Send CARE Packages

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Via Kevin Drum — L.J. Williamson writes in the Los Angeles Times says the local school districts have to make a choice:

The Los Angeles Unified School District receives about $2.85 a child a day from the state and federal governments to provide breakfast and lunch to students. Of that amount, according to the nonprofit group California Food Policy Advocates, or CFPA, about $2 must be spent on milk, supplies, salaries and benefits, leaving about 85 cents for the food on your child’s Styrofoam tray. Given this paltry budget, it seems astounding that our children are fed at all, yet L.A. Unified’s food service manages to serve nearly half a million meals each school day, and it does so within or exceeding U.S. Agriculture Department nutrition guidelines.

If this feat seems miraculous — and I defy anyone else to make an even moderately healthy meal for that amount — try doing it with even less.

That’s the kind of loaves-and-fishes territory that the food service might soon find itself in if the school board passes an initiative today expanding healthcare for cafeteria workers.

Part-time food service employees are seeking the same health benefits — including coverage for their families — that their full-time counterparts enjoy. Extending these benefits to cafeteria staff who currently work only three hours a day would cost an estimated $40 million a year, according to school board calculations.

Nowhere in the private sector do three-hour-a-day employees expect to be eligible for full family benefits; nowhere but in the surreal world of L.A. Unified would anyone have the nerve to ask for them.

Williamson concludes that the school districts should just say no to the cafeteria workers. But as Kevin, Ezra, and Melissa gently suggest, perhaps Williamson is not seeing the bigger picture.

Here we are, the Richest Nation in the World, and children in a major city are being fed a breakfast and lunch for $2.85 a day (what do those children eat, I wonder? Stuff rejected by the dog food factory?), and the cafeteria workers don’t have health benefits. And all this motherbleeper concludes is that the cafeteria workers have some nerve.

Exactly what is wrong with us?

Notice, Ezra says, “that every single time a group of individuals seeks health coverage, they’re forced into direct warfare with their immediate colleagues, place of employment, etc. So in this case, cafeteria workers who need coverage are set in opposition to children who need food.” The notion that we ought to be doing better than this for both the children and the cafeteria workers doesn’t even flicker through Williamson’s head.

To paraphrase the Ronald Reagan quote in the last post, someday we will tell our children and our children’s children what it once was like when America wasn’t a third-world shithole.

“We Are All Uninsured Now”

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Laurence J. Kotlikoff writes in the Boston Globe:

BIG NUMBERS, like 45 million uninsured Americans, are hard to grasp. But that number came home to me at a recent conference. The keynote speaker was former Supreme Court justice Sandra Day O’Connor. Her topic was our healthcare system, and her message was personal and anguished.

The gist was that even she lives in constant fear of major uninsured health bills. Not her own — those of her son. He can’t afford insurance because his son — her grandchild — has a preexisting condition.

As I listened, a light dawned: O’Connor and the rest of us with health coverage are also uninsured. We too face terrible, albeit more remote, healthcare risks — the risk that our employer will drop our plan, that Medicare will go bust, that our plan won’t cover our needs, that premiums will eat us alive, that our doctor will stop taking our insurance, that long-term care will wipe us out, and that our uninsured friends and family members will need major financial help.

These risks are entirely avoidable. We can have an efficient, transparent system that includes everyone; treats everyone fairly; covers all the basics, including prescription drugs, home healthcare, and nursing home care; and costs little more than what we now spend. But we can’t get there via the piecemeal reforms that President Bush, most of his would-be successors, and our state governors are advocating.

To clarify, state governors are not necessarily “advocating” piecemeal state-by-state solutions. It’s more correct to say that the states are stepping into the leadership void and crafting whatever solutions they can. Currently on the Right, “let the states do it” is a favorite health care talking point. On the other hand, righties love to point to the failures of several state programs to argue that the same programs would fail at the national level, also.

As Ezra Klein explains here in detail, “providing health care for all citizens is one of those tasks, like national defense, that the states are simply unequipped to manage on their own.” States cannot tackle the underlying cause of the problem, which is that the private health insurance industry and other moneyed interests are setting the rules and calling the shots. Any solutions the states come up with will be no better than work-arounds.

Kotlikoff writes that we seem to be heading “toward a balkanized healthcare system with the old in Medicare, the poor in Medicaid, most workers in employer plans, and the losers — the otherwise uninsured — in highly subsidized, limited-coverage plans. Loser plans.” But as we’ve seen with the S-chip controversy, right wingers don’t even want to pay for the “loser plans.”

Although he seems to understand the problem, Kotlikoff’s “solution” is for Washington to hand out vouchers that people can use to purchase health insurance. The private health insurance industry and other moneyed interests would still setting the rules and calling the shots. Not a solution, I say.

But his larger point is one politicians, particularly those in Washington, need to wake up to. The health insurance crisis is no longer just a matter of poor people, or the unemployed, being left uninsured. The health insurance crisis has spread to the middle class. If even a former Supreme Court justice is worried, it is spreading to higher-income citizens as well.

