Issues Now!

The Public Health Insurance Option As A Strong Competitor

Jason Rosenbaum2 — Thu, 28 May 2009 13:25:29 -0700

Jacob Hacker at Campaign for America's Future laid out the case for a Medicare-like public health insurance option:

A Medicare-like public plan would be much more stable and secure than other approaches. It would provide the broadest possible choice of doctors. It could be offered throughout the nation on the same terms. It would have the lowest administrative costs. And its bargaining power and large risk pool would allow it to offer the most affordable possible premiums and most effectively restrain costs while upgrading the quality of care.

Health Care: How 'Public' Must A Public Plan Be?

In the days leading up to the America's Future NOW! conference starting June 1, we're hosting an online dialogue featuring conference speakers on the key issues they will be addressing during the conference. Join the conversation by clicking the "Discuss" link below or contribute your own post.

Plan to attend the America's Future NOW! conference in Washington.

Joe Paduda disagrees, arguing that the savings Hacker sees from Medicare are overstated. Instead, he proposes a different model for the public health insurance option:

I could go on, but the point is clear - Medicare's supposed administrative and medical cost advantages are not real. That does NOT mean a public plan option isn't viable. In fact, there is a government plan that is kicking the collective private health plan industry's rear end. It's the Veteran's Administration, and rather than Medicare, i'd base a national plan on a dramatic expansion of the VA.

Who's right? Well, both—or neither.

First, I should take issue with one of Paduda's assertions. Medicare does indeed hold down health care costs. Its costs are growing slower than private insurance. Now, that doesn't mean costs aren't growing; they are. If we don't control health care costs, Medicare will indeed break the bank. That's why we need the public health insurance option.

To analyze which type of public health insurance option will work best, I think it helps to understand the goal of the public health insurance option. First and foremost, the public health insurance option should exist to provide people with a place they can go to get quality health insurance if and when their private insurance fails to provide them with what they need. People should always have a choice to get out of the private, monopolistic system if they want.

This choice will lead to increased competition. (I'm not sure why Paduda says it "may" lead to more competition; it seems to me that increased competition is pretty much a guarantee.) The public option should be able to bargain with providers for lower rates, and with less overhead, it will be able to provide services for at least nominally less than private insurance right off the bat. This, combined with an insurance program designed to protect people's health and not a corporate bottom line, will make the public health insurance option a strong competitor. Private insurance will be forced to respond.

This competition between public and private seems to me to be the main driver of lower costs and better outcomes. Private insurers will likely get creative finding ways to out-deliver and undercut public insurance. And public insurance, with access to a vast pool of data and government transparency regulation, will be able to really understand costs in the health care system in a new way, and derive further solutions from that, solutions like the ones Atul Gawande has proposed in this must-read article in the New Yorker.

So, in a way, it doesn't matter much if the public health insurance option is Medicare-like or Veteran's Administration-like. As long as it provides people with quality health care and peace of mind, it will be popular. And as long as it is a strong competitor, it can adapt down the line to ratchet down health care costs even further.

Medicare For All: The Wrong Answer To The Right Question

Joe Paduda — Thu, 28 May 2009 06:25:59 -0700

Jacob Hacker's enthusiasm for a 'real' public plan option is laudable. It also dramatically overstates the strengths of Medicare. I'm not entirely convinced that we need a public plan option, and am even less sure that Medicare should be the basis for a public plan option.

That said, there are at least three solid arguments for a public plan option;

1.) at least one public health provider actually does a terrific job of holding down costs while delivering outstanding care (hint it's not Medicare);

2.) most markets are already dominated by one or two large private insurers, making it extremely difficult for another private insurer to effectively compete. a government plan may (emphasize MAY) offer more competition which might (emphasize MIGHT) lead to lower costs/better outcomes, and

Health Care: How 'Public' Must A Public Plan Be?

3.) private insurers have done a lousy job of holding down costs, delivering better outcomes, and servicing their insureds. It is hard to see how a governmental plan could be any worse, and easy to envision much better results.

In my mind those arguments tip the scales in favor of a public plan option, and give the lie to opponents' arguments against said option.

But Hacker overstates the case for Medicare, and in so doing weakens the case for a public plan option. Specifically, he argues that Medicare has lower administrative costs and does a better job holding down medical trend. I disagree.

As has been well-documented, government plans have unfair advantages over private plans: they don’t need to maintain reserves, earn profits to attract capital, or pay premium taxes. These result in big dollar 'savings' over private plans. It is also important to note that Medicare's cost structure is dramatically different in other ways. Here are a couple examples:

1.) Medicare has no underwriting or sales expenses or marketing costs. No commissions, either. This saves a lot of admin dollars. This differential would disappear in a health connector-type system, with the playing field leveled by dramatically reducing commercial healthplans' marketing costs and elimination of their underwriting expense.

2.) Medicare has one-time enrollment and dis-enrollment, and greatly simplified eligibility processes. This cuts their costs, but would not continue under a connector model.

As significant as the admin expense argument is, it is Hacker's contention that "Medicare has increasingly out-performed private plans in restraining the rate of increase of health spending while maintaining broad access" that is the real problem with his argument for a public plan option.

The unfunded liability for future Medicare costs clearly and convincingly demonstrates that Medicare is not earning enough revenue to pay for future expense. In commercial insurance terms, they are dramatically under-reserved. Why? Premiums are not keeping pace with medical inflation, and Medicare is not controlling the primary driver of medical costs - utilization of services.

