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

Congressional Republicans Acknowledge That Republican Governors and State Legislators Are Death Panelists. Seriously.

Pam Renshaw had just crashed her four-wheeler into a bonfire in rural Folkston, Georgia, and her skin was getting seared in the flames. Her boyfriend, Billy Chavis, pulled her away and struggled to dial 911 before driving her to the nearest place he could think of for medical attention: an ambulance station more than 20 miles away.

The local public hospital, 9 miles from the crash, had closed six weeks earlier because of budget shortfalls resulting from Obamacare and Georgia’s decision not to expand Medicaid. The ambulances Chavis sought were taking other patients to the next closest hospital. It took two hours before Renshaw, in pain from second- and third-degree burns on almost half her body, was flown to a hospital in Florida.

So began a Nov. 25 article by Toluse Olorunnia on Bloomberg News.  I read the article that day and have thought about it off-and-on since then.  The article goes on to report that several public hospitals closed this year and that many more, public and private, including the world-reknowned Cleveland Clinic, Vanderbilt University Medical Center and Indiana University Health, are “seeking cost savings in areas such as cancer treatment, mental health and infant care.” Nationwide, hospitals have reduced their staffs by at least 5,000 since June.

And as it turns out, although the Bloomberg article did not mention it, some hospitals are reducing their primary-care physician residency positions significantly, including a reduction of 50 such residency positions in the northeastern Tennessee congressional district of Rep. Phil Roe, who himself is a physician.  He also is a Republican.  “It is basically because the law has cut reimbursements for hospitals,” Roe told Politico staffers Seung Min Kim and Jennifer Haberkorn, as they report in a Dec. 3 article titled “New Obamacare weapon for GOP: Doctors”. “They have to find savings somewhere,” Roe said.

The Bloomberg article is titled “Obamacare Cutbacks Shut Hospitals Where Medicaid Went Unexpanded.”  Most of the hospitals in question have large numbers of uninsured patients.  And nearly all of the hospitals are in states whose Republican governors and legislatures have refused to adopt the expanded Medicaid provision in the ACA and are opting instead to see hospitals close or drastically reduce services, resident-physician positions and other staff positions that until now had been paid for by, um, the federal government’s Medicaid funding.  The ACA switches that funding from the current Medicaid program to the expanded Medicaid program that Republican governors and Republican-controlled state legislatures have refused.

I’m sort of waiting for the Dems to, maybe, point out this interesting irony whenever a Republican claims that Obamacare is prohibiting hospitals from from continuing to fund what in fact the federal government, via that Republican doormat Medicaid, actually was funding.  Not Obama himself, of course, because it would require him to actually explain something that he probably thinks is complicated; other Dems, though.  Maybe soon?

Then again, it looks like another Republican congressman, Texas Rep. Michael Burgess, who also is a physician, has hit upon the solution at least to one problem: the shortage of primary-care physicians.  “Many families are now learning that they may not just lose their plan,” he said recently. “But if they like their doctor, they may lose their doctor, too. They may lose their doctor in part because there is already a shortage of primary-care physicians. Many of these plans will now be paying doctors less — so many doctors, whose waiting rooms are already full, have chosen not to participate in the new plans.”

Yep.  Eliminating doctors who accept healthcare insurance should take care of that crowded-waiting-room problem. The doctors who have chosen not to participate in the new plans probably will have available chairs in their waiting rooms, without even moving to larger office space.  And they’ll have available appointment slots, without expanding their workweek.

As a pyrophobic since the age of eight, when I met a lovely elderly gentleman, a neighbor of my best friend, who was a severe-burns victim, I dearly wish Ms. Renshaw well.  But the additional agony she endured because of the recent closure of the only hospital within ambulance distance was neither the fault of Obamacare nor of the federal government that wingnuts rail about.  The recently-closed hospital and others like it throughout the rural South and Plains states would have been closed decades ago, were it not for the federal government, Lyndon Baines Johnson, Democratic congressional majorities … and Medicaid.

