Relevant and even prescient commentary on news, politics and the economy.

Medicaid and cost containment

This GAO report makes for a perplexing stumbling block to cost savings.

Many of these individuals accumulated substantial assets, including million-dollar houses and luxury vehicles, while failing to pay their federal taxes. In addition, some case studies involved businesses that were sanctioned for substandard care of their patients. Despite their abusive and related criminal activity, these 25 providers received Medicaid payments ranging from about $100,000 to about $39 million in fiscal year 2006….CMS and our selected states do not prevent health care providers who have federal tax debts from enrolling in Medicaid. CMS officials stated that such a requirement for screening potential providers for unpaid taxes could adversely impact states’ ability to provide health care to low income people. Further, federal law generally prohibits the disclosure of taxpayer data to CMS and states.No tax debt owed by Medicaid providers has ever been collected from Medicaid payments through the continuous levy program. IRS has determined that Medicaid payments are not considered ‘‘federal payments’’ and thus not eligible for this program. GAO estimates that for the seven selected states the federal government could have collected between $70 million to $160 million during fiscal year 2006 if an effective levy program was in place.

(bolding is mine)

So the system loses millions in order to keep services inplace? Over time, doesn’t that sound odd?

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WTO GATS and protectionism or nationalism

Heritage notes that anti-dumping lawsuits have increased in the US and the administration is not attending to global free trade as we have dropped below the top ten.

Such measures are supposed to be used to prevent other countries from selling their goods here at below-market prices, and that makes sense. But as Index co-editor Mary Anastasia O’Grady points out, America now overuses this tool. In fact, since 1995, the United States has trailed only India in the number of antidumping cases it has filed.Many of those came as a result of the Byrd Amendment, named for Sen. Robert Byrd of West Virginia. This amendment encourages producers to file complaints with the government, because if any “dumping” is found, they get to share in the penalties collected.The World Trade Organization ruled two years ago that the Byrd Amendment violates international trade policies, and the U.S. has promised to comply with the WTO. But we haven’t done so yet, which means that eight American trading partners soon could retaliate against our unfair trade practices — a move that could start a trade war.There’s no need for that. After all, trade wars are expensive and end up hurting everybody, while, as the Index proves year in and year out, free trade builds economies and ends up helping everybody.If more of our politicians will recognize the benefits of economic freedom and go back to promoting it, next year we can return to the top 10 worldwide. And that would be good news — for everybody.

The NYT reports China is making moves as well.

The directive, issued in June, called for burdensome new safety inspections for foreign-made medical devices — but not for those made in China. The Bush administration is crying foul.

Even more worrisome to the administration is that the directive seems part of a recent pattern in which Chinese officials issue new regulations aimed at favoring Chinese industries over foreign competitors, despite efforts by Treasury Secretary Henry M. Paulson Jr. to ease economic tensions.

“There is clearly a growing economic nationalism in China that is leading to discrimination against foreign investors in pillar sectors of the economy,” said Myron Brilliant, vice president for Asia at the United States Chamber of Commerce. “It’s not only a threat to foreign investors but it also undermines China’s transition to a market-based economy.”

Life gets complicated.

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Patriotism is done by people, not companies

BBC reports:

A $1.2bn (£590m) contract for training Iraqi police was so badly managed that auditors do not know how the money was spent, the US state department says.
The programme was run by a private US company, DynCorp. It insists there has been no intentional fraud.
Auditors have stopped trying to audit the programme because all the documents are in disarray and the government is trying to retrieve some of the money.
Training Iraqis to take over security is a key part of US strategy.

Stuart Bowen Jr, the Special Inspector General for Iraq Reconstruction (SIGIR), blamed the problems on long-standing contract administration problems within the state department office that awarded the contract.
He said “lack of controls” and “serious contract management issues” within the Bureau for International Narcotics and Law Enforcement Affairs (INL) made it “vulnerable to waste and fraud”.

Another BBC article states:

An independent panel has strongly criticised the way the US army manages contracts to supply its troops in Iraq and Afghanistan.
The panel said there were high levels of fraud and waste in relation to contracts worth $4bn (£1.9bn) a year.
It blamed a lack of oversight and said only about half the army’s contracting staff were properly qualified.
Defence Secretary Robert Gates said he was “dismayed” by the report and the Pentagon would pursue its suggestions.
The army says it is pursuing 83 criminal inquiries related to contract fraud and more than $15m in bribes have been exposed.
The panel did not address specific allegations against individuals, but made clear that a lack of oversight and too few army contracting personnel had exacerbated systemic problems.

