Health Politics of Fear

Well, at some point we had to expect our Representative Scott Garrett to weigh in on the health care debate. In this week's Garrett Gazette he did, and his message is to be terrified of choice.

That's literally what the health care debate is over. Cut out all of the horror stories from other nations that don't apply, because that's not what we're talking about, and it comes down to choice. Even though Garrett and his fellow Republicans scream about rationing, most honest brokers acknowledge it already happens. We're talking about having an extra choice in our insurance options.

At about $100 billion a year, citizens are going to have to get health insurance, providers are going to have to become efficient, and citizens can shop for the same sort of plan Garrett and other Federal employees get.

Obviously, this scares the hell out of those spending $1.4 million a day to lobby against the effort. See, if insurance actually works as the market should dictate, instead of as a scam, the more people in an insurance pool the broader the risk is spread and the lower the cost.

Unfortunately, that's not how the system has worked. While Republicans have dusted off the early 90's playbook against health care, and are rehashing some of the misrepresentations of truth from the SCHIP debate; there are as many if not more horror stories generated by our current health care system. From hospitals dumping patients in alleys to insurance companies arbitrarily deciding people's access to care, we're living in a rationed system now.

Everyone knows at least one person who has had an issue with an insurance provider. And lets not forget that all of us who have insurance have to pay more for critical treatment of what could have been preventable when the 47 million uninsured need something.

However, we know that Garrett will vote against this based on "principle." However, as with his opposition to SCHIP, Garrett's belief that states should get to decide things for themselves, as he often cites the 10th Amendment, goes straight out the window:

Removing burdensome state coverage mandates and opening up the health care marketplace to competition across state lines could dramatically reduce health care costs in New Jersey and across the country.

So, the mandated coverage that states have decided their citizens should have needs to be removed by the Federal government. But isn't Garrett the one that argues states should be allowed to set their own standards for, well, everything else but health care?

To his credit, Garrett does address some of the things in the mammoth 1,000 page bill as being good ideas. From the Gazette:

Effectiveness: The current health care system reimburses the number of procedures rather than the quality and efficacy of the care. While doctors are compensated for extra tests and hospitals visits, they are not paid for offering telephone consultations or implementing health care IT. By encouraging quality over quantity of care, we can down on over testing and strengthen the doctor-patient relationship

This is part of what Mike Huckabee talked about when he said we have to go from a treatment of the sick mentality to a prevention and well-care mentality. It's a good idea, which is probably why steps are taken in the bill in this direction. Good ideas are good ideas regardless of party.

With Garrett being the only member of our Congressional delegation to oppose the SCHIP expansion, it makes sense that President Obama would come to our state tomorrow in support of Jon Corzine. Our program works, and reading what I have of the bill, it seems to be a further expansion of the good practices we have here. Every Republican except for Garrett believed enough in what we do here to vote for it to continue. We're a model for once. While Obama can boost Corzine, having an example that works boosts Obama.

Is the bill perfect? No. Will the Dem leadership have to capitulate to the Blue Dogs demands for some fiscal sanity? Absolutely. But while the fiscal conservative Democrats and the socialist Democrats find middle ground to move our nation forward, the fear mongering of Garrett and his Republican brethren mean once again our District doesn't have a seat at the table. They're not willing to honestly talk about the debate to their counterparts on the other side of the aisle or their constituents. So, we're going to be left out. Is that representation?

Immigration: So Now What?

With the death of the immigration bill, most people are left with a simple question: So now what? The plight of the 12 million or so illegal aliens in our nation is a very real situation, and this bill tried to do too much at one time and everybody on the fringes got so mad it really isn't a surprise it failed. Now that the Bill is dead, pundits say nothing significant is going to be done until 2009. Unfortunately, we now have 4% of our nation's real population left in limbo. Their status may not be legal, but it doesn't change the fact that they're here.