Here are a couple examples. Medicare's imaging expenses doubled between 2000 and 2007. Utilization of physician in-office services went up more than 10% in 2006. Back surgery rates for Medicare patients in Fort Myers Florida are five times higher than they are in Miami. And physician fees are scheduled to be cut 20.5% next January because total physician expenses under Medicare are way over budget. Not to mention the cost-shifting that currently has private insurers making up lost revenue from Medicare underpayments.

I could go on, but the point is clear - Medicare's supposed administrative and medical cost advantages are not real. That does NOT mean a public plan option isn't viable. In fact, there is a government plan that is kicking the collective private health plan industry's rear end. It's the Veteran's Administration, and rather than Medicare, i'd base a national plan on a dramatic expansion of the VA. Here are a few factoids...

- compared to commercial managed care plans, the VA provided diabetics with better quality care on seven out of eight metrics (NCQA report).

- In 2005, VA hospitals were the highest-rated health system, outperforming other systems including the Mayo Clinic and Johns Hopkins.

- the VA achieves higher scores than private hospitals for patient satisfaction, staffing levels, surgical volume and other significant quality measures

- for six years running, VA hospitals scored higher than private facilities on the University of Michigan's American Customer Satisfaction Index.

And costs haven't increased nearly as fast as they have in the private sector. In the ten years ending in 2005, the number of veterans receiving treatment from the VA more than doubled, from 2.5 million to 5.3 million, but the agency needed 10,000 fewer employees to deliver that care - as a result the cost per patient stayed flat. (costs for care in the private sector jumped 60% over the same period).

The VA did this by closing down unneeded facilities, developing an industry-leading electronic health record system, opening clinics, and dramatically increasing the quality of care, especially for patients with chronic conditions.

Oh, and patients can access their own health records - securely - anytime on the web.

Medicare's not the answer. A public plan option based on an expanded VA would force private plans to get better - a lot better - or lose share quickly to this very efficient, and very effective, health system.

Why We Can't Compromise On Public-Plan Choice

Jacob S. Hacker — Wed, 27 May 2009 11:45:46 -0700

Of all the components of the health reform package that will be debated in Congress this year, none inspires greater admiration or ire than the idea of “public plan choice.” Public plan choice means simply that Americans younger than 65 who do not have employment-based health insurance should have the option of enrolling in a new public health insurance plan that provides good coverage on equal terms in all parts of the country.

As I have argued at length, by creating a benchmark for private plans and a new means of reining in costs and improving quality, public plan choice is the key to ensuring that health reform provides quality affordable care to all Americans over the long term.

Health Care: How 'Public' Must A Public Plan Be?

Recently, some policy experts have called for a “compromise” approach that would involve state-based public plans designed to mimic state self-insured health plans. Some have even backed models that simply involve a government contract with one or more private insurers to administer claims. Neither approach would achieve the cost savings nor delivery system changes that a truly national public plan could. Indeed, in an online debate, Stuart Butler of The Heritage Foundation correctly stated that a self-insured nonprofit health plan such as those now run for public employees in many states would be “a public plan in name only.”

A true public plan cannot rely on private insurers to set premiums, provider rates, or terms of coverage, and it must be publicly accountable at the national level. The simplest, most workable, most cost-effective, and most attractive way to achieve these crucial goals is to model the new public plan on Medicare, the successful and popular public health insurance program for the elderly and disabled.

A Medicare-like public plan would be much more stable and secure than other approaches. It would provide the broadest possible choice of doctors. It could be offered throughout the nation on the same terms. It would have the lowest administrative costs. And its bargaining power and large risk pool would allow it to offer the most affordable possible premiums and most effectively restrain costs while upgrading the quality of care.

No less important, this model is overwhelmingly popular: In polls, between two-thirds and three-quarters of Americans say they want private plans to compete with a “government-administered public plan similar to Medicare.”

In stark contract, state-run plans or plans run by third-party administrators would have severe disadvantages:

1. They would require building a new plan (or a new set of regional plans and oversight agencies) largely from scratch, which would mean forfeiting the administrative, economic, and political advantages of building on the Medicare infrastructure.

2. Such models would also require forfeiting another major advantage of a Medicare-like public plan: the ability to provide enrollees with a broad choice of providers.

3. Most important, the prospect for cost restraint and/or quality improvement under these proposals would be limited. Medicare has increasingly out-performed private plans in restraining the rate of increase of health spending while maintaining broad access. A new public plan could draw on Medicare’s experience, as well as the experience of the national VA system, to improve its cost-control methods and enhance the quality of care.

In short, the public health insurance plan should be a model for how to deliver cost-effective high quality care. Only a national, comprehensive and truly public plan can provide this essential benchmark for private plans.

So let’s not compromise away an essential element of health reform. When the debate over reform heats up, advocates will need a clear, simple, and unthreatening vision of reform that makes a simple promise: Americans should get a real choice between private insurance and a Medicare-like public plan, not a false choice between private insurance plans and a “public plan in name only.”

The United States Needs a Cohesive Industrial Policy

Steven Capozzola — Tue, 26 May 2009 17:02:54 -0700

Clyde Prestowitz is absolutely right that the United States needs a cohesive, forward-looking national industrial policy. And furthermore, he is correct in pointing out the “policies of China, Japan, Korea and others to undervalue their currencies.” Such mercantilistic trade practices are an excellent reminder that other major economic powers already maintain their own inwardly focused industrial policy.

