptable in the richest country on earth.

Thursday Health Care Roundup

As if a more compelling reason were needed, today it becomes increasingly clear that doing nothing about health care reform is not an option, reports Talking Points Memo in, "Anthem Rate Hikes Just Tip Of Iceberg - Premiums Going Way Up In Six More States."

Health and Human Services Secretary Kathleen Sebelius today will release a new report showing more dramatic health insurance premium increases are proposed in Connecticut, Maine, Michigan, Oregon, Rhode Island and Washington.

[...]

The report quotes National Association of Insurance Commissioners officials predicting the nation will "see rate increases of 20, 25, 30 percent."

[...]

"Last year, as working families struggled with rising health care costs and a recession, the five largest health insurance companies - WellPoint, UnitedHealth Group, Cigna, Aetna, and Humana - took in combined profits of $12.2 billion, up 56 percent over 2008.

"These health insurance companies' profits grew even as nominal GDP decreased by 1 percent over this same time period.

"And recent data show that the CEOs of America's five largest insurers were each compensated up to $24 million in 2008."

If Idaho Republicans have a plan, they better come with it, since the Legislature has declared "sovereignty" over health care reform in Idaho.

---

Ezra Klein at the Washington Post explains why the "selling insurance across state lines" piece of the Republican health care reform plan (touted recently by Idaho Congressman Mike Simpson) will "not change the number of insured Americans or save much money, but it would make insurance more expensive for the sick and cheaper for the healthy" in "Selling insurance across state lines: A terrible, no good, very bad health-care idea."

They want insurers to be able to cluster in one state, follow that state's regulations and sell the product to everyone in the country. In practice, that means we will have a single national insurance standard. But that standard will be decided by South Dakota. Or, if South Dakota doesn't give the insurers the freedom they want, it'll be decided by Wyoming. Or whoever.

This is exactly what happened in the credit card industry, which is regulated in accordance with conservative wishes. In 1980, Bill Janklow, the governor of South Dakota, made a deal with Citibank: If Citibank would move its credit card business to South Dakota, the governor would literally let Citibank write South Dakota's credit card regulations. You can read Janklow's recollections of the pact here.

Citibank wrote an absurdly pro-credit card law, the legislature passed it, and soon all the credit card companies were heading to South Dakota. And that's exactly what would happen with health-care insurance. The industry would put its money into buying the legislature of a small, conservative, economically depressed state. The deal would be simple: Let us write the regulations and we'll bring thousands of jobs and lots of tax dollars to you. Someone will take it. The result will be an uncommonly tiny legislature in an uncommonly small state that answers to an uncommonly conservative electorate that will decide what insurance will look like for the rest of the nation.

Ooh boy... who reads that and doesn't think:  Idaho?  Be sure to read that whole piece to understand why that's a very bad thing.

---

And finally, both sides of the health care reform debate essentially agree that community health centers are a good way to provide care for the uninsured.  Kaiser Health News reports that, infused with cash from stimulus funds, these centers are paying off in multiple ways, in "Community Health Centers Providing Return On Investment."

A hefty infusion of cash for community health centers in last year's federal stimulus package may be paying off.

A new study, released Tuesday, just before the first anniversary of the stimulus package becoming law, found that $1.85 billion the federal government gave to clinics under the American Recovery and Reinvestment Act of 2009 has generated $3.2 billion in economic activity.

[...]

The National Association of Community Health Centers says the stimulus money has funded care for 1.6 million more people, including 900,000 uninsured, at 1,100 centers around the country. Visits by the uninsured to health centers rose 21 percent last year, NACHC says. Centers in California alone are expected to serve more than 380,000 new patients through 2011, according to Capital Link, which provided modeling for the study.

It pays to be stimulated?  Stimulus pays?  Insert your own corny slogan here.

Economic Insecurity

From a great read today at The Treatment:

Health care reform is not solely, or even primarily, about improving health. It's also about making sure that medical expenses don't ruin individuals and families financially, whether because of a truly catastrophic event that requires intensive hospitalization or a chronic disease that demands ongoing treatment. In other words, it's not just health security that Americans lack. It's economic security. And the one thing we know health care reform will do, even in the heavily compromised version that passed the U.S. Senate, is provide a lot of economic security.

Too bad the Idaho Legislature is busily tying a noose around economic security by obstructing federal health care reform (should it ever actually happen) and gleefully dismembering even the skeleton of what once was the bare-bones Idaho government (see the Mike Moyle quote in the right sidebar).

Just one question for Idaho Republicans:  Where's your plan?

Maybe you could start by getting off the phone.

Idaho Dems Respond to Health FreeDumb Bill

The Idaho Democratic Party responds to passage of the Idaho Health Freedom Act by the state House of Representatives Tuesday, with the following press release:

Idaho Democratic Party Chairman Keith Roark called on Republicans legislators to stop grand-standing with their law suit publicity stunt, to stop wasting taxpayers’ money and get to work.  