Righties are still pretending that people without health insurance are somehow all poor and undeserving. The uninsured are supposed to be content that, at least, if they get really sick, and treatment can no longer be postponed, they can show up at an emergency room and wait most of a day to see a doctor so they can be “stabilized” and sent home. I don’t expect the hard core Right to see the problem until they’re the ones dumped out of the system, leaving them one aneurysm away from death or financial ruin.

According to a recent CNN/Opinion Research Corporation Poll, 64 percent of Americans think government should provide a national health insurance program for all Americans, even if this would require higher taxes, and 73 percent think that government should provide health insurance for all children under the age of 18.

In 1988, Michael Dukakis made health care reform an important part of his platform. Back then, most middle class Americans were still paying only a small deduction from their paychecks for insurance plans that let them see any doctor they wished without worrying about networks. I remember that when George H.W. Bush was asked about healthcare reform, he looked somewhat baffled and said (all together now) “America has the best health care system in the world,” and he didn’t understand why Dukakis wanted to fix something that wasn’t broken. I think, back then, most middle class Americans bought that argument.

And in 1993, when the Clintons brought out their health care plan, the insurance industry’s “Harry and Louise” ads effectively frightened people to stick by the status quo. I had problems with the Clinton’s approach, but it’s interesting to me that the Right still speaks of it as a failure. It didn’t fail, because it was never tried. What is failing is the status quo.

I have thought for years that, some day, we’d reach a tipping point at which enough Americans were personally impacted by the failures and inequities of The Best Health Care System in the World that they would be desperate to change it. I think we’ve reached that tipping point. Even corporations are now calling for reform, although they are still talking about a “market-led” system. They can’t yet see that sticking to a “market-led” system is what brought us to this crisis, and all the “market-led” solutions amount to using tax dollars to keep the “private” health insurance beast alive. People are so invested in “government is not the solution” ideology that they make government the solution for maintaining a failed “private” system.

And even the states, the “laboratories” of new policy, are hamstrung by right-wing ideology. In today’s Los Angeles Times, the speaker of the California Assembly, Fabian Nuñez, describes the fight within the Golden State:

In the next 15 to 18 days before the Legislature adjourns, the narrow window of opportunity we have to achieve healthcare reform in California — reform that expands access for those who don’t have health coverage and keeps costs down for those who do — will start to close. If history is a guide, we can expect an anything-goes campaign in the next few weeks to delay, derail and demonize healthcare reform. We need to focus on some basic truths to keep that campaign from succeeding.

First, for nearly 10 months now, the reform proposals I put forward with Senate President Pro Tem Don Perata have been vetted in the legislative process, fiscally analyzed by academics and scrutinized by the media. Yet you can count on opponents saying, “We’re moving too fast; let’s slow down.” Practically speaking, what they are really trying to do is kill any reform — delay means death to controversial big-issue legislation. Given more time, the forces against healthcare reform will find ways to take more potshots at the proposals. We don’t need a special session of the Legislature later this year. We don’t need to punt to the 2008 election year.

After a discussion of various proposals, he continues,

Those who want to see more complete coverage also will object to our plan because they’d rather see a single-payer system — in which a government-run entity contracts with doctors and hospitals and handles all claims.

I embrace the idea; it is a noble goal and may one day prove to be the ultimate answer. It’s overwhelmingly supported by legislative Democrats and has growing support from Californians. But in 2007, a single-payer plan would be vetoed by the Republican governor just as he did the version the Legislature sent him in 2006. Sacrificing the good for the perfect doesn’t make sense in the world of public policy.

That’s the tune we’re all singing. Most Americans know what the solution to our problem is. What’s standing in the way is the Right. And the Right has so dominated politics in recent years that even progressive politicians are inhibited from bringing the the solution they really want to the table. Instead, they patch together something less comprehensive and less workable and hope it won’t be completely eviscerated by the Right before it comes to a vote.

And then, when the state program fails, the Right will point to it and say, see? Government doesn’t work.

Regarding S-chip, Bob Herbert writes in today’s New York Times:

The program is popular because it works. It’s cost effective and there is wide bipartisan support for its expansion. But President Bush, locked in an ideological straitjacket, is adamant in his opposition.

In addition to the new rules drastically curtailing the ability of governors to expand local coverage by obtaining waivers from the federal government, the president has threatened a veto of Congressional efforts to fund a more robust version of the overall program.

“It’s stunning,” said New York’s Gov. Eliot Spitzer. “He says he’s going to veto health care for kids because it’s too expensive at the same time that these continuing resolutions for the war, where we don’t even know what the cost is, are going through unabated. This is insanity.

“Everybody agrees this is the right thing to do except the Bush administration.”

States want to expand S-chip to middle class children not to undermine health insurance industry profits, but because more and more middle-class children are uninsured.

Wherever there are large numbers of families without coverage, you will find children who are suffering needlessly and, in extreme cases, dying. They don’t get the preventive care or the attention to chronic illness that they should.