Beyond GM: Our Bankrupt Industrial Policy

This becomes particularly relevant when discussing the U.S. auto sector. In fact, more than 7.2 million U.S. jobs are dependent on a healthy U.S. auto parts supply chain.

What’s needed to strengthen the automotive supply chain and revitalize American manufacturing are policies that get America back to work.

Our organization, the Alliance for American Manufacturing (AAM) recently undertook an 11-state, 34-city bus tour that culminated in a teach-in on Capitol Hill. As we took our message across the country, we found strong support for a more reciprocal trade policy and for a restructured U.S. auto industry that doesn’t simply rely on the offshoring of more production in order to meet a shrinking bottom line. Simply put, tax dollars should not be used toward the outsourcing of more U.S. production.

We must revise our approach to trade policy, including strong enforcement of existing U.S. trade law. We also need to reform our healthcare system and invest in research and innovation in order to restore American manufacturing. Anything less is simply short-sighted.

An Industrial Renaissance Policy

Clyde Prestowitz — Tue, 26 May 2009 13:39:11 -0700

For years Larry Summers and I had a running argument over industrial policy.

As a mainstream economist in good standing, he, of course argued that governments can't pick winners and losers and that even if it could, special interests would inevitably capture the process and distort it. Under no circumstances, he emphasized, should America have an industrial policy.

My view was that as an industrial nation we would inevitably make decisions that involved picking winners and losers. Breaking up AT&T, standards setting by the FCC or FDA, R&D spending by N.I.H, etc. are all examples of such decisions. The only question was and is whether those decisions would be guided by some overall productivity optimizing criteria or by chance or, more likely, the very special interests Larry feared.

Beyond GM: Our Bankrupt Industrial Policy

Well, now that the U.S. government owns the banks, insurance, and auto companies with Larry as the chief winner and loser picker, that whole discussion has become moot.

But now that we are picking winners and losers, the question of how we are doing it has become very important. So far, the answer is "not very well."

While pouring big bucks into GM and Chrysler to keep them alive, the administration has largely ignored one of the biggest factors making them uncompetitive - the exchange rate. The strong dollar and the policies of China, Japan, Korea and others to undervalue their currencies tend to undercut the rescue effort. Industrial policy will only work if it is a complete policy, and a complete policy in this case must be one that deals with the exchange rate question.

More important, however, is the question not only of saving Detroit, but more broadly, of revitalizing the whole U.S. productive base. To avoid a repeat of the experience of the past two years, we must come out of this crisis with a vastly reduced trade deficit. But to do that, we must begin to produce more of what we consume, which is, after all, what Obama has been talking about when he discusses creating green and other kinds of jobs. But the problem is that right now, the greener we get, the more we import because we don't make most of the stuff we would need to install.

Take batteries for instance. Electric cars, lawn mowers, and other devices need batteries. With a few small exceptions, U.S. companies don't make batteries. They also don't make windmill blades and turbines. They also don't make solar cells or concentrators.

Even if GM and Chrysler survive in some reduced form, a lot of workers are going to lose their jobs as a lot of factories are shut down. A sensible industrial policy would be looking at ways to replace those auto factories with battery, windmill, and solar cell plants. The new Commerce Secretary ought to be talking to Korean battery makers, Danish windmill producers, and Japanese photovoltaic cell manufacturers about why they should be investing in the U.S. and why they should be doing joint ventures with American companies. He should have some financial investment incentives to use to entice these companies to U.S. shores.

At the same time he should be creating government-industry consortia to promote development of these technologies in the United States. Use the Sematech consortium that was set up in the late 1980s to meet Japanese competition in semiconductors as a model. He should also be working with State governors to see to it that new factories are located so as to replace old ones and to take advantage of concentrations of worker skills.

In short, America needs a real industrial renaissance policy, not just a save GM and Chrysler policy.

Political Realists Rejoice, Climate Science Realists Demand More

Joseph Romm — Fri, 22 May 2009 11:44:18 -0700

Every journey of a 1000 miles begins with a single step — including stopping human-caused global warming at “safe levels,” as close as possible to 2°C. Many people have asked me how I can reconcile my climate science realism, which demands far stronger action than the Waxman-Markey bill requires, and my climate politics realism, which has led me to strongly advocate passage of this flawed bill.

The short answer is that Waxman-Markey is the only game in town. If it fails, I see no chance whatsoever of stabilizing anywhere near 350 to 450 ppm since serious U.S. action would certainly be off the table for years, the effort to jumpstart the clean energy economy in this country would stall, the international negotiating process would fall apart, and any chance of a deal with China would be dead. Warming of 5°C or more by century’s end would be all but inevitable, with 850 to 1000+ ppm. If Waxman-Markey becomes law, then I see a genuine 10% to 20% chance of averting catastrophe — not high, but not zero.

The Politics of Energy: How Much Capping And Trading?

Today was the first genuine step that the U.S. House of Representatives has ever taken on climate. And since the Committee is stuffed with members representing traditional (i.e. polluting) energy industries, it shouldn’t be harder for the full House to pass this bill than it was for the committee. That said, the House GOP leadership is certainly much savvier than Joe Barton (see here) — and agricultural and other interest groups have yet to flex their muscle. Much work remains keep the bill as strong as possible even in the House.