“The people of Idaho are looking for vision and leadership to address the financial crisis that is costing Idahoans their jobs and their financial security,” Roark said. “Idahoans need paychecks, not more unemployment checks and they definitely don’t need costly political gimmicks.”

“Idaho Republicans are chasing a political boogieman by threatening a lawsuit over a health care bill that has not even been enacted. When Republicans turn their fear mongering into senseless legislation – consuming precious time and resources during the state’s fiscal crisis – they misuse the legislative process and the trust of those who elected them.”

“Any doubt that this is grandstanding, was removed when Idaho GOP Chairman Norm Semanko weighed in yesterday as if on cue proclaiming he planned to use the bill to convince voters to vote against Democratic legislators.”

Roark applauded Idaho’s Democratic legislators for showing vision and promoting positive solutions to the real problems facing Idaho today: solutions that create jobs for working families rather than more work for government lawyers. The Democratic proposal known as IJOBs is focused on concrete ways to help Idahoans recover from the worst economic recession in half a century. “If the Republicans’ idea of creating jobs in Idaho is to hire lawyers to sue the federal government, we are in a lot more trouble this legislative session than I originally thought.”

“In fact, if Republicans continue to waste time and money with these kinds of publicity stunts rather than helping Idahoans find jobs, then Idaho voters will vote them out of office. Republicans have had been in control of the Idaho Legislature for decades and the effects of that control are all too apparent in the fiscal crisis that confronts us right now.  Mr. Semenko should direct his time and attention at getting the legislators of his own party to start taking their positions seriously.”

The Idaho Health FreeDumb Act

Idahoans have a right to their own stupidity.  They have a right to be irresponsibile, they have a right to fail to prepare for emergency and they have a right to dump the bill for their stupidity on their neighbors.  That's what the Idaho State House of Representatives said on a 52-18 vote yesterday, in passing the Idaho Health Freedom Act.

Forget for just a minute the absurdity of passing a law banning federally mandated insurance that doesn't even exist.  Or the incongruity of "protecting" citizens from insurance mandates while mandating your own.  Or the malignity of hoarding money for a phantom lawsuit when some people are struggling to put food on the table.

Forget all that for just a minute.

Think about this.  Right now your neighbor who doesn't have insurance and ends up in an emergency room without any way to pay is sticking you, the taxpayer, with the bill.  And the Idaho Legislature has drafted legislation that is all but assured of being signed into law protecting your neighbor's ability to continue sticking you with the bill.

Now there may be many understandable reasons why your neighbor doesn't have health insurance, most of which are addressed in the proposed federal legislation--issues of cost, availability and accessibility.  But maybe your neighbor is just willing to take a chance that he'll never need health insurance.  And if his actions affected only him, he'd have every right to make that choice.  The problem is, his action or inaction affects all of us when we end up having to pay off his losing bet.

Free health care . . . pretty sweet if you can get it.

The Idaho Health FreeDumb Act is one of the most partisan, ill-conceived, potentially damaging pieces of legislation the legislature has considered in awhile and the Idaho Legislature has chosen to protect your neighbor's right to be irresponsible and stick you with the bill.  In the name of freedom.  Stick that in your teabag.

Sheesh, next thing you know, the legislature will be asserting state's rights to opt Idahoans out of Social Security and Medicare.

Here's Your Option

This is precisely what it means to be stupidly shortsighted.

From "States Cutting Back Special Programs For Uninsured" at Kaiser Health News today:

Sherie Brace fears the coming of summer. That’s when a special health insurance program for low-income adults in Washington state is set to close, ending coverage for her and about 65,000 others.

“I’m terrified they’ll cut it out. Then I would not be able to go to the doctor if I have an asthma attack,” says Brace, 52, who has had asthma for years. She earns about $12,000 a year working for a Seattle-area home health care agency that gives workers $50 a month toward health costs.

[...]

“I take medication every day that helps me get up and go to work and do a good job,” says Brace. “If I don’t have those medications, I would end up probably in a wheelchair, having someone be a caregiver to me.”

Come on all you personal responsibility, health care reform is socializm, limited government free market-eers:  answer this.  Completely leaving aside issues of human dignity, which would be more cost effective?

Or you could just keep yelling. . . .

Hypocrisy Of The Year . . . So Far

Kudos to The Political Game for first bringing this issue to light January 14 in, "A Reminder Amidst Political Ploys" and again a week later in "What Compulsory Coverage Really Means."  Now, from Eye On Boise:

HB 391, the “Idaho Health Freedom Act,” has just been moved to general orders for amendment by unanimous consent of the House. Rep. Jim Clark, R-Hayden Lake, said the problem is that the bill, as written, would outlaw a requirement lawmakers enacted into law back in 2002: Requring all state college students to have health insurance.