“That has not only an immediate effect on their development,” said Mr. Spitzer, “but a long-term cost to society that is incalculable.” …

… Administration officials have argued that the CHIP program should adhere closely to its original intent of limiting coverage to families only slightly above the official poverty line. They said there is a danger that families with higher incomes would begin substituting CHIP for private insurance coverage.

The reality is that under the administration’s approach enormous numbers of children in families without a lot of money will be left with no coverage at all, private or otherwise. The expansion of CHIP is the most efficient, cost-effective way of reaching those youngsters.

And here we come to the plain truth:

What’s happening is cruel. Children who should be eligible for CHIP are being held hostage to policies driven by a desire to protect the big insurance companies and an ideology that views CHIP, correctly, as yet another important step on the road to universal health care.

Ronald Reagan, one of the tribunes in the fight against Medicare and Medicaid back in the ’60s, pumped up the warnings against “socialized medicine” by saying that if Medicare becomes a reality “you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”

I wonder what crazy things the ideologues think would happen if CHIP is expanded to cover the children who have no health insurance today.

The whole bleeping nation is being held hostage by right-wing insanity. When’s it going to stop?

Why Is the Right Afraid of Universal Health Care?

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Today’s Paul Krugman column connects the S-chip controversy and public school education, and wonders why one is bad but the other acceptable.

The truth is that there’s no difference in principle between saying that every American child is entitled to an education and saying that every American child is entitled to adequate health care. It’s just a matter of historical accident that we think of access to free K-12 education as a basic right, but consider having the government pay children’s medical bills “welfare,” with all the negative connotations that go with that term.

And conservative opposition to giving every child in this country access to health care is, in a fundamental sense, un-American.

Here’s what I mean: The great majority of Americans believe that everyone is entitled to a chance to make the most of his or her life. Even conservatives usually claim to believe that. For example, N. Gregory Mankiw, the former chairman of the Bush Council of Economic Advisers, contrasts the position of liberals, who he says believe in equality of outcomes, with that of conservatives, who he says believe that the goal of policy should be “to give everyone the same shot and not be surprised or concerned when outcomes differ wildly.”

But a child who doesn’t receive adequate health care, like a child who doesn’t receive an adequate education, doesn’t have the same shot – he or she doesn’t have the same chances in life as children who get both these things.

Actually, much of the Right wants to dismantle public education also — for our own good, of course. But let’s stick to health care.

Krugman may have a point about a “historical accident.” People are comfortable with the familiar, “the way we’ve always one things.” It’s like the “reefer madness” phenomenon. Liquor is legal and marijuana is not, even though liquor is the more dangerous of the two substances — people do become physiologically addicted to alcohol, and it is possible to die of an overdose of alcohol, which is not true of marijuana. But we’re used to liquor, so it’s OK. And we’re used to universal public school education, but not universal health care for children (or the rest of us), so the first is acceptable but the second is scary.

This blogger argues for the status quo:

Where in the Constitution does it say that every one has the right to health care?

Where in the Constitution does it say that every one has the right to an education? Or the right to call the fire department if your house catches fire? What’s the big bleeping deal with allowing We, the People, to use the federal government to solve national problems that aren’t being solved any other way? Isn’t that what bleeping government is for?

Besides, I bet you most people think that everyone should have access to affordable health care, but that is not the same as making it the responsibility of the federal government to provide it.

Well, yes, and if the U.S. health care system were providing at least basic health care to everyone who needs it, at an affordable cost, then we wouldn’t have a “health care crisis,” would we?

Certain conservatives may, for instance, think that it is unconstitutional to get the government (too much) involved or they may think that private companies can deal with the problem… or (shocker to people like Krugman who seem to believe that States in the US are not much different that provinces in the Netherlands) that States could and should deal with it.

Certain conservatives think that universal health care is unconstitutional, but that suspending habeas corpus or warrantless surveillance of U.S. citizens isn’t. This is why I don’t give a bleep about what certain conservatives think.

And states are not going to come up with anything but band-aid solutions; Ezra Klein explains why.

The blogger continues,

This issue is not between conservatives who do not want children to have a health care insurance on the one hand, and progressives who do want that on the other, it is about what solutions / plans actually work and the power of the federal government. Krugman, then, does not approach this subject from the perspective of someone who tries to bring people together to join forces on an issue, he approaches this subject from the perspective of a partisan liberal.

Krugman has written a ton of columns about possible solutions to the health care crisis. Here’s just one of them. But today’s column was not about solutions. This column is about why we haven’t been able to have a sensible national discussion about these solutions, much less put any of these solutions into practice.

Part of the reason is that politicians — and I’m not just talking about Republicans — are in the pockets of the health insurance industry. But the larger reason is that the American Right is in deep denial about the true dimensions of the crisis and what it will take to correct it. In fact, I have yet to see a substantive discussion about health care in mass media. What I’ve seen by way of “discussion” are right-wingers screeching about waiting lines in Canada. Thus, the United States remains the only industrialized democracy on the planet without universal health care for its citizens, and the only thing most Americans know about health care in other countries is that there are waiting lines in Canada.