For climate politics realists, it will be a staggering achievement if, in 12 months or so, an energy and climate bill that looks something like Waxman-Markey is signed into law by President Obama. After all, the United States hasn’t enacted a major economy-wide clean air bill since the Clean Air Act amendments of 1990. And that bill had a cap-and-trade system where 97% of the permits were given to polluters. And it focused on direct, short-term health threats to Americans.

The forces that are lined up against serious climate action today are incredible:

The Congressional GOP are almost unanimous in their opposition to any serious climate bill or any clean energy bill (see Hill conservatives reject all 3 climate strategies) — and they are committed to demagoguing the cost issue even to the point of embarrassing the outside-of-the-beltway GOP (Republicans (sic) for Environmental Protection “call out those Republicans who continue to spread the false claim that capping greenhouse gas pollution will — supposedly — cost American families $3,100 every year.”)

The polluting industries spend vast sums of money on lobbyists, on deceptive ads, and on right wing think tanks who spread disinformation. The status quo media under-reports and misreports the climate science and climate economics (see Must-read (again) study: How the press bungles its coverage of climate economics — “The media’s decision to play the stenographer role helped opponents of climate action stifle progress.”). The climate science activists can’t even agree on a message or whether they should even talk about climate science (see Mark Mellman must read on climate messaging: “A strong public consensus has emerged on the reality and severity of global warming, as well as on the need for federal action” — ecoAmerica “could hardly be more wrong”). From a political perspective, Democrats are being asked to face an onslaught of deceptive campaign ads claiming they have raised energy taxes in order to pass a bill whose climate benefits will not be apparent for a very long time — although the clean energy and jobs benefits will begin almost immediately (Nobelist Krugman: Climate action “now might actually help the economy recover from its current slump” by giving “businesses a reason to invest in new equipment and facilities”). And many of their constituents, primarily the conservatives and the conservative-leaning independents, don’t even think human caused global warming is a problem that needs aggressive government action, assuming they think it is a problem at all (see here).

From the perspective of political realism, it will be a great challenge just to stop this bill from being weakened as it winds itself through the House and especially the Senate.

From the perspective of climate science realists, the bill has two gaping flaws. And I don’t mean the allocations for big polluters. I know many of my readers disagree, but I just don’t think that the allocation undermines the goals of the bill at all, and in fact are a perfectly reasonable way of satisfying political needs while preventing windfalls for polluters and preserving prices.

The first flaw is the 2 billion offsets that polluters can potentially use instead of their own emissions reductions. I have previously explained why I am far less worried about domestic offsets (see here). In a regulated market with a cap, many of the domestic offsets will represent real reductions of US greenhouse gas emissions, and the total supply of cheap domestic offsets will be limited. I will blog tomorrow on why I do not believe the international offsets threaten the overall integrity of the bill. The bottom line is that the vast amounts of moderate-cost near-term domestic emissions reductions strategies — energy efficiency, conservation, replacing coal power with natural gas-fired power, wind power, biomass cofiring, concentrated solar thermal power, recycled energy, geothermal, and hydro power (see “An introduction to the core climate solutions“) – will be cheaper (in quantity) than most of the offsets will be in 2020.

Second, the 2020 target is too weak (see here). Given the lost 8 years of the Bush administration, it was inevitable that a bill which doesn’t even impose a cap until 2012 could not have the same 2020 target (compared to 1990 levels) than the Europeans are considering.

That means we’re going to build too much polluting crap in the next decade. That means we’ll have to go back and unbuild it at some point. More expensive, sure, than doing it right the first time, but no more difficult than deploying a dozen or so accelerated stabilization wedges globally in three to four decades needed to beat 450 ppm.

For me, a two-term President Obama (together with the next three Congresses) cannot solve the global warming problem, but can create the conditions that allow the next couple of presidents to do what is needed. Or he can be thwarted, making it all but impossible for future presidents.

The only hope for stabilizing at 350 to 450 ppm is a WWII-scale and WWII-style effort as I have said many times. And that implies a level of desperation we don’t have now (see “ What are the near-term climate Pearl Harbors?“). When we have that desperation, probably in the 2020s, we’ll want to already have:

* substantially dropped below the business-as-usual emissions path
* started every major business planning for much deeper reductions
* goosed the cleantech venture and financing community
* put in place the entire framework for U.S. climate regulations
* accelerated many tens of gigawatts of different types of low-carbon energy into the marketplace
* put billions into developing advanced low-carbon technology
* started building out the smart, green grid of the 21st century
* trained and created millions of clean energy jobs
* negotiated a working international climate regime
* brought China into the process

This bill is crucial to achieving all of those vital goals.

Kudos to Henry Waxman and Ed Markey — and a great many other progressive politicians and advocates — for making this historic moment happen.

Originally posted at Climate Progress

America Needs a 12-Step Program

Kari Fulton — Wed, 20 May 2009 09:18:02 -0700

It is a Monday morning in Washington, D.C. and the children of River Terrace Elementary are walking past carry-outs, liquor stores, traffic, and plumes of smoke from the Benning Road Peaking Power Plant dancing in the sky. The dance ends with a sprinkle of pellets of chemical warfare falling onto the community below. Scientists at the Agency for Toxic Substances and Disease Registry call it "particulate matter" and it has been linked to the area's high rates of asthma, bronchitis and cancer .

A few states away, at Marsh Fork Elementary in West Virginia, little children are also filing into class, smack dab in the middle of coal country. Sludge fills their drinking water, so they are told not to drink it. Sometimes they cannot even go out to play, because the cracks in the playground are oozing out toxic coal sludge. Why?