The bill would give the state the authority to sue the federal government should they pass health care reform legislation that mandates individuals carry a health insurance policy.  Apparently the Idaho Legislature wants to protect its right to be the sole executer of mandates on the citizenry.

Over the weekend here at MGR, this bill and Idaho leaders advocating against health care reform were called stupidly shortsighted... add shamelessly hypocritical.

Minnick Proposes 'Meaner' Health Care Reform?

Friday, Idaho Congressman Walt Minnick held a town hall meeting in Sandpoint, the Bonner County Daily Bee reported, taking questions on a variety of topics, including health care reform.

Minnick is part of a bipartisan group that is meeting to restore a leaner, meaner reform bill that he thinks will pass.

He even predicted that his Idaho GOP counterparts could sign on.

Included in the bill is insurance reform, antitrust protection, insurance competition across state lines and malpractice reform.

“This doesn’t solve the problem of 30 million people being uninsured but it also doesn’t cost nearly what the current bill does,” Minnick said.

This would be hilarious if it wasn't so heartbreaking.

To start with, it's absurd to think that Minnick is part of any serious bipartisan health reform effort, unless he is simply talking about himself and House Republicans.  It's hard to imagine Speaker Pelosi or the Democratic Caucus relying on Minnick to negotiate anything on their behalf, especially after spending the last six months trying to discredit her and other Democrats in appearance after appearance across the state.

Next, the four things Minnick mentioned as part of his "reform package"—insurance reform, antitrust protection, insurance competition across state lines and malpractice reform—are lifted virtually straight from the GOP proposal.  It doesn't take a Pentagon economist to predict that Minnick's GOP counterparts would sign on to this idea; it's theirs!  But the GOP proposal, in even the most generous terms, can hardly be called reform and, even by his own admission, Minnick's idea leaves tens of millions uninsured.

Perhaps Minnick should have joined the Republican Caucus at their issues conference where claims of reform were largely dismantled by President Obama in his Friday visit.  Others, including the Congressional Budget Office, have looked at the proposal and come to the same conclusion.  An easy to understand, point by point analysis of the GOP proposal can be read here which, in part, found this [emphasis added]:

The CBO found that the [Republican] bill would result in 3 million Americans gaining health insurance by 2019, leaving 52 million Americans uninsured, 17 percent of the population excluding unauthorized immigrants. By contrast, the Senate bill would reduce the number of uninsured by 31 million, leaving only 6 percent uninsured. The Republican bill neither expands Medicaid nor offers help to lower- or middle-income Americans who cannot afford health insurance, and thus fails to cover the uninsured.  It also does less to reduce the deficit than either the House or Senate bill. The Republican bill would, according to the CBO, reduce the deficit by $68 billion over the 2010 to 2019 period.  The Senate bill would reduce the federal deficit by $132 billion.

The CBO projected that the Republican bill would, by 2016, decrease premiums in the small group market by 7 to 10 percent and by 5 to 8 percent in the individual market. But these reductions would largely be the result of a decay in health benefits--the plans would have lower "actuarial value," which means fewer benefits and higher cost-sharing. And the mix of the insured would change, too:  The market might become more accessible to people with lower medical risks, but only because it was becoming less accessible for people with higher medical risks.

Finally, it is highly unlikely that there is another soul in this country looking for "meaner" health care reform.  The current health care system is already mean enough for millions.  What Americans need is a health care system that works and Mr. Minnick, the only thing "meaner" about your "bipartisan" proposal is that it doesn't, actually, and leaves millions behind.

Let Them Eat Cake

Advice for Governor Otter and the Idaho Legislature from Idaho Mountain Express:

They need to talk about the elephants in the room, including the de facto zero sales tax on sales of goods on the Internet and taxes on gasoline that haven't been increased since 1996.

The first is grossly unfair to bricks-and-mortar retailers who must charge sales taxes on goods while Internet merchants gain the advantage of being able to charge less.

The second is stupidly shortsighted.

State departments and commissions on the chopping block have quickly found ways to stave off their demise for now.

But nothing will save education and the services needed by Idaho's weakest citizens unless Otter and legislators take off the political blinders, roll up their sleeves and do what businesses and families do every day: Figure out palatable ways to bring more money through the door.

Won't happen.  Won't happen because stupidly shortsighted is apparently a sacred mantra for Idaho leaders.  As we speak, the governor and legislators are hoarding money on the off chance they'll need to tell the federal government to shove its health care reform.  And not to shove health care reform for them.  They've already got theirs.  They want to tell the federal government to shove health care reform on behalf of every other Idaho citizen.

What they don't like—what they are stockpiling our money to fight—is a mandate that everyone buy insurance, never mind that they are already enforcing their own insurance mandates on Idahoans.  (Apparently they don't like the feds creepin' on their corner.)

In very simple terms the problem is this:  if you don't require that everyone buy insurance but you do require that companies insure everyone with preexisting conditions and not drop anyone when they get sick, the price of health insurance will go through the roof.  Companies simply will not take on the cost of paying millions of claims for the less healthy without increasing premiums, co-pays or deductibles for everyone.  There has to be a larger pool of generally healthy people in the mix.

