NIH Research Opportunity: Economics of Retirement

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National Institutes of Health
Economics of Retirement (R01)
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Department of Health and Human Services
National Institutes of Health
Economics of Retirement (R03)
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Department of Health and Human Services
National Institutes of Health
Economics of Retirement (R21)
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Longer Lives “a Call to Action” for the 21st Century

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By Mark Gorman

Is the world beginning to take notice of global ageing?

The message that extended life expectancy, falling fertility rates and accelerating ageing are now truly global phenomena seems to be getting a wider hearing, and in the past few months a number of different voices have been raised on the issue.

Global ageing vs. global economy

In an article in the December 2010 edition of "Foreign Affairs" for example, Nicholas Eberstadt writes: "It is apparent that the future global economy will not be able to rely on the kind of demographic inputs that helped fuel growth in the era before the current global recession".

Rapid population ageing, he argues, represents an almost entirely undiscounted long-term risk for the world's emerging countries.

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PhillyBurbs.com: More grandparents raising grandchildren

Image via WikipediaBy: GEMA MARIA DUARTE

More than 2.4 million people in the U.S. are raising their grandchildren, often with limited means.

The Christmas tree was bare. No gifts were under it. So she vowed she would never have another Christmas like that one in 1990.

Dolores Chapman was raising seven grandchildren and none of them had a gift to open. That Christmas the kids weren't allowed to go out and play with their Bristol Township neighbors.

"I felt bad," she said.

The next day, with $200, Chapman purchased gifts for her grandchildren on sale.

This Christmas, the 63-year-old grandmother is caring for three other grandchildren - a 5-year-old girl, an 8-year-old boy and an 11-year-old girl.

It's tough being a grandparent and raising grandchildren on a fixed income, she said. Of her 18 grandchildren, she's raised 10 of them.

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TIME GOES BY | REFLECTIONS: On Liberalism

by Saul Friedman (bio)

I think I’ve figured out what’s been bothering me about President Obama. He is intelligent, articulate, maddeningly cool, calm and pragmatic and his values seem humane and liberal. But in rejecting any semblance of an ideology, he seems to have no firm set of ideas that guide his policies and to which he is committed, which may explain why he moves so easily to the center.

In sum, I am bothered because I believe he is the personification of the decline of the liberalism I grew up with and generally supported most of my life.

Obama called himself a “progressive” when he was in the Senate. But I can’t imagine him saying, now, what John F. Kennedy said, when asked to define a liberal:

“...someone who looks ahead and not behind, someone who welcomes new ideas without rigid reactions, someone who cares about the welfare of the people...If that is what they mean by a ‘Liberal’, then I’m proud to say I’m a ‘Liberal.’”

If there is a difference between Obama and most of his Democratic predecessors, Roosevelt, Truman, Johnson or Kennedy, all of whom were unafraid to call themselves liberals, it’s that there is no real liberal movement behind him. Indeed, Obama seems to have rejected such a movement, although I’m not sure there is much of what could be called a liberal movement left.

The word “progressive” is empty of commitment or meaning. Liberalism, after all, has a long and honorable place in the history of political thought, and it has meaning, which we are losing.

I’m not talking about the left of center blogosphere which is ephemeral, self-absorbed, splintered and politically fickle. I do not see that it has an abiding set of beliefs or loyalties or interests, beyond the blog, which lasts only as long in the universe as a twitter of text. It goes without saying that the most liberal of blogs have little to do with trade unions, which have been at the heart of the liberal agenda.

But I’m getting ahead of myself, for the tweets of Twitter and Facebook and the blogs have zilch to do with the liberalism in my lifetime.

As I’ve recounted, I came of age in the Brighton Beach section of Brooklyn. A mostly Jewish enclave on the shores of the Atlantic. Our neighbors in nearby Coney Island were Italian. And virtually all of us came from immigrant families who knew enough about politics to have fled the old countries.

In America they joined unions or fellowships like the Workmen’s Circle and the Italian American Social Club. But the unions gave that generation and mine great political and, yes, class consciousness and strength.

The International Ladies Garment Workers’ Union, the rival Amalgamated Clothing Workers, the Furriers, the Cloakmakers and Hatmakers were among those, mostly Jewish-led, unions that became powerful and wealthy New York institutions that even built housing for workers.

Elsewhere in America, the Boston Irish organized the men and women who worked in the textile mills of New England; the United Mine Workers of the legendary John L. Lewis brought some semblance of sanity, dignity and safety to the mines of West Virginia and Pennsylvania.