Why are these children and so many more people around the world suffering from cancer, disease, chemical warfare, increased violence and economic instability? All for the sake of fossil fuels. Brittanica Encyclopedia defines fossil fuels as, "any of a class of materials of biologic origin occurring within the Earth's crust that can be used as a source of energy. Fossil fuels include coal, petroleum, and natural gas. They all contain carbon, and were formed as a result of geologic processes acting on the remains of (mostly) plants and animals that lived and died hundreds of millions of years ago." This ancient source supplies 90 percent of all the energy used by industrially developed nations. It turns on our lights, heats our stoves, fuels our cars.

The Politics of Energy: How Much Capping And Trading?

For almost a century, scientists have been developing technology to make us less reliant on fossil fuels. In 1910, American Engineer Frank Schuman built one of the first practical industrial scale solar plant, at Meadi, Egypt. Schuman proclaimed enthusiastically, "Sun power is now a fact and no longer in the 'beautiful possibility' stage... It will have a history like aerial navigation. Up to twelve years ago it was a mere possibility and no one took it seriously."

Unfortunately Schuman's innovative technology and his solar powered predecessors have been placed on the back burner, as world economies lean toward less expensive, but more dangerous fossil fuel. This dependence on fossil fuels has become a monkey on our back that we cannot seem to shake. Almost 100 years later, we are still facing the threats of oil shortages and struggling with an addiction to this dangerous, life threatening commodity. But why?

Why. Because the fossil fuel industry is so addicted to the profits from controlling the masses with oil and coal, that they even have the audacity to call it "clean".

Please, don't believe the hype. Ain't no such thing as clean coal. Ask the parents of the children at Marsh Fork Elementary, who live in the Appalachian mountains, and work in the coal mines blowing up mountaintops to gather up coal.

Thedirtylie.com, found that in the past twenty years, "mountaintop removal has obliterated an estimated 470 mountains in Appalachia, crushing 1 million acres of the world’s most productive and diverse temperate hardwood forests and smothering 1,200 miles of streams. At the current pace, the coal industry will have decimated a piece of Appalachia the size of Delaware - more than 1.4 million acres — by the end of the next decade."

The falling rock from mountaintop removal tumbles and hits the homes of the Appalachian people below. With one stroke, seven, nine, ten generations of memory falls to pieces. The rock breaks the homes, but the work breaks the soul.

In Nigeria, the quest and acquisition of fossil fuels has also lead to oil related violence. A 2004 Fact Finding Report by the Human Rights Watch, “Rivers and Blood: Guns, Oil and Power in Nigeria’s Rivers State,” found companies like Shell have taken over indigenous land and partnered with corrupt politicians to maintain control over oil markets and Nigeria's government. Since late 2003, the running fight for control of these villages and towns has resulted in the deaths of dozens of local people and forced tens of thousands to flee their homes. Schools and businesses have closed. Homes and property worth millions of dollars has been destroyed. Hundreds of mostly young male fighters have also been killed. The violence has created a profound climate of fear and insecurity in Rivers State, leaving local people reluctant to return to their homes or to seek justice for the crimes committed. Although it is dangerous, the people work in the mines because that is all they know. They are now addicted too, but crying for a twelve step program.

Please America, check-in to rehab from fossil fuels. Please America, go into rehab for our souls. We are watching the earth die, not realizing that the same things that are killing our planet are the same thing that are killing us too.Greenhouse gases are the number one cause for climate change around the world. The Environmental Protection Agency estimates that over half of the greenhouse gas emissions from United States come from power plants like the Benning Road Peaking Plant, in the River Terrace Community, in Washington, DC. Another third comes from transportation and the exhaust that comes from automobiles fueled with oil from oil refineries like the ones in Nigeria's River State. As one of the world's largest emitters of greenhouse gas emissions, our energy usage is causing the world to heat up with vengeance.

This addiction is worse than any drug, and runss so deep that most of us don't even realize we are fiends; from petrolatum jelly vaseline to cars that run on gasoline, to month after month of making ends meet to pay a light bill, or heating bill — while Mother Earth continues to be pimped for our comfort and satisfaction.

But can you really blame the people when you have fossil fueled fiends running our markets and our country? They introduced us to the good stuff and said we had to have it to succeed; to run that red-hot corvette and thaa private jet is what will really make you feel free. Unfortunately, this type of "freedom" doesn't come to many. So most people in the world are just reading the advertisement and breathing the fumes from car exhausts and jet fuels. Particulate matter slowly falling is inhaled, causing yet another child to miss a day of school. The doctor will say it's just another asthma attack.

There is another way to freedom. Today, more and more countries are revisiting the work of engineers like Frank Schuman who saw renewable energy such as wind and solar as more than just a "beautiful possibility". As an activist in the Youth Climate Movement and organizer with the Environmental Justice and Climate Change Initiative, I've had the honor to work with amazing leaders from around the world, all working together to spark a truly clean and just energy revolution that creates healthy and sustainable jobs, preserves our planet and frees millions of people around the world from addiction to fossil fuels.

In 2007 the Energy Action Coalition, which is made up of 50 organizations, including EJCC, came together to host the first ever youth summit on the Climate Crisis. The event gathered together over 6,000 young people from the U.S. and Canada. With Power Shift 2007, we held the largest lobby day on climate in U.S. history. Power Shift 2007 engaged a nation and helped to make climate change and renewable energy a major topic in state and national elections.