And that is why those who understood it were demanding that a public option be included in any health care reform package.  If you are going to require that everyone buy a policy, you have to give them a choice.  A choice that includes something besides the crappy policies currently offered by the insurance company monopoly.  A choice of buying into a not-for-profit pool if it meets their needs.

It would be like having a freeway system alongside a toll road system. One built and maintained by the government and one built and maintained by private companies.  Those who like the private route and find that it gets them where they want to go, can take that road.  For those who don't, there is an alternative route.

A requirement that everyone take the toll road would be insane, yet that is exactly what a mandate without a public option does.  On the other hand, if the toll road is going to be the only route available, without a mandate very few will be able to afford even getting on the road.  But yet, it was the public "freeway system" that was demonized as "socialism" by those trying to scare people and score political points.

Stupidly shortsighted.

Idaho, those are your "leaders"—your Congressional Delegation, your Governor and your Legislature—advocating a toll road-only option for you, because they obviously know best.  And on your behalf, hoarding money so they can tell the federal government where to shove your health care reform.

Nothing ever tasted so bitter.

Definitely Eye-Catching

Thanks to transparency measures instituted by House Speaker Nancy Pelosi (D-CA) last summer, constituents now have online access to the Statements of Disbursements, a "quarterly public report of all receipts and expenditures for Members of Congress, Committees, Leadership, House Officers and Offices of the House of Representatives."  This publication includes each representative's Member Representation Allowance which is the individual budget each Member is given to run their D.C. and District offices.  The SOD fact sheet says, for most Members, these budgets ranged from $1.3 to $1.9 million for 2009.

The most current report is published in three volumes totaling over 3,000 pages and includes the period from July 1 to September 30 of 2009.  The online version can be accessed as a single pdf or three separate files corresponding to the three published volumes.  The report includes details of each expenditure which is processed and evaluated by the House's Office of Financial Counseling, handling over 4,000 of these per week.

The office expenditures for Idaho 1st District Congressman Walt Minnick are included in the second volume and a snip of the summary is shown below.  The quarterly amount is shown in the column on the right and the left column contains the year-to-date totals.

One interesting expenditure during this period was a printing and reproduction expense of $30,800 made to Erwin and Muir Public Affairs for work done on August 11, followed ten days later by a franked mail expense of $24,327.

Erwin & Muir is a public affairs and political consulting agency located in Oakland, California.  They

... know how to untangle a complex issue or political situation, and create a solution through solid analysis, strategy and management.  Whether you are a political candidate or committee, or an organization with an issue to resolve, we can design a program for you that will deliver the right message to the right audience.  We know how to deliver wins.

Their services include:

• General consulting for campaigns
• Grassroots organizing
• Direct mail

According to the website, the agency portfolio includes "direct mail and vote-by-mail pieces on behalf of candidates for president, senate, congress, assembly, supervisor and city council" which also claims to provide "eye-catching mail that provides voters with the information they need to make an informed choice on Election Day."

Apparently Walt Minnick used his taxpayer-funded office budget to hire a political consulting agency to create a slick direct mail piece that was then mailed at taxpayer expense to residents of Idaho's 1st District, or at least some portion of them.  And apparently all legitimately, according to the office which handles tens of thousands of expenditures per quarter.

Not having received the mailing, although residing in the 1st District, it'll take some speculation as to the "complex issue or political situation" Minnick needed help "untangling" at that time—but not much.  Who could forget the summer health care reform fight and the August teabagger recess?

Walt Minnick needed a campaign consultant to design an "eye-catching" piece of direct mail convincing voters of the 1st District that they didn't want any of the dangerous, big-government, socialized medicine health care reform plans that he would later tell Politico his constituents just didn't understand?  And we paid for that?

Change. . .Or Not

"Republican leadership simply does not understand change.
Do you want to hire an administration which took 20 years to decide that Social Security was not socialism?"

Senator Henry M. Jackson (D-WA)
on the Goldwater/Scranton GOP primary, June 27, 1964

Health care reform:   just get it done, already.  Millions can't wait.

Frontier Gibberish

Not to be outdone by the governor, yesterday in a bit of "authentic frontier gibberish," the state legislative Health Care Task Force voted to send to the Legislature a resolution opposing federal health care reform—whatever it might be.  No matter that the bill "doesn’t really even exist yet," as House Minority Leader John Rusche (D-Lewiston) pointed out, the task force voted to go on record as agin' it and recommended the Legislature do the same.

Chairman Dean Cameron (R-Rupert) is apparently "appalled" at perceived constitutional violations in both versions of the current federal legislation, including a mandate to purchase insurance.  Apparently he is not appalled at his or the task force's own hypocrisy.