Because of the seriousness of this matter, I won’t try to put a pithy ending to this post.  I’ll just say that the current crop of Republican politicians, national and state-level, are death panelists–and that it’s past time for the mainstream media, Democratic elected officials, and, yes, Obama himself, to explain that to the public.  Each time that a Koch puppet-as-pol, or some columnist for the Washington Post, tells the public that hospital closures and a reduction in physicians and in hospital staff and services is the result of Obamacare, the Dems–including those who are running against Republican incumbents–need to point to, say, Kentucky, which with the exception of the small border it shares with Illinois is completely surrounded by Medicaid-expansion refuseniks.  As in, “Soooo, Rep. Roe.  Seems your state is really missin’ the ole Medicaid assistance that kept your hospitals open, fully staffed, and in the black. What’s the problem there? I mean, in that state just north of your border the hospitals seem to be doin’ just fine under the new system.” A nice ad campaign, with the name of the respective Republican officeholder in each state legislative and congressional district, can’t be all that expensive, can it?

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The Antidisestablishmentarianism Theory of Obamacare Illegality. (The ACA has a (dis)establishment clause! Who knew?) [Updated.]

A federal judge in the District of Columbia will hear oral arguments on Tuesday in one of several cases brought by states including Indiana and Oklahoma, along with business owners and individual consumers, who say that the law does not grant the Internal Revenue Service authority to provide tax credits or subsidies to people who buy insurance through the federal exchange. …

The subsidy cases, if successful, would strike at the foundation of the law. Subsidies and tax credits, which could be available to millions of low- and middle-income Americans, are central to Mr. Obama’s promise of affordable care. In drafting the law, Congress wrote that such financial help would be available to people enrolled “through an exchange established by the state” under the law.

A New Wave of Challenges to Health Law, Sheryl Gay Stolberg, New York Times, today

Hmm.  Okay, let me take a crack at this.  The law gives each state the option of running its own exchange or instead allowing the federal government to run an exchange for the state–an operation that must be done separately for each state, because each state has its own insurance companies offering different policies than other states, and subject to state insurance laws and state agency oversight.

The law doesn’t say “through an exchange run by the state” under the law; it says “through an exchange established by the state” under the law.  The states know their options.  Fourteen of them chose to establish an exchange by setting one up and running it.  The rest have chosen to establish an exchange by delegating to the federal government the job of setting up and running the exchange for the state.

The law itself, in other words, by requiring that each state choose one of two mechanisms to establish an exchange–directly or instead by delegation to the federal government–required every state to have (i.e., to establish) an exchange.  The tax credit, or subsidy, provision of the statute does not limit tax credits (subsidies) to people who live in states that choose to physically set up and run the state’s exchange itself.  It provides that benefit to people regardless of their state of residence, because by operation of law–specifically, by operation of that law–states can establish their exchanges by delegating to the federal government the physical setting up and running of the exchange.

Depends, in other words, on what the meaning of established is.  Or, more accurately, on what Congress intended the meaning of “established” to be.  And I’ve just told you what that is.  Surely, the federal courts understand the concept of contracting out a tech job.  Thirty-three states have chosen to contract out this job to the federal government.  Except, of course, that the contract was not negotiated but instead compelled by law.

Voila!  The antidisestablishmentarianism theory is disestablished.  The tax credits/subsidies clause in the ACA applies even to you, Red State denizens who qualify financially.  Congratulations.  I mean, my condolences.

But also in the article is this jaw-dropper, a quote from Jonathan Adler, a law professor at Case Western Reserve University and one of the two proud creators of the ACA disestablishment-clause hypothesis:

Among critics of the law there is a feeling that the law doesn’t have the same legitimacy as a law that passed with bipartisan support.

Let me take a crack at this, too.  This will only take a moment: I don’t recall the provision in the Constitution that classifies laws duly enacted without bipartisan support illegitimate.  But I do wish the Dems had remembered that Article or Amendment in 2001 when Congress enacted the first set of tax cuts for the wealthy, without bipartisan support.  Not that it would have mattered, though.  I mean, who knew that when the Supreme Court put George W. Bush in office via an opinion that said its legal reasoning would apply to that case only, the five justices in the majority also meant that the clause in the Constitution that delegitimizes laws enacted without bipartisan support doesn’t apply to laws enacted by only Republicans?   But you can bet it doesn’t.

Adler’s partner in theory development is a Cato Institute “health policy scholar” Michael F. Cannon, and the Times article gets a quote from him too.  Not to be outdone in the outragousness department by his compadre, Mr. Cannon thusly described the Strategic Airwaves Command plan developed immediately after the ACA was signed into illegitimate law:

After the A.C.A. was enacted and after the president signed it, a lot of people — me included — decided that we weren’t going to take this lying down, and we were going to try to block it and ultimately either get the Supreme Court to overturn it or Congress to repeal it.