Are there any conservatives out there who say that children should, quite simply, never see a doctor? Of course not. This is not what the debate is about.

I’m sorry, but that is what the debate is about. Children are being denied medical care. This is really happening. It is not imaginary. It does those children no good to say that, in principle, we’re fine with all children seeing a doctor. We’re just not going to do anything to make it possible.

I write about health care a lot, and I’ve written several posts that look at various solutions. And I don’t much care which party or which politician comes up with a workable solution. In fact, so far none of the Democratic presidential candidates has come up with a plan that I’m all that excited about.

But the Right is coming up with nothing. Less than nothing. For example, I’m certain that Health Savings Accounts would make the problem worse, for reasons Kevin Drum explains. As he says, “solutions” coming from the Right don’t even rise to the level of band-aids; they’re more of a papering-over.

If by some miracle someone comes up with a workable plan that does not involve a federal program, I’d be thrilled. I am not advocating or a federal solution just for the sake of a federal solution. I’m advocating for a federal solution because I haven’t seen any other plans that would come even close to solving the problem.

The first step in finding a solution is understanding the problem. I see no indication that anyone on the Right has made that step.

We’re back to “lead, follow, or get out of the way.” On health care, the Right won’t lead, they won’t follow, and they won’t get out of the way. They just obstruct and deny.

Supporting the [Enemy] Troops

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Hannah Allam writes for McClatchy Newspapers:

Iraq’s deadly insurgent groups have financed their war against U.S. troops in part with hundreds of thousands of dollars in U.S. rebuilding funds that they’ve extorted from Iraqi contractors in Anbar province.

The payments, in return for the insurgents’ allowing supplies to move and construction work to begin, have taken place since the earliest projects in 2003, Iraqi contractors, politicians and interpreters involved with reconstruction efforts said.

Your tax dollars at work.

A fresh round of rebuilding spurred by the U.S. military’s recent alliance with some Anbar tribes — 200 new projects are scheduled — provides another opportunity for militant groups such as al Qaeda in Iraq to siphon off more U.S. money, contractors and politicians warn.

“Now we’re back to the same old story in Anbar. The Americans are handing out contracts and jobs to terrorists, bandits and gangsters,” said Sheik Ali Hatem Ali Suleiman, the deputy leader of the Dulaim, the largest and most powerful tribe in Anbar. He was involved in several U.S. rebuilding contracts in the early days of the war, but is now a harsh critic of the U.S. presence.

And we thought all that money was just going to waste.

The biggest source of, um, overruns seems to be security.

A U.S. company with a reconstruction contract hires an Iraqi sub-contractor to haul supplies along insurgent-ridden roads. The Iraqi contractor sets his price at up to four times the going rate because he’ll be forced to give 50 percent or more to gun-toting insurgents who demand cash payments in exchange for the supply convoys’ safe passage.

One Iraqi official said the arrangement makes sense for insurgents. By granting safe passage to a truck loaded with $10,000 in goods, they receive a “protection fee” that can buy more weapons and vehicles. Sometimes the insurgents take the goods, too.

Sounds a bit like the old Mafia.

One senior Iraqi politician with personal knowledge of the contracting system said the insurgents also use their cuts to pay border police in Syria “to look the other way” as they smuggle weapons and foot soldiers into Iraq.

“Every contractor in Anbar who works for the U.S. military and survives for more than a month is paying the insurgency,” the politician said, speaking on condition of anonymity because of the sensitivity of the matter. “The contracts are inflated, all of them. The insurgents get half.”

I’d say that’s an argument for getting the bleep out.

Taking Care of Our Own

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As you know, the Bush Administration has moved boldly to protect the insurance industry from the State Children’s Health Insurance Program, or “S-chip.” The Bushies have attached tough new strings to the program to prevent states from expanding coverage to children of middle-income families. Many of these strings are designed to prevent families already covered by private insurance from dropping it and moving to the subsidized programs.

However, most of the middle-income children the Administration wants to keep out of the program are not covered by private insurance, either.

This Associated Press story from Texas explains the problem:

… The Houston teaching assistant’s 18-year-old twins were bumped in May from the state Children’s Health Insurance Program, known as CHIP in Texas. The overtime she worked pushed the household income above the program’s limit. The boys relied for six years on the program, which covers kids to age 19.

The Pacheco twins are among thousands of children whose families’ incomes are too high to qualify for CHIP but still can’t afford private insurance. While some in Texas are hoping to raise the limits to allow more coverage, President Bush and some in Congress want to keep the income ceilings intact.

This week, the administration directed states to make children wait a year before enrolling in the program, a guideline aimed at preventing families from dropping private insurance to enroll in CHIP.

About half of the estimated 1.4 million uninsured children in Texas don’t qualify for CHIP. Some are undocumented, some have pre-existing conditions that keep them from getting private coverage, and others are like the Pachecos whose incomes prevent them from enrolling in CHIP.

Children’s advocates in Texas had hoped that one day the state would raise the income limits, which in the state is 200 percent of poverty level, or $41,300 for a family of four.