From The Political Game:

If they each believe it is unconstitutional for the federal government to ask its citizens to purchase health insurance, what is it then if the state they represent requires some of its residents to purchase health insurance? Irony? Hypocrisy? You tell me.

As chairman of the Joint Finance and Appropriation Committee JFAC, Senator Cameron should know that here in Idaho since 2003 the State Board of Education has enforced a policy requiring full fee-paying college students attending classes in this state maintain adequate health insurance.

Some fine "authentic frontier gibberish" indeed.

Minnick: The Message Didn't Get Through

Late today Politico took a look at what health care reform will mean for Democrats in 2010 and had this to say about our 1st District Congressman:

Rep. Walt Minnick (D-Idaho) said he did four town halls over the holiday recess. "That was the consistent theme, strong opposition based on talk radio talking points,” said Minnick, who voted no on the bill. He took straw polls in each event and "all of my audiences have been opposed to the president's proposal, save one."

"Most of my audiences are strongly opposed to it. The administration simply didn’t get through, certainly in more rural areas, the message just didn’t get through because there’s neither an understanding or support for it in vast swaths of my district. Heck, there’s no support for it in any place."

The administration didn't get through?  Sure, Walt, throw up your hands and say, "Gee, my constituents didn't understand it therefore they didn't want it," as if you weren't complicit in their misunderstanding of it.  You were spouting those "talk radio talking points" yourself.

What... did you expect your constituents to believe you were lying to them when you frightened them with "expensive government bureaucracies," "socialized medicine" and "big government" takeovers?  Even after the Congressional Budget Office estimated that the House bill would reduce the deficit, the thing you claim was your raison d'être, you couldn't bring yourself to vote for it.

There were other issues that had some Idaho Democrats questioning, but the position you took early on in the health care reform debate will have been your undoing.

Walt Minnick: A Whole Different Animal

Over the holidays, a friend and I spent three hours listening to KBOI's Nate Shelman show, recorded December 22, with Idaho Rep. Walt Minnick sitting in as guest host.  About midway through the show, Chuck called in from Boise insisting, his voice quivering with a rage that he admitted having difficulty controlling, that people with preexisting medical conditions didn't deserve health insurance because they didn't have the foresight to obtain insurance beforehand.  Seriously.  He equated it to someone wrecking their car and then trying to buy car insurance to cover the damage.  He was angry at the prospect of losing his insurance and being "forced on a government plan" and vowed to do everything in his power to ensure that Minnick never serve another day in Congress if he voted with Speaker Nancy Pelosi one more time.  I'm pretty sure he wasn't threatening any physical harm but he was pretty worked up.

Minnick's response?  Up against a news break, Minnick used his thirty seconds to cite a Washington Post article that labeled him the congressman with the most independent voting record in either party.  Maybe to him, Walt's voting record is more important than whether or not people with preexisting conditions can get health care, but it's unconscionable that when given the opportunity to correct this gross misconception to an audience so desperately and obviously in need of it, Walt used the time to grovel for votes and tout his "independent" voting record.  

Over last summer and into the fall Minnick made no secret of his distaste for the health care reform bill eventually passed by the House.  In fact much like Gov. Butch Otter's unfounded, recent threats to sue the federal government upon enactment of any reform, Minnick attempted to beef up his anti-govm'nt credentials by scaring Idahoans with co-opted buzz words like "big government takeover" and "socialized medicine."  Walt even appeared at a TEA Party-hosted town hall where he took the opportunity to skewer Boise's North End Democrats (who had generously given time and money to his campaign), implying they were more extreme than this tea party fringe.

Even then we knew of the fringe-y ideas held by this tea party crowd

These are people who believe that they need to "take their government back" by holding constitutional conventions, who are encouraged to quit paying taxes until "their grievances are redressed," that the President isn't President and that the U.S. is on the verge of Fascism.

but since those heady days of summer, it seems the whole GOP rug has unraveled leaving nothing but fringe.  When a U.S. Senator tells Americans from the floor of the Senate that they ought to be praying for the demise of a fellow Senator—and Americans do it—something has gone terribly awry.

Crazy North End Democrats indeed.

Gone are the days when Walt Minnick could speak movingly about his experiences with a health care system badly in need of reform or call Bill Sali extreme with a straight face.

No one expected that Walt would be the embodiment of a liberal lion once in Congress, but most Democrats hoped he would at least occasionally emit a cub's mew.  Unfortunately he can't even do that.  Walt's turned out to be a completely different species.

A 'Day of Reckoning'

Take a few minutes and listen to this clip of Senator Sheldon Whitehouse (D-RI) as he spoke in the health care debate yesterday.

Along similar lines is this post at The New Republic: "The Republican Health Care Blunder."

A snip:

The GOP leadership put immense pressure on all its members to withhold consent from any health care bill. The strategy had some logic to it: If all 40 Republicans voted no, then Democrats would need 60 votes to succeed, a monumentally difficult task. And if they did succeed, the bill would be seen as partisan and therefore too liberal, too big government. The spasm of anti-government activism over the summer helped lock the GOP into this strategy -- no Republican could afford to risk the wrath of Tea Partiers convinced that any reform signed by Obama equaled socialism and death panels.