Mr. Cannon will testify today at a televised House committee hearing about his and Professor Adler’s theory.  The professor must have a scheduling conflict, because he apparently is not on today’s witness list.  But presumably Mr. Cannon, scholar that he is, can cite the legal authority for the proposition that laws aren’t legitimate unless enacted with bipartisan support if it’s a Democratic rather than a Republican majority that voted for the bill.  He’s not a lawyer, but he does work for the Cato Institute.  Which, as the Times article notes, is libertarian-leaning.  As opposed to, say, democratic-leaning.  But not as opposed to fascist-leaning.  Which the current Republican Party, egged on by its corporate-funded puppetmasters, is.

What’s next from the libertarian crowd?  Polling places only in gated communities? Damn! I shouldn’t suggest it, should I?  Oh, well; they’d have thought of it on their own soon enough. That’s why Cato is called a think tank.

UPDATE: Reader Jack writes in the Comments thread:  “The relationship between Cato and the Ayn Rand Institute (ARI) improved with the nomination of Cato’s new president John A. Allison IV in 2012. He is a former ARI board member and is reported to be an “ardent devotee” of Rand who has promoted reading her books to colleges nationwide.” Wiki

Also, “….but so intense is Allison’s devotion to Rand’s work that he has waged a campaign to make college students read it, using the power of the BB&T Charitable Foundation and millions of dollars in donations to schools to achieve his goal.” Jane Mayer, http://www.newyorker.com/online/blogs/newsdesk/2012/07/kochs-cato-john-allison.html.”

It does seem to me that the mainstream media should stop referring to Cato as a libertarian think tank now that that organization is simply an arm of the Koch brothers’ propaganda machine.

ALSO: Here’s a report on the argument yesterday afternoon in the case.

SECOND UPDATE: An exchange between reader EMichael and me in the Comments thread:

  • EMichael
    December 4, 2013 9:28 am

    Hard to figure out whether to laugh or cry.

    Fairly humorous that one half of the GOP’s healthcare reform platform is to stop the ambulance chasers via tort reform while using the same ambulance chasers to stop the Dem healthcare reform.

    The sad part is that there are judges who will not just laugh at these people and throw them out of his courtroom.

  • Beverly Mann
    December 4, 2013 1:37 pm

    Yup, EM. There’s a cadre of lawyers who have made this their specialty: tortious-interference-with-Obamacare. It’s apparently quite lucrative.

 

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Was the Nov. 30 Deadline the Make-or-Break Moment for Obamacare? No . . .

Somewhere in the future months, one of us is going to have to eat crow here on the success of the PPACA. The Republicans, Teabaggers, Healthcare Insurance Companies, Gerrymandered Republican Districts, ALEC, Koch Bros, etc. are working their hardest to make this much needed change in how people gain coverage fail. Meanwhile healthcare insurance companies are scamming the public with the cancellation of policies they should have never written after 2010 and are increasing policy premiums in spite of the MLR. Its the PPACA’s fault . . .

In my own state of Michigan, 315,000 people, a minority of the 9 million voters, have signed a petition to force women who want abortion coverage to seek a rider to their policy independent of PPACA coverage. Given that the state has refused to set up a state exchange and has used the Federal Exchange adding to the overloading of it, I wonder how the Federal Government will weigh in on this silliness. This petition is dangerous as it will not be put to vote on the November 2014 ballot. Instead, it will go to the Republican controlled legislature to decide whether it becomes law of not and bypass the Republican governor who vetoed a similar bill. Michigan has quite a few laws which beg for Federal review. Most recently, The state Attorney General decided he would not review juveniles sentenced to life imprisonment without parole claiming it only applies to future trials. Huh????

Maggie Mahar does a good review of the current PPACA deadline which warrants greater acknowledgement.

Was the Nov. 30 Deadline the Make-or-Break Moment for Obamacare? No . . .

Why March 31 is Far More Important –Particularly for Younger Americans 

The media has described November 30 as the administration’s “self-imposed” enrollment deadline, but conservatives—and the media itself—insisted on a date, demanding, over and over again, that the administration answer the “$400 million question”:

How long will it take to fix the Federal Exchange?