In January of 2009 the Energy Action Coalition came together once again within the first 100 days of President Barack Obama's term for Power Shift 2009. Through Power Shift 2009, we gathered 12,000 young people from around the U.S. and the world, all in solidarity for a truly just renewable energy economy. We gained the attention of our local senators and congress people by storming the halls of Capitol Hill, wearing green hard hats symbolizing a unified call for more green jobs and investment in a new green economy.

With a new administration, the voices of the Youth Climate Movement and the calls from the grassroots advocacy of communities living near the coal fields, power plants and oil refineries are finally starting to be heard. On March 24, 2009 the Environmental Protection Agency announced it will suspend and review permits for two mountaintop removal coal mining operations — and putting hundreds more mountaintop coal-mining permits on hold until it can evaluate their impact on our nation’s streams and wetlands. On April 17th, the agency announced its findings from a 2007 Supreme Court Ordered report and found that greenhouse gases are a serious threat to public health and welfare. With a sense of hope for the future, EPA administrator, Lisa Jackson announced, “This finding confirms that greenhouse gas pollution is a serious problem now and for future generations....This pollution problem has a solution – one that will create millions of green jobs and end our country’s dependence on foreign oil.”

Within the first 100 days of the Obama Administration, the United States has taken the first steps in a twelve step process to end our addiction to fossil fuels. We have acknowledged that we have a problem and it is directly connected to the fossil fuels we consume. If we want to live free, if we want to continue living in our perceived luxuries, we must take a moment to reduce our waste, reduce our pace of energy consumption, and thinkt.

Today is the time to make a decision. Just like the workers in the coal mines of West Virginia, we are reaching our rock bottom and it is time for an intervention and introduction to a twelve step program to end this addiction to fossil fuels. By reviewing the twelve step program developed in 1935 by Alcoholics Anonymous founders Bill Wilson and Dr. Bob Smith, I have created 12 steps the United States and the American people must take to alleviate this addiction and truly reach Eco-freedom and Environmental Justice.

Step 1. Admitting we have a problem, and that the United States is the largest emitter of greenhouse gases that are causing climate change. We are dependent on unhealthy and unstable fossil fuels, and are playing a role in the destruction of ourselves, others and the planet.

Step 2. Start to believe there is a power higher than ourselves. For whatever reason, that higher power allowed us to live on this planet. We must give thanks by tending to this planet as the planet has tended to us.

Step 3. Make a decision to embrace the "WE" mentality instead of the "ME" mentality. The world is more that one person. At this stage, we begin to live our lives with conscious respect for the planet and all beings inhabiting this world.

Step 4. Take a soul searching and fearless inventory of our personal practices, and the social circumstances that have allowed this addiction to fossil fuels to run our lives.

Step 5. Continue our soul searching quest, and publicly admit to ourselves, Mother Earth, and the world the exact wrongs we have done to the earth and to our bodies through this addiction to fossil fuels.

Step 6. Be entirely ready to transition off of fossil fuels and unsustainable habits, purchases and practices.

Step 7. Work together to create a grassroots and mainstream culture of support in removing our countries over materialistic and consumerist shortcomings that allow this addiction to fossil fuels to grow larger as a threat to our planet and our humanity. Humbly ask and listen for guidance and support from Mother Nature and the international greater good.

Step 8. Making a list of people countries and environments we have harmed and be willing to make amends to them all. This will be quite a feat for United States, or almost any developed nation, to accomplish. However, in our own lives we can begin by making a list of environmental hazards in our communities or in communities that may receive the waste from our community.and pledging to advocate for land remediation and support with environmental justice concerns.

Step 9. Making direct amends to the communities, countries and environments that we have harmed due to our addiction to fossil fuels, except when to do so would injure them or others. While we must make amends for our wrongs, we must listen to the needs of people we have wronged first, and make sure they even want our help. We can make direct amends to the earth and to communities impacted by our environment by giving back through tree planting, advocacy work, fundraising support for local grassroots actions and clean-up/service projects to restore our communities and our environment.

Step 10. Continuing taking personal inventory and not be afraid to admit when we are wrong. As a world leader, America must shred an misconceived image of superiority. This image has helped greatly in allowing us to fall into one of the worst recessions since the Great Depression. At this step we won't allow our pride to keep us from saving people and the planet.

Step 11. Staying connected and in tune with a higher power, grassroots community efforts and to the mission of our country that is expressed in the constitution. Through a process of deep thought and research making sure that we realize who we truly are in this world and in this universe. Becoming more aware of the deeper role America can play in protecting our environment and reducing the threat of drastic climate change.

Step 12. At this point our country will have experienced such a dramatic sociological and cultural shift that if asked we could truly work with other countries like China, India and Europe as we all overcome our addiction to fossil fuels.

However in order to reach step twelve, we must all take step one.

The Environmental Protection Agency, grassroots environmental advocates and everyday people around the world have started taking the first steps towards Eco-freedom. We are gathering together to make sure our country makes the first step as well. This year, 2009, is a critical turning point in our future. Major legislation on climate change is being debated on the floors of Capitol Hill, and in December, leaders of industrialized nations around the world will come together in Copenhagen, Denmark for the 15th annual United Nations Climate Change Conference.