“The largest growth of uninsured has been in the middle class,” said Barbara Best, executive director of Texas Children’s Defense Fund. “Families earning $50,000 to $60,000 a year can’t afford private health insurance. Why can’t they benefit through the system as well?“

In 2005, the average cost of life insurance in Texas was was $9,100 per family, about $760 a month. I assume it’s higher now.

Officials also said states can’t enroll children in families who earn more than the CHIP income limit until 95 percent of children who qualify for CHIP or Medicaid are enrolled in those programs.

Last year, 41,523 children covered by CHIP left because their family income exceeded CHIP income limits, according to the Texas Health and Human Services Department.

A department study found 1 percent of the 2003 average monthly new enrollees, 21,295 kids, had dropped private insurance to get CHIP coverage.

But, that 1 percent is taking bread out of the mouths of health insurance executives. BTW, via a quickie google search I learned that health insurance profits are booming.

The dwindling number of Americans still covered by employee-subsidized health care are sheltered from the realities of health insurance cost. Texas is one of the states without those nasty “regulations” righties sneer at that prevent health insurance companies from refusing to cover sick people, yet it also has the highest percentage of uninsured citizens — 27.1 percent — of any state. The high percentage of uninsured has an unfortunate impact on Texas.

Regarding S-chip, this op ed from today’s Orange County Register expresses the Bushie POV:

A Bush administration policy that would make it less easy for states to expand a children’s health insurance program well beyond the low-income children it was designed to cover has been greeted with outrage.

The most logical explanation is that some legislators really want the government to “crowd out” private insurance as a prelude to replacing it with an all-inclusive government program that covers everybody. …

… The government has already allowed states to offer the program to families above the official poverty level of $20,650 for a family of four. Most states now offer it to those at double that level, or $41,300 a year. Some states are at 250 percent ($51,625), and New York wants to offer it to families at quadruple the poverty level, up to $82,600.

At such levels, however, a subsidized government program starts to look better to people who already have private health insurance. Thus the “free” (i.e., taxpayer-paid) insurance starts to “crowd out” private insurance.

The Bush administration would make states that want to offer the program to families at more than 200 percent of the poverty level wait until 95 percent of those at or below the 200 percent figure are covered before they expand it.

That has states eager to expand a program — with “free” federal money — howling on behalf of “the children.” Enough already.

Spoken like a man who’s never had to buy private insurance for a child with a pre-existing condition. Attempt to buy, I should say.

See also: “Stiff-Arming Children’s Health“

Charity Nation

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Last week I wrote that in the past two years more than a million American have volunteered to help restore the Gulf Coast, yet they aren’t making much of a dent. Today Douglas Brinkley writes in the Washington Post:

Over the past two years since Hurricane Katrina, I’ve seen waves of hardworking volunteers from nonprofits, faith-based groups and college campuses descend on New Orleans, full of compassion and hope.

They arrive in the city’s Ninth Ward to painstakingly gut houses one by one. Their jaws drop as they wander around afflicted zones, gazing at the towering mounds of debris and uprooted infrastructure.

After weeks of grueling labor, they realize that they are running in place, toiling in a surreal vacuum.

Two full years after the hurricane, the Big Easy is barely limping along, unable to make truly meaningful reconstruction progress. The most important issues concerning the city’s long-term survival are still up in the air. Why is no Herculean clean-up effort underway? Why hasn’t President Bush named a high-profile czar such as Colin Powell or James Baker to oversee the ongoing disaster? Where is the U.S. government’s participation in the rebuilding?

And why are volunteers practically the only ones working to reconstruct homes in communities that may never again have sewage service, garbage collection or electricity?

Eventually, the volunteers’ altruism turns to bewilderment and finally to outrage. They’ve been hoodwinked. The stalled recovery can’t be blamed on bureaucratic inertia or red tape alone. Many volunteers come to understand what I’ve concluded is the heartless reality: The Bush administration actually wants these neighborhoods below sea level to die on the vine.

This is a really good article, so please read it all. He concludes that the Bush Administration is deliberately discouraging people from re-populating New Orleans, although he doesn’t draw the conclusion that Digby and I and others have drawn — that the goal is to create a reliably Republican voting block in New Orleans by dispersing the mostly black and mostly poor parts of the population, which mostly votes for Democrats. We’ll see how that turns out in the future.

Brinkley thinks the goal is to prevent people from moving back to areas below sea level that are likely to be flooded again, especially since the feds don’t want to pay to erect better flood protection. That may be part of it, too. And it isn’t just New Orleans that’s not getting fixed. There are people still waiting for help in Alabama and Mississippi as well.

Whatever the reason for government non-action, the Katrina experience ought to put to rest the idea that private charities can replace government welfare, disaster relief and other “safety net” programs. I say ought to; empiricism hasn’t yet stopped a rightie from believing whatever he wants to believe. But for the rest of us, the Katrina experience reveals that sometimes you really do need government. It’s fine for volunteers to cook soup, clear brush, or help re-roof a house. But if electricity and sewage services are never restored to that house, what’s the point?