Ultimately, Jeffrey Zients, the Obama administration’s new health-care website, promised the site would be “generally operational” for “the vast majority of users” by the end of November.”  No one quite knew what that meant. But immediately, the media turned the November 30 deadline into a headline. On November 28,CNN declared:  “A moment of truth approaches for President Barack Obama’s signature health care reforms with Saturday’s self-imposed deadline to get the website to work properly for most users.”

Reuters chimed in: “President Barack Obama’s healthcare law is facing its biggest test this weekend since its disastrous October 1 launch . . .  If the website does not work on Saturday’s deadline, that could turn off millions of uninsured Americans, especially young and healthy consumers whose participation in the new insurance exchanges are critical.”

Where, I wondered, is Reuters getting its information? From Fox News?

Younger Americans Are Not as Intimidated by Website Snags

There is absolutely no reason to think that 20-something and 30-somethings are more frustrated with the technical glitches than anyone else. There is, in fact, every reason to think that young Americans are not nearly as bothered by software bugs.

First, keep in mind that most Millennials haven’t even tried to sign up. This is because they are not as anxious as older, sicker Americans about securing insurance.

But when they do go to the Healthcare.gov website, a twenty-something is likely to have an easier time than a 50-something when trying to work his way around glitches. Unlike many of their elders, Millennials solve software snags every day – at home, at work, at school. Twenty-five-year-olds who have grappled with Windows 8 will not be daunted–or surprised—by a few bugs.  For many younger Americans working through such problems is almost intuitive.

This also helps explain why, despite the sustained bad-news blitz, a CNN poll released just last week shows 18-34-year-olds overwhelmingly believe the president’s healthcare law will work: “Seven in 10 younger Americans think the current problems faced by Obamacare will eventually be fixed. Senior citizens are split, and most people between 35 and 65 years old think that the system is permanently broken,” said CNN Polling Director Keating Holland. . (So much for 35-65 year boomers. Some of the folks in my generation are getting grumpy).

The Success of Reform Turns On the Health of Those Who Sign Up

Keep in mind that 18-34-year-olds are needed to make the Exchanges work. As Ezra Klein pointed out recently, what matters most is not the absolute number of Americans who join the Exchanges this first year, but who they are. He explains:  “Back in July, when Sarah Kliff and I asked the White House how they defined ‘success’ in 2014, they always defined it as a function of the mix of people in the exchanges  . . . rather than the number of people in the exchanges . . . More wasn’t necessarily better. Twenty million enrollees would be a disaster if only 1 million of them were young and healthy. . .

“If they got 10 million people to sign up, about 3.9 million had to be young and healthy. If they got 4 million to sign up, success would mean making sure 1.5 million were young and healthy.. . . so long as the ratio was right, the premiums will remain low, and so when people eventually come to buy insurance, they can get a good deal, and they’ll want to sign up.”

In other words, it doesn’t matter whether 7 million or 5 million Americans join the Exchange this year. If enough 20 and 30-something’s join the risk pool, this will ensure that premiums are as low in 2015–or even lower– than they were in in 2014. This is the scenario that reform’s opponents fear most..

Many Young Americans Will Wait Until March

Those who argue that reform is a “failure” because October and November enrollments remain low emphasize that if potential Obamacare customers haven’t signed up by the end of November they will have only 23 shopping days left if they want be covered by January 1.

But many hale and hardy 20-somethings don’t really care whether they are insured by the first of the year. They just want to avoid forking over $95 because they  decided to ignore the mandate that they purchase coverage. In that case, they have until March 31. That is when open enrollment ends—and when the penalty kicks in for those who decide not to buy insurance.

What Happened When Massachusetts Mandated That Its Citizens Buy Healthcare?

Massachusetts’ experience suggests that, for young healthy Americans—the folks we need to keep premiums at reasonable levels– March 31 is the most important deadline

In Massachusetts enrollment in Commonwealth Care began in March of 2007. The state mandated that  but the state’s citizens wouldn’t have to pay a $291 penalty if they purchased insurance by November of 2007.A study published in the New England Journal of Medicine shows just how important that November deadline was.