The number of army personnel responsible for managing contracts in Kuwait, Iraq and Afghanistan dropped as the number of contracts and their value soared over 12 years, the panel found.
Only about half of all contracting personnel are certified to do their jobs, it added.
The panel said some 2,000 extra staff were needed to deal with a 600% increase in the workload.
“This is a systemic issue within the army and within the DoD [Department of Defense],” said Jacques Gansler, chairman of the commission.
Senator Joe Lieberman, chairman of the Senate Committee on Homeland Security and Governmental Affairs, said it could take the state department up to five years to review invoices and demand repayment from DynCorp for unjustified expenses.
“This scenario is far too frequent across the federal government,” he said.
DynCorp had been asked to improve its management of government-owned equipment in Iraq twice before.

There are many sides to the issue. One is a government that can account for expenditures in a sane way with a reasonable margin of error, which at present is not in place. This is being simply responsible and efficient in my mind. The other is prosecution for fraud, which is another matter and ex post facto, and harder than even being more efficient.

Since it appears to be bi-partisan issue overall in Congress to simply continue the process, why is it framed as partisan? It would seem to me either you are for gross wastefulness or not. And to reduce oversight while increasing spending seems counter-intuitive.

So do we just live with it? Is the margin of error in wastefullness the political issue here? Or is the concern marginal as only a concern for Ron Paul ? Is it unpatriotic to waste tax money and fail to deliver a service so grotesquely but vital to national security? Maybe not criminal, but severely undermining our security is unpatriotic.

What did Cheney mean by “deficits don’t matter”? Can a market believe in patriotism? Or a CEO within the confines of his/her company policies?

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A new GI Bill

NYT suggests this deficit spending.

Veterans today have only the Montgomery G.I. Bill, which requires a service member to pay $100 a month for the first year of his or her enlistment in order to receive a flat payment for college that averages $800 a month. This was a reasonable enlistment incentive for peacetime service, but it is an insufficient reward for wartime service today. It is hardly enough to allow a veteran to attend many community colleges.

It would cover only about 13 percent of the cost of attending Columbia, 42 percent at the University of Hawaii, 14 percent at Washington and Lee, 26 percent at U.C.L.A. and 11 percent at Harvard Law School.

MEMBERS of Congress and other political leaders often say that the men and women who have served in our military since 9/11 are the “new greatest generation.” Well, here’s a thought from two infantry combat veterans of the Vietnam era’s “wounded generation”: if you truly believe that our Iraq and Afghanistan veterans are like those who fought in World War II, let us provide them with the same G.I. Bill that was given to the veterans of that war.

Are we funding private contractors to provide increased income for soldiers? How many of the soldiers are US citizens? Blackwater raided the Chilean army for several hundreds of soldiers…do we have figures? Is there any connection?

Is an education bill a more productive use of funds for us, leaving aside immediate concerns for a second?

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Another restroom post? Intellectual conumdrums

Salon published an essay on restrooms and handwashing, perhaps because AB has persisted in posting on this issue.

So far this year Americans have used 1.8 million tons of paper towels and tissue, according to the American Forest & Paper Association, an industry group. There are approximately 3 million hand dryers installed in the country and most run for 30 seconds around 100 times a day, according to World Dryer Corp., one of the country’s leading manufacturers. That’s 690 billion watts of electricity every day — enough power to run an estimated 280,000 homes for an entire year.

So the Climate Conservancy, a nonprofit group started by Stanford University climate scientists, which aims to help consumers determine the greenhouse gas emissions associated with products, helped me crunch some numbers. Its calculations look not just at carbon dioxide, but the other five gases, identified by the Kyoto Protocol, that contribute to global warming (methane, nitrous oxide, perfluorocarbon, hydrofluorocarbon and sulfur hexafluoride) to get what is called a CO2 equivalence.

Anyway, the hand dryer would seem to be the wise choice. But hold on. There’s something else to consider. The average temperature of air that flows from a warm air dryer is insufficient to kill most bacteria, according to a 1998 study by Britain’s University of Westminster. The study finds that paper towels removed 58 percent of the bacteria from people’s hands. Air dryers, meanwhile, increase the numbers of all sorts of bacteria by 255 percent! That’s because the dryers either suck up germs and then spew them back out, or people don’t spend the necessary time under the heat to kill the germs.

If one hand dryer sequence uses the equivalent of 1/16th mile of driving for an average car, how much mileage do we get out of the issue? Apparently some more. As a micro-cosm of individual responsibility and the complexities of issues involved, and as a cultural issue and market of personal responibility, I find it is in your hands to decide.