There was a tremendous amount of disappointment from our Senator Bob Menendez, a champion of the reform. Our Representative Scott Garrett loved this outcome, and seems to believe any reform must punish the undocumented. The Economist had an accurate take on the stance taken by him and many other Republicans.

That most Republicans would be against reform was a given: although a handful of them helped to craft the bill, most Republican legislators, and the bulk of Republican voters, saw it as an “amnesty” for those who broke the law by sneaking into the country. They were not persuaded by yet more promises to fix the border. Nor, however, did they propose any alternative measures for dealing with the people already working in America.

For many Republicans, it seems, this is a good issue for them to rally the base and raise money; a solution is not as beneficial to them as the problem existing. It's estimated that in the 1990's, the number of illegal immigrants increased a net amount of 500,000 a year (incoming; less deaths, returns, legalization, etc.). With the INS's estimate of 7 million illegals here in 2000, and an estimate of 12 million illegals being reported last year, the net increased to over 800,000 a year while the Republicans held a grip on Washington.

By the end of 2009, that means we're looking at roughly 14.5 million people. We were already talking about a population larger than that of New Jersey and Connecticut combined; we might as well throw on New Hampshire while the politicians in Washington twiddle their thumbs and raise campaign cash.

So what do we do?

With an estimated price tag of $41 billion a year, a mass deportation program (finding, jailing, deporting) is off of nearly everyone's table, except for people like Garrett (how else do you punish an illegal alien?).

Relying on the Feds to come up with some sort of meaningful ID system seems dicey. There's already a 3 million passport backlog they're dealing with; coming up with 12 million more IDs seems unlikely.

Building the "fence" is a giant waste of taxpayer money, that does little more than let Congress say "Look, we built a fence. We're doing something." Meanwhile, people will go around and under the boondoggle.

Going after the employer seems to make sense, but with so many people working for so many different places, it seems unlikely enforcement will be effective.

So what do we do?

The 14th Amendment might have a clue:

Section 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

States already must provide equal protection of the law to anyone within their borders; would the States be within their rights to grant residency to illegals if they choose?

Granted, Article I, Section 8 of the Constitution vests the power to come up with a uniform law of naturalization to Congress. However, I'm not talking about citizenship or a path to citizenship, I'm talking about non-transferable residency. There isn't anything in the Constitution that says States couldn't determine residency, at which point the Tenth Amendment defers to the State. After all, the States seem to be the ones who benefit and suffer the most from the presence of the undocumented.

On the positive side, States receive sales tax from the individual (if it applies), income tax from those they buy things from, and taxes from those who employ them. On the negative, States pick up the tab to fund schools, medical care and social services for the undocumented. So wouldn't it make sense to let places like Texas, California, and New Jersey craft a workable solution for ourselves? It could go either way, throw them out or let them stay, but at least there would be something.

There are more questions than answers with this issue, but while Washington is in a state of self-inflicted paralysis over immigration, why not give the States a shot? Communities have started taking their own steps anyway, ranging from housing crackdowns to creating worker centers, what would the States do? On many policy issues States have been the experiment lab, where a Federal policy is then crafted on their best practices, so why not now?

At the very least, it would make for one heck of a Supreme Court case.

NJ's Rights Attacked (Again)

One of the fundamental beliefs I've held for the entire time I've been politically conscious is that while the Federal government sets minimum standards, it is a State's right to determine if those standards adequately protect it's population. Granted, there will always be issues where the interest of the nation leads to standards above what some States would like, the number of those issues is where the classic divide between Republicans and Democrats stands. However, up until the Bush Administration, it was almost unheard of that the Federal government would attempt to trump a State's right to enforce a more stringent safety standard than the Federal one. Now, for at least the third time in less than a year the Administration is attacking New Jersey's right to protect us.