This web document, which appears to have been written before the Bush II Administration, asks us to imagine what might have happened had there been no federal response to Hurricane Andrew in 1992. Well, now we don’t have to imagine. (But speaking of Hurricane Andrew — George H.W. “Poppy” Bush was president in 1992, and the federal government was slow to respond then, also. Maybe the Bush family carries a “don’t respond to hurricanes” gene.)

Righties like private charities because they don’t want to pay taxes for “welfare.” The Bush Administration likes private charities so much, it diverts tax dollars to them. Michelle Goldberg wrote in Kingdom Coming: The Rise of Christian Nationalism (pp. 107-108):

The diversion of billions of taxpayer dollars from secular social service organizations to such sectarian religious outfits has been one of the most underreported stories of the Bush presidency. Bush’s faith-based initiatives have become a spoils system for evangelical ministries, which are now involved in everything from prison programs and job training to teenage pregnancy prevention, supplanting the safety net that was supposed to catch all Americans. As a result of faith-based grants, a growing number of government-funded social service jobs explicitly refuse to hire Jews, gay people, and other undesirables; such discrimination is defended by the administration and its surrogates in the name of religious freedom. Bringing the disposed to Jesus Christ has become something very close to a domestic policy goal of the United States government. And all this has happened with far less notice or public debate than attended the removal of Terri Schaivo’s feeding tube or the halftime baring of Janet Jackson’s breast.

Goldberg writes that the term “compassionate conservative” comes from the title of a book by Marvin Olasky. This New York Times article from 2000 by Alison Mitchell explains how Olasky influenced Bush’s “thinking” on charity:

Mr. Rove also introduced Mr. Bush to Marvin Olasky—a proponent of 19th century-style charity over the entitlements of the welfare state—whom the governor calls “compassionate conservatism’s leading thinker” in a foreword to Mr. Olasky’s newest book.

Those introductions amounted to the first building blocks of the “compassionate conservative” platform Mr. Bush is running on today: tax incentives that he predicts will lead to an explosion of charitable giving; an emphasis on using religious institutions to deal with poverty, drug abuse and other social problems and a pledge to “usher in the responsibility era,” to replace the notion that “if it feels good, do it.”

The core concept of this platform is that while government has a responsibility to the needy, it does not have to provide the services itself. This approach can be seen in everything from Mr. Bush’s proposals for a tax credit to help people buy health insurance to his call to divert some Social Security payroll taxes into individual investment accounts.

I like the part about “19th century-style charity.” In early 19th century America, local laws usually made some provision to care for the indigent. Generally this worked well enough, especially in communities where everyone knew everyone else. As the nation became more urban and industrialized, and particularly with the great influx of immigrants, the old system proved inadequate. In the latter part of the 19th century private charities, most of them religious, sprang up by the tens of thousands, and for a time it was common for state and local governments to give cash grants to such charities to do social work rather than create public bureaucracies. How well this worked is debatable. African Americans often were excluded from receiving help, for example. In any event some major disasters — notably the Great Mississippi Flood of 1927, the Dust Bowl, and the Great Depression — pretty much swamped the system that Olasky wants to go back to.

Although the hard-core Right vowed to dismantle the New Deal from its beginnings, as I’ve written before most Americans were fine with the New Deal, including Social Security. And in the 1950s they were fine with the GI Bill and mortgage subsidies that helped the Greatest Generation become way more affluent than their parents had been. Nor do I remember a great hue and cry from the general population against Medicare when it was created in 1965. However, Lyndon Johnson’s “Great Society” programs were perceived by white Americans as tax money being spent mostly on inner city blacks. (This was not the whole story, but white poverty in America tends to be rural and invisible.) All of a sudden white middle-class America swung Right and discovered the virtues of self-reliance. All those right wingers who had crusaded against the “welfare state” finally had a big enough audience to swing elections.

But in the 1960s white middle-class Americans thought of themselves as economically invincible, thanks in part to such New Deal reforms as the FSLIC (which would become insolvent during the Savings and Loan Crisis, which was brought about by right-wing faith in deregulation and free markets, but that’s getting ahead of the story). Going back to Depression conditions was unthinkable to a middle class American then.

But I’m not sure it’s quite so unthinkable now. It ain’t the 1960s any more, and I’m not just talking about patchouli oil. Middle class Americans don’t feel so invincible today. And I don’t think American whites are, on the whole, as dog-whistle racist as they were 40 years ago. I suspect Americans are less interested in shrinking government and drowning it in a bathtub than they used to be.

Of Soldiers, Spooks, and Do-Gooders

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Right wing spokespersons are dutifully picking up Bush’s “Iraq is Vietnam” theme and trudging along with it. There are a couple of examples at the Corner. Here is the reliably inane Jonah Goldberg:

The mainstream media and a lot of liberal-leaning analysts seem to think it’s politically foolish or reckless for Bush to compare Vietnam to Iraq because they have one very specific narrative in mind when it comes to that war: America shouldn’t have gotten in, couldn’t have won, and then lost. What they have long failed to grasp is that’s not the moral of the story in the hearts of millions of Americans who believe that we could have won if wanted to and it was a disaster for American prestige and honor that we lost (whether we should have gone in is a murkier question for many, I think).