The International Workers of the World (the Wobblies) organized with bloody struggles against company goons, the copper mines of Montana and the far west and gave us songs like Joe Hill.

In Michigan, the United Auto Workers with the Reuther brothers were born in radical sit-down strikes in which they and their families took over the factories to fight the violence from Ford’s strikebreaking thugs. Longshoremen, merchant seamen, retail store workers, waiters and newsmen were organized, despite the lack of laws, to protect their right to do so.

The politics of these workers – and most did not bother to vote – ranged across the ideological spectrum: anarchist, communist, syndicalist, socialist, incipient fascist and Democrat. But no Democrat had been elected since Woodrow Wilson; the progressive Republican era of Theodore Roosevelt had died and very few working Americans had anything in common with the then dominant Republicans of Herbert Hoover and his ultra-conservative Treasury Secretary, Andrew Mellon, who was a social Darwinist believing, after the 1929 market crash, in the economic survival of only the fittest.

The obvious political vacuum was explored first by the unsuccessful 1928 presidential candidacy of New York’s Irish Catholic governor, Al Smith. But it was left to Smith’s vice-presidential pick and his successor in Albany, New York Governor Franklin D. Roosevelt to put together a coalition of union workers, big city ethnic groups from immigrant backgrounds who had been left out of American politics and family farmers who had lost almost everything in what came to be known as the Great Depression.

Catholics, Jews, southerners (who boycotted the party of Lincoln) and midwestern Protestants choking on the barrage of dust that buried their farms – these were among the forces that came together for the Roosevelt landslide in 1932.

Some revisionist historians claim the New Deal was an afterthought, tailored by a pragmatic president to meet the crises of the Depression. But the fact is that the Roosevelts – Franklin and Eleanor – were keenly aware of the suffering among the people who voted for them. As Roosevelt said,

“I see one-third of the nation, ill-clothed, ill-housed and ill-fed.”

And unlike too many Democrats, before and after him, he moved not to the center but to the left. With the help of advisors, his “brain trust,” many of them from Yale and Jewish, he fashioned policies that kept faith with the people who voted for him. He was proud to fight those who didn’t.

The New Deal gave the people who voted for him jobs through the Works Progress Administration and the Civilian Conservation Corps. But more important and longer lasting was the National Labor Relations Act which protected the right to organize labor unions; the Wages and Hours Law, which institutionalized the 40-hour week; the Child Labor Laws; and, as part of the Social Security Act, unemployment insurance.

The New Deal took on the Andrew Mellons and the banks, curbing runaway speculation with Glass-Steagall and the National Banking Act; the Wall Street barons with the Securities and Exchange Commission; and the commercial pirates with the Federal Trade Commission.

No small part was played by Roosevelt's talented cabinet appointees including Interior Secretary Harold Ickes, Treasury Secretary Henry Morgenthau, Labor Secretary Frances Perkins and the Agriculture Secretary, Henry Wallace.

In short, the New Deal became the expression of modern American liberalism which saved capitalism from the demands of those more radical and angry socialist and communist elements of the American working classes, but moderated and transformed the excesses of the free and unfettered market.

Those, of course, are the hallmarks of social and political liberalism in an industrial society.

The Depression dragged on, with some improvement, until the great stimulus of the Second World War. But as Wikipedia notes,

“[T]he programs of the New Deal were extremely popular, as they improved the life of the common citizen by providing jobs for the unemployed, legal protection for labor unionists, modern utilities for rural America [through the great dams in the west, the Tennessee Valley Authority and the Rural Electrification Association], living wages for the working poor and price stability for the family farmer.”

Because Roosevelt remained faithful to those who brought him to the presidency, the voters stayed with him through his death in 1945, as he led the nation out of its traditional isolationism towards Europe to help his friend Winston Churchill and the Soviet Union’s Joseph Stalin confront the threat of fascism.

And even while fighting a two-front war against Hitler and the Japanese Empire, Roosevelt built on his New Deal with his call for Four Freedoms and the organization of the United Nations with Eleanor as it early ambassador.

Indeed, the Roosevelt-liberal coalition and the Democrats as the nation’s majority party, remained generally intact through 1968, the end of the presidency of Lyndon Johnson who had been a New Deal member of Congress. As President, Johnson renewed the liberal agenda with Medicare, Medicaid and landmark civil rights laws.