Researchers began by separating enrollees into two groups—those who were healthy when the joined Commonwealth Care, and those who were not.  Using claims data from the first year that these patients were part of Commonwealth Care, they measured the health mix of the population who had enrolled from March 2007 through June 2008, looking at average age, average monthly health care expenditures, and the proportion of enrollees suffering from a chronic illness. We identified patients as having a chronic illness if within the first 12 months after enrollment they had an office visit at which a diagnosis of hypertension, high cholesterol level, diabetes, asthma, arthritis, an affective disorder, or gastritis was recorded

The chart below reveals the enormous spike in the number of healthy applicants joining the program in November–just in time to dodge the penalty. That month, there was a much smaller increase in the number of chronically ill people signing up for insurance. Many already had purchased insurance.

< a href="http://www.nejm.org/doi/full/10.1056/NEJMp1013067">NEJM Commonwealth Care enrollees

The chart also shows that the number of healthy applicants continued to outpace sicker applicants for another six months. Clearly the mandate made a huge difference in ensuring that younger customers joined the pool. I suspect that over the next four months, we’ll see the same pattern nationwide.. I don’t expect to see most Millennials scrambling to buy insurance in December. Very likely, the bigger spike will come in March. This is why MIT’s Jon Guber an architect of Massachusetts Reform, plan calls the October and November Obamacare enrollment figures “basically meaningless”:

Look, when we opened our system in Massachusetts the first month the people could pay premiums and enroll, 123 people enrolled,” Gruber points out  ”By the end of the year, it was 36,000. That meant we got .3 percent of the people the first month. By that standard the federal government did great, 1.3 percent of the people the first month. It’s too early to say anything useful. The real deadline we have to focus on is March of next year.” 

I agree. When we look at who has signed up at the end March, we will be able to assess how well reform is doing—and how likely it is that premiums will rise in 2015.

Was the November 30 Deadline the Make – or – Break Moment for Obamacare?  No  .  .  .  Maggie Mahar; Economist, The Healthbeat Blog

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Oh, Stop, Matthew Yglesias. And COUNTLESS Pundits Like you.

That’s an enormous lowering of expectations, and a reminder to liberals about the formidable barriers to further expansion of the welfare state. The public has long been skeptical of the political system’s practical ability to do the things progressives say they want to do. A health care website that comes in months late, over budget, and still lacking full functionality confirms all those fears when it was initially meant to debunk them. And that’s true whether or not it in some sense “works.”

— Matthew Yglesias, Healthcare.gov Has Already Failed: Website problems won’t stop Obamacare, but they’ve already wrecked progressives’ ambitions. Slate, today

Yglesias was discussing the Obama administration’s statement yesterday that healthcare.gov is now working reasonable well in its capacity to handle log-ons.  The update, Yglesias said, tacitly acknowledged  that “‘t]he government, according to the people who run the government, shouldn’t be expected to do things well.”

That’s right, Matt.  What liberals have always wanted was a healthcare insurance website that works the way Amazon’s does.  They never really much cared whether healthcare insurance, and healthcare itself, was available to people who have a preexisting medical condition and don’t have an employer that provides group insurance, or who just plain can’t afford huge premiums. They just used that as a pretext to get the Amazon-like website, or to try to.

The government shouldn’t be expected to do things well.  If, by “things,” you mean websites.

Just wondering whether I’m the only one who is really, really tired of the punditry’s asinine conflation of means and ends–or, more specifically, of a website’s operations and access to medical insurance and medical care.  I doubt that I am.  I think it’s just that big-name pundits tend to conflate form and substance, because, well, that’s what big-name pundits do.

What a dumb blog post.  Yglesias’s, on Slate; not mine, here.

 

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DFAS and 8 trillion dollars and more since 1996

Via Reuter’s Scot J. Paltrow Part 1

Defense Finance and Accounting Service, or DFAS (pronounced “DEE-fass”). This agency, with headquarters in Indianapolis, Indiana, has roughly 12,000 employees and, after cuts under the federal sequester, a $1.36 billion budget. It is responsible for accurately paying America’s 2.7 million active-duty and Reserve soldiers, sailors, airmen and Marines.

It often fails at that task, a Reuters investigation finds.

A review of individuals’ military pay records, government reports and other documents, along with interviews with dozens of current and former soldiers and other military personnel, confirms Aiken’s case is hardly isolated. Pay errors in the military are widespread. And as Aiken and many other soldiers have found, once mistakes are detected, getting them corrected – or just explained – can test even the most persistent soldiers (see related story).