And Byron York digs up an old article by James Webb that describes the aftermath of the fall of Saigon (Webb’s full article can be found here). Webb wrote in 2000 that the antiwar view of Vietnam was oversimplified, even cartoonish, and I agree that was usually the case. But then, so was the pro-war view.

York is implying, I think, that because terrible things happened in Southeast Asia after our military left, our military should not have left. He fails to note that terrible things happened in Southeast Asia while we were still there, and that most of the really bad things that came after — such as the rise of Pol Pot and the Khmer Rouge — came about because of our military actions in Southeast Asia. In other words, the monster turned loose by our leaving was one of our own creation.

And who’s to say that, had we stayed longer, the monsters that eventually would have been unleashed wouldn’t have been bigger and badder?

The Right’s sudden, tender compassion for Cambodians reminds me of the concern that materialized in 2002 for the poor gassed Kurds. American right-wingers brushed off the gassing of the Kurds when it happened, in 1988. Attempts by liberals in Congress to address the issue were squelched by the Reagan administration, which continued to support the perpetrator, Saddam Hussein. Years passed without the poor Kurds being given a second thought. But suddenly, in 2002, when the Bush Administration needed to paint Saddam Hussein as the new Hitler, the Right seized upon the gassing of the Kurds as an unforgivable atrocity — which, of course, it was and always had been. And just as suddenly American wingnuts were beside themselves with anguish over the Kurds, and they insisted another second could not be lost in coming to their rescue, even though the gassing had occurred 15 years earlier and the Kurds had been protected from Saddam Hussein by U.S. flyovers since 1991.

I agree with Goldberg that there are “millions of Americans who believe that we could have won if wanted to and it was a disaster for American prestige and honor that we lost.” In a nation of more than 300 million you can find several million people who believe just about anything. However, I doubt that remorse over what happened to southeast Asians flickered through all that many wingnut hearts. It was, as Goldberg said, all about “prestige and honor.” And when Goldberg writes —

This is a point the Democrats fail to grasp: being on the side of surrender in a war is popular enough during the war, but if you succeed lots of Americans will later get buyer’s remorse and feel like it was a mistake and the next generation will see things very differently than their anti-war activist parents.

— he fails to understand that millions of Americans in the early 1970s wanted us to stay in Vietnam, and these are the millions who kept alive the “we could have won had we stayed” notion. It wasn’t “buyer’s remorse,” because minds didn’t change. Somewhere in America there may be a handful of people who opposed the Vietnam war at the time but came to regret ending it, but I’ve never met such a person. The hawks, on the other hand, nursed their bitterness and shame, stubbornly refusing to notice that leaving Vietnam had no bad effects on the United States. Which, IMO, amounted to big honking empirical proof that what happened to South Vietnam was not a vital interest of the United States, and we shouldn’t have sent troops there to begin with.

What Really Happened in America is that once we were out of Vietnam the whole nation dropped the subject like a hot potato. This was a bipartisan subject dropping. The terrible things happening in Southeast Asia after 1975 had no measurable political ramifications here in the U.S. that I can think of.

It may be, as Goldberg suggests, that Americans too young to remember the Vietnam War themselves have been persuaded that we could have “won” had we stayed. It’s fairly easy to support a war when you are in no danger of being drafted to fight it. But in all these years no Vietnam War hawk has ever been able to explain to me what we would have “won” had we won, except more and bigger trouble, possibly from the Soviets, or China. Hawks never think past the parade.

Vietnam and Iraq are similar in that they present the same paradox — that victory could equal defeat. By that I mean using enough military force to utterly crush the warring factions would amount to throwing away our political objectives. The operative phrase, I believe, is “Pyrrhic victory.” To those who continue to complain that we could have “won” in Vietnam, and could still “win” in Iraq, I say, of course. But this isn’t a game. Get over childish ideas about “victory” and “defeat” and see the bigger picture, for once.

Instead of talking about winning and losing, we should clearly understand what our objectives are in Iraq and then consider how those objectives might be achieved. Military “victory” and “defeat” are abstractions that don’t apply to the reality.

Vietnam and Iraq are different in that, once out of Iraq, I doubt we will be able to shove it out of our minds as we did Vietnam after the fall of Saigon. The Middle East is far more strategically important to us than Southeast Asia was. How we withdraw really does need to be given serious thought and planning. Just because we Americans could ignore what happened in Southeast Asia in the late 1970s doesn’t mean we will be able to ignore what happens in Iraq after we leave. Matters could get worse there. On the other hand, they could get better. There are so many variables I don’t think anyone can know with certainty how events will play out. However, the argument that we can’t leave because the situation might get worse if we do does not wash.

Andrew J. Bacevich writes in today’s Los Angeles Times:

Politics, not ideology, will determine the future of the Middle East. That’s good news and bad news. Good news because the interests and aspirations of Arabs and non-Arabs, Shiites and Sunnis, modernizers and traditionalists will combine to prevent any one faction from gaining the upper hand. Bad news because those same factors guarantee that the Middle East will remain an unstable mess for the foreseeable future.