For 8 years the world has been waiting for the U.S. to make a statement. This year will be the first time the Obama administration will be a part of the negotiations, and it is the hope of the world that the U.S. will take a lead in addressing global climate change by making true steps to reducing our greenhouse gas emissions. The decisions we make today will decide the future of our children and generations to come. It's time to listen to seven generations from today. It's time to drop the fossil fuel habit and start creating the beautiful reality of a renewable energy economy that is based on justice, human rights and sustainability!

To learn more about what you can do to advocate for getting the United States into a Fossil Fuel Rehab program visit powershift09.org, ejcc.org and checktheweather.net.

Without The Grassroots, No Choice But To Deal

Bill Scher — Wed, 20 May 2009 08:26:37 -0700

David Roberts laments the political squeeze the Waxman-Markey climate compromise puts on progressives, forced to choose between "what justice and prudence demand and what's possible within the current constraints of power politics" but ends on a hopeful note: "if a small step is all you can take, I guess you take the small step."

It appears that right now a small step is all we can take, but did it have to be so? And will it always, especially when we don't have time for only small steps if we are to avert a climate crisis? The political reality for progressives must face is that there are enough congressional Democrats from fossil fuel producing states to block any legislation.

The Politics of Energy: How Much Capping And Trading?

There are two ways to overcome the political hurdle. Either cut deals with the coal, oil, auto and utility industries that weaken (but hopefully don't completely undermine) the legislation. Or convince voters in those areas that their interests are not the same as those of fossil fuel CEOs, motivating them to take action and putting public pressure on key congresspeople to back stronger climate protection legislation.

Cutting deals can be handled behind closed doors in the halls Congress. Generating public pressure requires major grassroots mobilizing.

The political reality Reps. Henry Waxman and Ed Markey had to face is there has been no major grassroots mobilizing in the broader progressive movement. While poll numbers show strong support for strong legislation, there has been no grassroots intensity to back that up, to convince skittish politicians that the public is demanding action immediately, and will hold politicians accountable if they don't follow through.

Yes, environmental groups are active. Yes, there have been some ads and email appeals. But the issue has not dominated the progressive conversation in recent weeks, and it did not become the top priority issue across most areas of the progressive movement -- even though the most critical negotiations were happening this month.

This is not necessarily the fault of individuals. There has been little in the media -- either traditional or new -- to let individuals know that the past month has been the critical time to influence climate legislation. Engaging voters in the legislative process has not been a priority for traditional media outlets more interested in stoking outrages du jour, and sadly, new media outfits have been spotty on this front as well.

But broad, deep, relentless and coordinated grassroots mobilization is the only thing that can put a wedge between special interest lobbying and Congress. If we aren't present in the halls and offices of Congress, you better believe every day corporate lobbyists are.

So faced the reality of no grassroots mobilization providing real wind at their backs, Waxman and Markey had to deal. And bless 'em for it, or else we'd really be nowhere.

But until we figure out how to get the millions of progressives to engage the legislative process early in the process, we'll be stuck with choice after choice of watered-down legislation or no legislation at all.

The Waxman-Markey Rorschach blot

David Roberts — Tue, 19 May 2009 02:25:13 -0700

The story of climate change, like the progressive story itself, is about the distance between what justice and prudence demand and what's possible within the current constraints of power politics. It just so happens what when it comes to climate, the distance is unusually large.

The scale of the global shift that will be necessary to rebuild the world's energy infrastructure, radically increase the intelligence of its resource use, and preserve and enhance its natural carbon sinks is beyond anything contemplated in human history. What's worse, not only does it need to be done, but it needs to be done quickly, and over the objections of some of history's most wealthy and powerful special interests. It is an almost perfect political problem.

This has given the issue a kind of Rorschach quality (the blot, not the masked vigilante). Against the scale of the task, virtually any effort today's dysfunctional politics can cook up appears pathetically, criminally inadequate. Then again, against the baseline of total denial and hostility that defined the Bush years, virtually any effort can seem worth celebrating. Anything is better than nothing, but nothing is enough.

Which brings us to the Waxman-Markey climate/energy bill, aka the American Clean Energy and Security Act, or ACES.

There's a great deal of anger and frustration among greenies this week. The original draft of ACES was a mixed bag: its "complementary policies" (the 75% of the bill devoted to energy stuff unrelated to cap-and-trade) were excellent, and its targets for climate pollution reduction were bolder than anticipated, but it allowed for far too many carbon offsets and left unsettled the key issue of how the pollution permits under cap-and-trade would be allocated. It original draft came out a couple weeks ago and since then the green world has struggled to come to terms with it.

After the draft proposal was released, the bill went into closed-door negotiations in the Energy & Commerce Committee, which is packed with legislators from carbon-intensive states. Republicans have, of course, decided on blanket opposition to any climate measures, so the negotiations were entirely between Dems from low-carbon (generally liberal, generally wealthy, service and white-collar) states and Dems from high-carbon (generally conservative, generally poor, coal and manufacturing) states. (The media has, for whatever reason, decided that the latter group deserves the appellation "moderates.")

Everyone knew the ambitious original draft would get trimmed back in committee, but what emerged as the consensus bill last week was ... mangled. In summary, everything that put real short-term pressure on industry was weakened. Whereas the IPCC and the UNFCCC recommend reaching 20% below 1990-level emissions by 2020, WM will reach just 4%. Whereas Obama, the CBO, Waxman, Markey, progressive groups, green groups, and anyone else who's taken a substantive look at the question favors a system in which all the pollution permits are auctioned off (to raise revenue that can cushion low-income ratepayers, invest in clean energy, and deny polluters windfall profits), the WM bill now gives away 85% of permits, most of which don't shift to auctions until after 2030. Coal utilities, "clean coal" projects, oil refineries, energy-intensive industries like steel -- they all get huge handouts.