 

Part 2

This account is based on interviews with scores of current and former Defense Department officials, as well as Reuters analyses of Pentagon logistics practices, bookkeeping methods, court cases and reports by federal agencies.

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Ending the Era of Minority Rule

Obstructionism has been the modus operandi by Republicans in Congress to oppose President Obama with special emphasis in the Senate. Through the use of the filibuster, the Senate Republican minority has been able to block presidential appointments or sway them to less likely candidates, block the appointment of Federal Judges to the bench, and obstruct the enforcement of laws by blocking appointments to the NLRB . To bring about the end of a filibuster through cloture, 60 of the 100 senators had to vote in favor of it under the current Senate rules.  

With the appointment of Mitch McConnell as the Republican Senate minority leader, the number of cloture motions filed to break a filibuster has increased with <a href=”http://www.senate.gov/pagelayout/reference/cloture_motions/clotureCounts.htm” target=”_blank”>3 of every 10 clotures</a>  filed having occurred since McConnell’s appointment. The numbers are up drastically since Obama became president and McConnell became the Senate Minority leader (redundant alert). Maybe McConnell does not like the president as the current practice is certainly not reminiscence of past practices.

 

cloture_gfx-03

 

Senator Henry Reid decided to employ the nuclear option:

“a Senate procedure that will allow a majority of the Senate to effectively change its rules to limit widespread obstructionism by the minority. As the trigger for this reform involves seven executive branch nominees being held up by Senate Republican filibusters, the likely consequence of this round of rules reform will be to eliminate the minority’s ability to filibuster nominees.” 

The president will now be able to appoint to the judiciary and to legislative positions with just a majority rule vote. If it appears to be unfair, more nominations by President Obama since he took office have been blocked than all other presidents combined.

 

filibusters

 

Maybe they just do not like Barack Obama the man?

 

References:

“Huge, huge victory for Political Sanity today,” November 2013, http://digbysblog.blogspot.com/2013/11/huge-huge-victory-for-political-sanity.html

“Why Senate Democrats Had To Invoke The Nuclear Option,” November 2013,  http://thinkprogress.org/justice/2013/11/21/2972671/senate-democrats-invoke-nuclear-option/

Everything Yo Need To Know About The ‘Nuclear Option And Harry Reid’s Plan To Fix The Senate,” July 2013, http://thinkprogress.org/justice/2013/07/12/2291781/everything-you-need-to-know-about-the-nuclear-opinion-and-harry-reids-plan-to-fix-the-senate/

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The Kosher Butcher Who Was Not a Person Until He Incorporated Himself*

Religious liberty, [Tenth Circuit Court of Appeals] Judge Tymkovich wrote, cannot turn on whether money changes hands. “Would an incorporated kosher butcher really have no claim to challenge a regulation mandating non-kosher butchering practices?” he asked.

Court Confronts Religious Rights of Corporations, Adam Liptak, New York Times, today

Why, yes, Judge Tymkovich, of course an incorporated kosher butcher really would have a claim to challenge a regulation mandating non-kosher butchering practices.  But that’s because the kosher butcher also is an actual human and was one even before he incorporated himself, er, his butcher shop.

The butcher would have a claim as, um, the butcher–Ira Greenberg, human being, exercising his religious right to use kosher-butchering practices to kill his own food, and his religious right to obtain kosher meat in order to limit his meat eating to kosher.  He also would have a due process right to practice his trade and make a living, unencumbered by an utterly arbitrary and irrational prohibition (or, to use legal formality, a prohibition that has no legitimate governmental interest). And Ira Greenberg Kosher Meats, Inc., would have a similar due process claim, a constitutional claim that, unlike campaign-contribution claims or free-exercise-of-religion claims, could be invoked legitimately by a corporation, because it, unlike political contributions and religious practice, actually would concern the right to operate as the sort of business that it is.

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Wall Street executive compensation

Robert Schiller began a look at executive compensation:

Last Wednesday, we presented our findings, “The Squam Lake Report: Fixing the Financial System” (Princeton University Press). Ben S. Bernanke, the chairman of theFederal Reserve, helped introduce the book at a conference at Columbia University. He said he agreed with the principle that “the stakeholders in financial firms — including shareholders, managers, creditors, and counterparties — must bear the costs of excessive risk-taking or poor business decisions, not the public.”

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