Sometimes people can manage their own affairs. Does the U.S. need to attend to that mess? Perhaps not.

Here the experience of Vietnam following the U.S. defeat is instructive. Once the Americans departed, the Vietnamese began getting their act together. Although not a utopia, Vietnam has become a stable and increasingly prosperous nation. It is a responsible member of the international community. In Hanoi, the communists remain in power. From an American point of view, who cares?

Bush did not even allude to the condition of Vietnam today. Yet the question poses itself: Is it not possible that the people of the Middle East might be better qualified to determine their future than a cadre of American soldiers, spooks and do-gooders? The answer to that question just might be yes.

There is much hysterical rhetoric coming from war supporters about the “cause of freedom.” I suggest the best way to support the “cause of freedom” is to let people have it.

See also Dan Froomkin’s “The Lost Year” and the Saturday cartoons.

Update: This post of Digby’s slipped my mind, but deserves to be mentioned here. A right-wing organization called Family Security Matters sent around an email, since scrubbed, advocating nuking Iraq.

The wisest course would have been for President Bush to use his nuclear weapons to slaughter Iraqis until they complied with his demands, or until they were all dead. Then there would be little risk or expense and no American army would be left exposed. But if he did this, his cowardly electorate would have instantly ended his term of office, if not his freedom or his life.

And this reveals the “inadequacy of democracy.” Barbara Comstock, Monica Crowley, Frank Gaffney, Laura Ingraham and James Woolsey are among the righties on the Family Security Matters board of directors.

Pills and Politics

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Via Media Matters, we find that Leslie Hanks, vice president of Colorado Right to Life, is worried about the addictive properties of birth control pills.

“Let’s face it, they’re [Planned Parenthood] in the business to kill babies for profit,” she said. “First and foremost, they get young girls hooked on their birth control pills, which don’t work,” Hanks said.

Media Matters points out that birth control pills do work to prevent conception pretty reliably; “oral contraceptives work with 92 percent efficacy for the first year of ‘[t]ypical [u]se’ and are 99.7 percent effective with ‘[p]erfect [u]se,” MM says. So if Planned Parenthood is encouraging people to use contraceptives, which it does, then it really isn’t primarily “in the business” of abortion, is it?

Further, “Planned Parenthood® Federation of America, Inc. is a tax-exempt corporation under Internal Revenue Service code section 501(c)(3) and is not a private foundation. (Tax ID #13-1644147) Contributions are tax deductible,” their web site says. Strictly speaking, they are not “in the business” for profit at all. I believe it operates mostly on donations and endowments.

Regarding the abortion question, Eleanor Clift argues that Democrats should refocus the debate on birth control.

Family planning is an issue Republicans generally like to avoid because it threatens the coalition between economic conservatives and the religious right. Business types tend to be live-and-let-live, while a segment of social conservatives oppose birth control with almost the same fervor they oppose abortion. Family planning is such an under-the-radar issue for Republicans that Nancy Keenan, president of NARAL Pro-Choice America, says the Right to Life organization doesn’t advertise a birth-control position. “But you find in that movement—and they’ve become much more assertive about it—if you use birth control, you are stopping a life and that’s not acceptable,” she says. Listen to right-wing talk radio and you’ll hear how making birth control available or teaching sex-ed in public schools leads to sex. That’s an argument equivalent to believing that putting air bags in cars causes accidents, says Keenan.

The American public may be ambivalent about abortion, but I’m sure a whopping majority approve of birth control as an alternative. Cristina Page pointed out recently that there’s a strong, under-the-radar anti-contraceptive movement. Further, she says elsewhere, pro-choice politicians would do well to make contraception an issue.

Americans, pro-life and pro-choice, support contraception particularly because its the only proven way to reduce unintended pregnancy and abortion. (Only 11 percent of sexually active women don’t use contraception and from this 11 percent comes 50 percent of the nation’s abortions.) But very few voters are aware that not one pro-life organization in the United States supports contraception. Instead, pro-life groups lead campaigns against contraception. Ninety-one percent of the American public strongly favors contraception. When pro-choice presidential candidates make the discussion about prevention, contraception and results, they’ll win. No less than 80 percent of self-described pro-life voters strongly support contraception too.

The irony of the so-called (imagine my voice dripping with contempt) “right to life” position is that passing laws that ban abortions doesn’t stop abortions. This can be proved with solid empirical evidence; many nations that outlaw abortions have higher rates of abortion than nations with more liberal abortion laws. The one factor that, reliably, does lower abortion rates is access to and use of contraceptives. It is well documented that increasing the use of contraceptives correlates to lowering the rate of abortions within a population. You can’t say the same about passing laws prohibiting abortion.

You’ll never persuade the thick-headed Leslie Hanks of this, of course, but I think most Americans really don’t want the Morality Police to take away their contraceptives.

See also Susie at Suburban Guerrilla.