Before the bill mandated that utilities ramp up renewable energy to 25% of their portfolio by 2025, and increase efficiency savings to 15% by 2020; now those two standards have been combined, to 20% total by 2025, 5% of which can be efficiency. Before the bill had tough performance standards on new coal plants; those have been weakened. Before the bill had a low-carbon fuel standard which would have blocked a rush to tar sands oil and other filthy new sources of fossil fuel; that's gone entirely. Before the bill had huge money for "clean coal"; now it has extra-huge money.

In short, the revised bill is triumph for coal patch Dems and big business and a punch in the gut for greens. It immediately came in for criticism from environmental groups, some of which have withdrawn their support entirely. There's real debate among greenies whether this bill would do anything to spur action in the short-term; whether it would address the pressing issue of existing coal plants; whether it would completely defang the EPA.

Then again.

Al Gore still supports the bill. Paul Krugman still supports it. Obama still supports it. What do they know (or think) that, say, Greenpeace doesn't?

It comes down to how you see the big picture and the larger forces of history -- that Rorschach blot. Those who have turned against the bill think there will be one chance to do this; they cite the Clean Air Act to show how crappy compromises get cemented in place in legislation and become very, very difficult to reopen. They're worried that if a weak bill is put in place, by the time the country seriously revisits it it could well be too late. It blows the one chance.

The bill's supporters think history is on their side. They see the most important goals as establishing a long-term declining cap on CO2 (the 2030 and 2050 targets remain strong in W-M), getting a carbon trading system up and running, and above all shifting off the status quo trajectory. They also point out that the U.S. desperately needs something to take to the international climate talks in Copenhagen in December. Only a show of good faith will get the rusty gears of multilateral negotiation turning again, and that process, too, cannot wait. As time passes, they say, climate change will hit harder, increasing political pressure to strengthen the system. States will accelerate their own programs; clean businesses will gain size and lobbying muscle; everyone will get much more serious about the problem and cognizant of the opportunities. This is the beginning of a journey that will only gain, not lose, momentum.

Who's right? It depends on what time of day you ask me.

All I know is, today the Obama administration is unveiling new fuel efficiency standards for vehicles. We should have had these in place long ago; they're still not as good as other developed countries'; the emissions they'll reduce will only be a tiny fraction of what's needed.

But it's a step. And if a small step is all you can take, I guess you take the small step.

The Case for Patience

Ryan Avent — Thu, 14 May 2009 11:55:52 -0700

In response to Dean’s response, let me begin by clarifying my position on a timeline for regulatory reform.

I don’t believe we need to wait for a year or more before beginning the effort to reshape the financial system—in fact, I think we could begin right now. I would like to see the White House and the Congress working toward a comprehensive regulatory overhaul this very minute, which might be put up for a vote within a matter of months. What I don’t think we should do is rush the reform process through as an explicit response to this crisis. What we’d like the financial system to look like a year or two down the road should not be a major consideration in determining how to achieve financial stability now. The priority should be addressing the immediate crisis in as effective a manner as is possible given constraints.

Should We Bail Out This Bailout?

Having said that, I think it’s most helpful to divide Dean’s proposals into two categories. The first is his proposal for immediate resolution of the problem of potentially insolvent banks. He says:

That is real simple. The shareholders get wiped out and the bondholders likely get wiped out too. That's the way capitalism is supposed to work.

This is the kind of message that should appeal to angry voters—take over the banks and wipeout the fat cats what created the mess. I don’t believe that following this path would have the effect Dean desires, however. Restructuring one or a handful of banks would leave most of the difficult work to be done—it wouldn’t obviate the need to regulate leverage and behavior. Even if nationalization could be accomplished in the cheapest manner possible—by wiping out bondholders—it’s likely that the process of cleaning up a Bank of America or a Citigroup would be quite expensive (particularly if depositors got nervous and began withdrawing funds). This expense would mean that new appropriations for the banks would be necessary, which would no doubt blunt the public’s satisfaction at having a big bank go down.

Further, and as Dean knows, there is some risk (and potentially a significant risk) that nationalization would touch off a new round of financial instability. This wouldn’t only prove damaging to the administration’s efforts to reform the financial stability; it would also threaten the Obama presidency and the whole of the progressive agenda.

Dean’s other regulatory proposals are sound in principle, and I hope they are incorporated in whole or in part into legislation. But here, too, I think it’s better to take one’s time and produce the best legislation possible rather than rush ahead to take advantage of public sentiment. For one thing, I doubt that anger at bankers will wane in the near future, but for another, I’m skeptical that this anger can be channeled into an effective regulatory framework. “Let the banks fail,” is a rallying cry. Even, “Reduce financial compensation,” could resonate with the public. “Alter the procedures by which Fed presidents are chosen,” is destined to cause eyes to glaze over.

Just have a look at the recent fate of mortgage cramdown legislation. This should have been something the public could rally behind, and it certainly should have been an issue on which standing with the banks proved politically poisonous. And yet stand with the banks legislators did, enough of them to kill the measure. Anger works for bringing down people and institutions. At fine-tuning rules it is of limited utility.