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Strategic Outreach Non-profit

SOFAR: Strategic Outreach to Families of All Reservists

The Psychoanalytic Couple and Family Institute of New England (PCFINE), with the support of other psychoanalytic groups throughout the country, has launched a new pro bono program called SOFAR: Strategic Outreach to Families of All Reservists. Through this program, SOFAR coordinates the delivery of psychotherapy and psycho-educational services to the families of Reservists and National Guard members who are stationed in or returning from Afghanistan, Iraq, and Kuwait.
The goal of SOFAR is to provide a flexible and diverse range of psychological services that fosters stabilization, aid in formulating prevention plans to avoid crises, and help families to manage acute problems effectively when they occur. Our highest priority is to help families to develop and maintain coping skills during the phases of Alert, Mobilization/Activation, Deployment and Reunion/Reintegration. Clinicians will be available to provide individual and family therapy and lead support groups targeted for families, mothers and parents on such topics as stress management, anger management and general coping skills.
SOFAR aims to reduce stress on Reservists and Guard Members by letting them know that SOFAR is there to support their families when the need arises. The program is beginning with more than 70 credentialed volunteers who are meeting with members of Family Readiness Groups of the Army Reserves, based in the Boston, MA and surrounding communities. Families of Army Reservists have received information about the program and are encouraged to contact the program by calling us at 617-266-2611 to request an assignment to one of the participating clinicians in the Greater Boston area. All families will be guaranteed strictly confidentiality within the limits of the law.
Once a family member requests services from SOFAR, the clinician will conduct an assessment and develop a treatment plan for the individual and/or family. The family member and the clinician will negotiate the duration and frequency of services to best meet the needs of the family with the resources SOFAR can provide. Should the family require additional community resources, the clinician will assist in making referrals to appropriate services.
Once the program has been assessed and appropriate changes made to accommodate the needs of the population, SOFAR will work to replicate the program nationally through the 27 local chapters of Division of Psychoanalysis (39) of the American Psychological Association and the 31 institutes of the American Psychoanalytic Association.

The gift that keeps on giving, even for a conscientious objector.

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Ecuador and water

Ecuador’s experiment in private water markets is not ending well.

It is a well kept secret that Bechtel won a contract to privatize the water in Ecuador’s largest city, Guayaquil, just months after the massive citizen protests that threw Bechtel out of Bolivia.
In October 2000, a local Bechtel subsidiary, Interagua, signed a 30-year concession contract to run the water and sanitation services in Guayaquil. The privatization process was promoted by loans from the Inter-American Development Bank and a guarantee from the Multilateral Investment Guarantee Agency (MIGA), a World Bank agency.
Now, more than six years later, the residents of Guayaquil are demanding damages from the company for water contamination, an end to water cut-offs, and a return to local, public control.

Interagua’s operations in Guayaquil earned $300 million in revenue. Despite these profits, Interagua did not initiate the rehabilitation programs it had promised. Concerns and complaints mounted over broken pipelines, floods due to malfunctioning sewage systems, exorbitant water rates, poor water quality, and environmental damage due to the lack of wastewater treatment during this first five-year period.

I suppose there is no proof public or a public-private partnership would have done better, but it does not add to Bechtel’s resume. While there were humanitarian concerns, that was not the market failure. They did not spend the money on contract items.

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Waterboarding reality

Small Wars Journal posted a piece by former SERE trainer (hat tip to News Trust and then TPM to get me to Small Wars Journal)

…In fact, waterboarding is just the type of torture then Lt. Commander John McCain had to endure at the hands of the North Vietnamese. As a former Master Instructor and Chief of Training at the US Navy Survival, Evasion, Resistance and Escape School (SERE) in San Diego, California I know the waterboard personally and intimately. SERE staff were required undergo the waterboard at its fullest. I was no exception. I have personally led, witnessed and supervised waterboarding of hundreds of people. It has been reported that both the Army and Navy SERE school’s interrogation manuals were used to form the interrogation techniques used by the US army and the CIA for its terror suspects. What was not mentioned in most articles was that SERE was designed to show how an evil totalitarian, enemy would use torture at the slightest whim. If this is the case, then waterboarding is unquestionably being used as torture technique.

The carnival-like he-said, she-said of the legality of Enhanced Interrogation Techniques has become a form of doublespeak worthy of Catch-22. Having been subjected to them all, I know these techniques, if in fact they are actually being used, are not dangerous when applied in training for short periods. However, when performed with even moderate intensity over an extended time on an unsuspecting prisoner – it is torture, without doubt. Couple that with waterboarding and the entire medley not only “shock the conscience” as the statute forbids -it would terrify you. Most people can not stand to watch a high intensity kinetic interrogation. One has to overcome basic human decency to endure watching or causing the effects. The brutality would force you into a personal moral dilemma between humanity and hatred. It would leave you to question the meaning of what it is to be an American.

We live at a time where Americans, completely uninformed by an incurious media and enthralled by vengeance-based fantasy television shows like “24”, are actually cheering and encouraging such torture as justifiable revenge for the September 11 attacks. Having been a rescuer in one of those incidents and personally affected by both attacks, I am bewildered at how casually we have thrown off the mantle of world-leader in justice and honor. (bolding is mine)

I suggest you check his profile as well. And get ready for swiftboating during the hearing and after tomorrow if he follows through with his testimony. It is about time the MSM did some research….oops, not on MSM, just stenotyping politicos. Either for or against.

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