[...]

The Republicans eschewed a halfway compromise and put all their chips on an all or nothing campaign to defeat health care and Obama's presidency. It was an audacious gamble. They lost. In the end, they'll walk away with nothing. The Republicans may gain some more seats in 2010 by their total obstruction, but the substantive policy defeat they've been dealt will last for decades.

The Convenient Conservative

It has become nearly impossible to determine what is driving Idaho Congressman Walt Minnick these days.  Is Minnick really being driven by what's "Right for Idaho" as he claims?  Or is it just whatever's right for Walt Minnick?

The bluest of the Blue Dogs, Minnick bills himself as a "true fiscal conservative," vowing to vote at every opportunity to strip earmarks from spending bills and "demanding that Congress balance the budget."  Last week Minnick voted for a measure that, according to the Center on Budget and Policy Priorities, will cost $609 billion over ten years.  In a press release, he touted the vote as a guarantee for Idaho family farmers who would otherwise be burdened with onerous tax increases.

The measure, which passed the House on a 225 to 200 vote, permanently extends the current estate tax exemption of $7 million per couple and keeps the tax rate at 45 percent.  Without this legislation the exemption would have dropped to $2 million per couple in 2011.  Minnick also supported Republican procedural attempts to eliminate the tax for two years and has supported excluding farm land from the tax completely.

Being a businessman for 30 years, as he is fond of saying, Minnick is acutely aware that a decrease in revenue has the same effect on a balance sheet as an increase in costs—not what you'd want to see in a budget, especially one you were demanding be balanced.  Evidently a vote against spending roughly $900 billion on health care reform is sexier than telling those inheriting multimillion dollar estates to pay a little more for the services they receive.  That, or it just sounds better to teabagging voters.  Or maybe Walt Minnick is just a convenient "true fiscal conservative."

Whatever the case, it is unclear who Minnick thinks he is protecting from "onerous" taxes.  In his press release he conceded to estimates that only 100 people in the entire United States would be affected by estate taxes under this recent legislation.  But how many Idaho family farms would actually be "saved" from this onerous tax if the legislation is enacted?

Lucky for us, the U.S. Department of Agriculture takes an annual survey of just such things.  The balance sheet for the average operator household, or family farm, from the most recent Agricultural Resource Management Survey, is shown below.  [The assets and liabilities are broken out further in this chart and access to all the data and tables can be found here.]

According to the survey, the average family farm in the West is currently worth just over $1 million—far below the $7 million exemption that Minnick felt it vital to preserve and even well below the $2 million exemption that would have been "onerous" to family farms.  The average Idaho farm family would have been exempt from estate taxes in either case.

It is crystal clear that it is not the average family farm Minnick is protecting.  In fact, it doesn't take a survey to see that there is nothing average about a $7 million estate and that Walt Minnick is just fiscally conservative when it's convenient for him to be so.

Protecting multimillion dollar estates is more important to Walt Minnick than providing health insurance to average Idahoans.  That may be right for Walt Minnick but it's not right for Idaho.

A Model For Building Healthy Communities

There's a great read at Kaiser Health News today on how two counties in rural Kentucky are delivering health services in the "worst health care region in America" and that despite the health care reform debate, some area experts don't anticipate much changing as a result of these current proposals.  Instead citizen involvement and community initiatives are driving a bottom-up approach to building healthy communities.

A few snips:

“We’re out here dying and we’re showing up in the emergency room when we’re half dead, instead of saying, you know what, I live in this community. I want sidewalks,” she says. “I want ambulance services. I want grocery stores convenient, (so) that all of my neighbors can get there. I’d like to see some form of public transportation,” much needed by people without cars in steep mountain country.

[...]

“Currently the issues are framed as insurance or not insurance,” he says. “Having insurance gives you financial access to a system, assuming there is a system. It gives you nothing more than that. And getting into the system, if there is one, doesn’t tell you anything about the quality of care, the availability of services, the way the patients and families are treated.”

[...]

“As with so many issues,” Fox says, “we have this myopic kind of vision of what health is, or what housing is, or what drug abuse is: well, hey, they’re all utilized by the human body, and unless you deal with the whole issue, there’s going to be tons of fallout. That’s why it’s important that you get people in decent housing that they can have a refrigerator, they can have potable water, they can have decent sanitation.”

As Dr. Forest Callico, former director of the Appalachian Regional Hospitals and a rural health advisor to both the Clinton and second Bush administrations, summed it up in the article, "It’s not all about the money.  We have to transform the way we take care of people."