First, it was an Administration supported bill aimed at eliminating New Jersey's right to label the food we buy at the supermarket as we saw fit (Rep. Garrett voted against this bill and it died in the Senate). Then, it was the EPA announcing an increase in the amount of pollutants like mercury and lead a company could dispose of in the environment before they reported how they did it. Now, it is the Department of Homeland Security continuing it's march toward an April 4th change in regulations that would weaken New Jersey's regulations on the chemical plants we have in our state that contribute to New Jersey being home to the "Two most dangerous miles in America."

At a hearing held by Senator Frank Lautenberg in Newark yesterday, a Deputy for DHS Lawrence Stanton had this to say:

"The federal government has a role to play as well as the states, and we believe as a matter of principle that these things can be worked out," Stanton said.

The Homeland Security Department plans to preempt a local or state rule only when the rule would "frustrate" Washington's ability to secure plants, he promised.

That's all well and good, and would make sense if it wasn't an established fact that our security regulations are the most stringent in the nation, so preempting only stands to make us less safe. With NJ's population density and seven plants within range of a million people, our tougher standards are intended to prevent another Bhopal disaster. In a worst case scenario at one of those seven plants, the loss of life from Bhopal(15,000) compared to what New Jersey would suffer is akin to comparing the loss of life from Hurricane Katrina (1,836) to the 2004 Tsunami (229,866). It would be Bhopal on steroids.

This dangerous change in DHS policy came before the Senate last year at the behest of the Administration, and they rejected the idea of endangering us by weakening our regulations. Still, the Administration announced the DHS regulations on their own, the Friday afternoon before Christmas (so no one would notice). And what noble cause, national security and public safety requirement dictates our State getting watered down Federal regulations: Corporate interests.

During the hearing yesterday, Stanton acknowledged that his understanding was that the chemical lobby would prefer to have the weaker Federal regulations trump our State's right to protect us. While corporate interests were not so explicitly rolled out with the DHS proposal initially, when the EPA rolled out the weaker reporting requirements they didn't mince words, citing the billions their proposal would save business. Seeing a jarring public health and safety conflict with relaxing the EPA standards, Senator Olympia Snowe (R-Maine) requested the Government Accountability Office to look into how this rules change transpired. Here is a bit of what they reported to the Senate a couple weeks ago:

Although we have not yet completed our evaluation, our preliminary observations indicate that EPA did not adhere to its own rulemaking guidelines in all respects when developing the proposal to change TRI reporting requirements. We have identified several significant differences between the guidelines and the process EPA followed. First, late in the process, senior EPA management directed the inclusion of a burden reduction option that raised the Form R reporting threshold, an option that the TRI workgroup charged with analyzing potential options, had dropped from consideration early in the process. Second, EPA developed this option on an expedited schedule that appears to have provided a limited amount of time for conducting various impact analyses. Third, the decision to expedite final agency review, when EPA’s internal and regional offices determine whether they concur with the final proposal, appears to have limited the amount of input they could provide to senior EPA management.

They rushed the process not to protect the public interest or safety, but because they had already received over 118,000 letters in opposition (out of about 120,000) to the plan. There is no way this ever would have gotten through the House, let alone the Senate. The same mode of operation is being used with regard to the DHS attack on our chemical safety laws. They couldn't get it through the Senate, and now the Administration has decided to go through the bureaucracy.

I have no issue with the majority of chemical companies already doing business in our state. While some companies do resist increasing regulations further, the majority have been good partners in disaster planning with First Responders I've spoken with. I also fully understand and appreciate the contributions the chemical industry provides for our State and nation. That said, I also appreciate the fact that they are generating the billions they do with our tougher regulations in place. If other companies wish to tap into our talented and experienced pool of employees, they too can make a profit in NJ without subverting public safety via an overstep of Federal authority.

A large chemical disaster will have one certain outcome, citizen sickness and death. The question is, how many will die and how many will have died unnecessarily if the Administration succeeds? If they haven't already grown the moral fortitude to fight this plan, I hope our entire Congressional delegation will soon be loudly criticizing it, if not they should be held accountable next year.