Uninsured Idahoans Deserve More

The miserable have no other medicine but only hope
— Shakespeare, Measure for Measure

Claudio was in prison hoping for a pardon to spare his life, but he could just as well have been foretelling of the lottery that passes for a U.S. health care system when Shakespeare penned those words for him.  With the House of Representatives set to vote this weekend on landmark health care legislation, giving those without health insurance, or prospects for getting it, something besides hope, Idaho Blue Dog Congressman Walt Minnick and staff were penning an editorial on, what else but, financial regulation reform?

The editorial was followed by a brief notice today that, as he has indicated since July, he would in fact be voting against health care legislation tomorrow.  Meanwhile, nearly 20 percent in his district are uninsured, ranking 304 among 436 congressional districts (including D.C.) and he is apparently doing nothing to ensure that his own campaign staff aren't among the uninsured.

Reforming financial regulation is crucial and although Minnick voted against the legislation in committee that he's now touting having written portions of, with a landmark vote on health care looming, perhaps his priorities are a little skewed.  Although purely incidental, his regulation editorial did contain this one mention of health insurance:

That's why my managers would share motel rooms, rent economy cars and get the same health insurance as the newest file clerk. That's why when times got tough I cut my salary first and most before I asked anyone else to sacrifice.

We've heard this from Minnick before.  In an interview for KUOI radio in Moscow while on the campaign trail last year, when asked how his company could afford to provide the same health insurance to all his employees Minnick responded:

We took that as a real priority in my company and whether you were a receptionist or drove a forklift in one of our plants you had the same insurance and we just thought it was important if you're going to keep employees long term.  We [were able to afford it] because our employees worked harder, worked smarter and provided better customer service. ... Businesses are just people and if the people don't enjoy what they're doing and work hard and want to make the business successful there's no way management can make it successful, so we thought [providing health insurance] was a real priority.

Apparently, Minnick thought more of his business employees than his campaign staff.  According to his finance reports, the campaign provided none of them with health insurance.  In 2008, while enjoying his employer-sponsored insurance and traveling around the state advocating universal access to comprehensive, affordable coverage, unless they had means to obtain their own, Minnick's campaign staff went without.

During the 2008 election cycle, of Minnick's paid campaign staff, the eleven who were on the payroll for six months or longer were paid (excluding bonuses) on average an amount equivalent to an annual wage of just over $29,000, assuming they worked the entire year and at the same rate.  These prorated salaries ranged from $11,000 for the communications assistant to $63,000 for the campaign manager brought on for the final months of the campaign.

This means that not only was health insurance not provided for his paid staff, interestingly enough, at the salary the campaign was paying, every one of them would fall below the income limit making a family of four eligible for affordability credits under the current House proposal.  The proposal provides affordability credits on a sliding scale for those who can't get coverage through an employer or other means and who cannot afford to purchase a policy on their own.  The credits are phased out for incomes above 400 percent of the poverty level, or $43,320 per year for an individual and $88,200 for a family of four.

No one on Minnick's 2008 campaign staff made anywhere near the limit for a family of four and only his campaign manager was making more than the individual limit, meaning that had this legislation been in effect then and they met the other requirements, they would have been eligible for financial assistance to purchase their own policies.

Minnick's records show that his campaign staff for the current election cycle who don't also work on his congressional staff are not provided health insurance either.  While the campaign recently touted going over the $1 million mark in fundraising for the 2010 election cycle and reported close to $650,000 in cash on hand, he apparently can't afford heath insurance for his employees.  But he adamantly opposes the legislation that would keep them from numbering among the uninsured.

Most campaign workers, paid or otherwise, aren't in it for the money.  Most put in the long hours because they believe in a cause and are trying to make a difference.  It's hard to imagine that any of those working tirelessly for little compensation and no benefits to put Walt Minnick over the edge last year did so believing he would be the most conservative member of the Northwest delegation.  In fact at least some of them most assuredly did not.

After ensuring that he was reimbursed for every nickle of his own money spent while campaigning—down to each last soda pop (seriously)—the least Walt could do, if he's going to vote against health care reform, is to make sure those he employs have insurance.  They don't deserve anything less than the person driving a forklift at SummerWinds.

All Idahoans deserve a health care plan that includes more than hope.  Unfortunately Walt has other priorities.

'Under' Every Great Man. . .

Recently released economic data from the U.S. Census Bureau's ongoing American Community Survey indicates that during this recession Idaho's poor—especially women and children—aren't faring well.  It's not clear that those making decisions in this state have plans to ease this burden any time soon.  In fact if anything, it seems the load being carried by Idaho women and children will get heavier before it gets lighter.

Average household income ($59,429) is down from the previous year.  The percentage of people using food stamps (7.6%) is up.  Households with incomes less than $25,000 (23.5%) are up. Those making between $25,000 and $35,000 (12.2%) are down.  The percentage of children with all parents in the workforce (65.1%) is up.  Per capita income ($22,748) is down.  The percentage of grandparents responsible for grandchildren (54.2%) is up—from 26th to ninth in the nation.  More people—renting and buying—are paying a higher percentage of their income in housing costs.

Nowhere is it more evident just who is taking the brunt of this recession than in the number of Idahoans living in poverty.

While the percentage of all Idaho families below the poverty level increased slightly from 9.3 percent in 2006 to 9.4 percent in 2008, during the same period female householders living in poverty grew at a significant rate of 17 percent.  The number of single women with children under eighteen living in poverty climbed from 34.7 percent to 40.6 percent.  Those with very young children (under five) jumped nearly ten percentage points, from 47.7 percent to a whopping 56 percent.

One contributing factor is the disparity in earnings between men and women in Idaho, where the median earnings for women are 72 percent less than for men.  This disparity has persisted over time, but Idaho women working full-time, year-round in 2008 had a median salary of $29,730, down slightly from $29,880 in 2006.  Men, on the other hand, saw their median wage increase over the same period from $40,866 to $41,461.  In only five states (Wyoming, West Virginia, Utah, Indiana and New Hampshire) do women encounter a greater earnings disparity than that of Idaho women.  [For a sobering snapshot of how this earning disparity persists across all occupations in Idaho, even those dominated by high percentages of women, check out this chart.]

Idaho women were more likely than men to find themselves living in poverty in all educational attainment categories.  Fifteen percent of female high school graduates had incomes below the poverty line compared with eight percent of men.  Even nearly 6,000 women with a bachelor's degree or higher had incomes below the poverty line in 2008—nearly two-thirds more than their male counterparts.

The survey estimates that in 2008, 13.7 percent of Idaho children under eighteen were without health insurance—nearly 4,000 more than '06 and '07 estimates of 12.2 percent.  The number of uninsured Idahoans overall is estimated to be 267,000 or 17.8 percent.  Although the survey doesn't separate these most recent numbers by gender [at least I defy anyone to locate this data if it exists], a report issued in March from the Robert Wood Johnson Foundation indicates that in the last decade the number of uninsured women in Idaho has increased at a rate of 37 percent, while the rate of increase for men is 4.7 percent.

Women in Idaho earn less, are more likely to live in poverty, are becoming increasingly uninsured and, as the primary caretakers for children in this state, during this recession are being asked to do more with less.  With his new budget proposals that include slashing 6 percent out of higher education, inexplicably the governor of this state is cutting women off at the knees, creating obstacles to the primary tool they have of creating a better life for their children—education.

Idaho women are legendarily tough but this gives a whole new meaning to "women and children first."

Update 10.06.09:  Betsy Russell has more on 2008 children's health insurance data from the U.S. Census Bureau Current Population Survey with results that vary from the data in the American Community Survey.

Public Option: Get Serious

"Inventor of the public option explains why it's crucial"

I think it's pretty clear why if you look at what's happened over the last generation in American health insurance. Private insurance plans have basically failed us, and we need to have competition between a new nonprofit public health insurance plan that puts patients first and not private insurance companies.

Read it if you haven't yet.  Then check this out:

Got Insurance?

Yeah?  For how long?

From Kaiser Health News:

Employers struggling with the steady rise of health insurance costs – which in 2009 increased 5 percent to an average of $13,375 for family coverage -- are passing on more of the expense to their workers through higher deductibles and co-payments, according to survey released today.

With increasing deductibles and co-pays how many will simply forgo preventative care?  And at this rate, how many families will even be able to afford premiums in 2019 at $30,803 per year?

Percent of Insured Workers With A Deductible Of $1,000
Or More For Single Coverage

Source: Kaiser Family Foundation/Health Research & Educational Trust Survey Employer-Sponsored Health Benefits, 2006-2009.

Health Care In the Land of the F-f-f-free

Sing along folks:

"We're Number 37
We're the USA
The big Number 37
And we're so proud to say
We got old people crying at the pharmacy
Pay your deductible
This aint the land of the f-f-f-free Grandma
We're Number 37
We're the USA"

h/t:  The New Republic

Idaho Reps on Rebuke of Wilson

Today the U.S. House of Representatives voted to rebuke Congressman Joe Wilson (R-SC) for his "You lie!" outburst during President Obama's health care speech to a Joint Session of Congress last Wednesday.  The resolution passed on a 240 to 179 vote with seven Republicans joining the Democratic majority in favor and twelve Democrats voting with the GOP against the measure.

Idaho's Reps Mike Simpson and Walt Minnick voted along their respective party lines, Rep. Simpson voting against and Rep. Minnick in favor of the rebuke.

In case you've been living under a rock or perhaps hiking the Appalachian Trail, get caught up on the Joe Wilson saga here.  Watch portions of the resolution debate here.

---

H Res 744 — Official text currently unavailable; a copy can be found here.

Clerk of the House
Congressman Minnick — Yes
Congressman Simpson — No
Democratic Position — Yes
Republican Position — No
Result — Passed 240-179, 5 present, 10 not voting