Alas, beginning with the Cold War and the rise of McCarthyist red-baiting, liberals in self-defense, joined in the anti-communism fervor, which led America into two winless wars.

But despite the elections of Republicans Dwight Eisenhower, Richard Nixon and Ronald Reagan, most of the great pillars of New Deal Liberalism – the labor laws, Social Security, the SEC, the FDIC and the FTC stood the test of turbulent times.

To the country’s great shame, one of the most important elements of New Deal liberalism, the Glass-Steagall Act, was killed under a Democrat, Bill Clinton, in 1999, and the nation has not yet paid the price of turning the banking industry and Wall Street loose on the American economy. (Clinton, caving in to the demands of Newt Gingrich, also permitted the beginning of the privatization of Medicare.)

The end of Glass-Steagall, which was murdered by Clinton’s banker, Treasury Secretary Robert Rubin and his sucessor, Lawrence Summers, was, in large part, what marked the decline of my brand of liberalism. Clinton, proud to be a centrist, had declared, “the era of big government is over.” And he hailed the end of Glass-Steagall giving a signing pen to Sanford Weill of Citigroup who gave the top job in the company to Rubin.

Thus, according to the acerbic journalist Chris Hedges, liberal government and governance of the robber barons had been replaced by the worship of Wall Street and corporatism. At the same time, as Robert Higgs wrote in a preface to Arthur Ekirch’s book, The Decline of American Liberalism,

“[L]iberalism once meant embrace of commerce and material progress, but this presumes an environment of peace and diplomacy as a means of resolving conflict...Liberals embraced militarism and dragged liberalism down with it. That dramatic shift led to the invention of this creature called conservatism.”

Hedges, a Pulitzer Prize winning former correspondent for The New York Times, goes further. He wrote for Truthdig on September 13,

“There are no longer any major institutions in American society, including the press, the educational system, the financial sector, labor unions, the arts, religious institutions and our dysfunctional political parties, which can be considered democratic.

“The intent, design and function of these institutions, controlled by corporate money, are to bolster the hierarchical and anti-democratic power of the corporate state. These institutions, often mouthing liberal values, abet and perpetuate mounting inequality....

(See the latest census figures documenting that inequality; the rich are getting very rich and the poor are mostly out of work).

“The menace we face does not come from the insane wing of the Republican Party...but the institutions tasked with protecting democratic participation....Do not fear the tea party movement, the birthers, the legions of conspiracy theorists...Fear the underlying corporate power structure, which no one, from Barack Obama to the right wing nut cases...can alter.”

He quotes my old friend, Ralph Nader:

“The corporate state is the ultimate maturation of American-style fascism. They leave wide areas of personal freedom so that people confuse personal freedom with civic freedom...But they do not have the freedom to participate in the decisions about war, foreign policy, domestic health and safety issues, taxes or transportation...

“[T]he price of the corporate state is a deteriorating political economy...the question is, at what point are enough people going to have a breaking point in terms of their own economic plight..to say, enough is enough.”

Hedges concluded:

“The failure of the Obama administration to use the bailout and stimulus money to build public works...has snuffed out any hope of serious economic, political reform coming from the corporate state...the rot and corruption at the top levels of our financial and political systems, coupled with the increasing deprivation felt by tens of millions of Americans are volatile tinder for a horrific right-wing backlash in the absence of a committed socialist alternative.”

Or the kind of committed, grass roots and trade union-based liberalism that has been part of the American tradition. Perhaps it lurks somewhere among the blogs. Perhaps.

TIME GOES BY | REFLECTIONS: On Liberalism

Recession deals a double blow to those both disabled and unemployed

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By Donna St. George Washington Post Staff Writer

If he had his wish, Alex Maltby would be working with autistic children as a classroom aide, the best job he ever had. Instead, he is at his mother's kitchen table in Silver Spring pondering job possibilities -- 33 years old and visually impaired, looking for a way to make a living. The search has gone on and on.


It is a brutal job market for many workers, but even more so for those with disabilities, who can struggle in the best of times. For them, the unemployment rate is now 14.4 percent -- 50 percent higher than it is for other workers, and the jobs gap is larger still because so many are not counted as being in the workforce.

"The job situations for many people with disabilities are more precarious and less stable," says John Butterworth, a senior research fellow at the Institute for Community Inclusion at the University of Massachusetts in Boston.
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TIME GOES BY | Reverse Mortgages – Part 2: The Basics

by Ronni Bennet

Because there are many small details to know about reverse mortgages and enough individual questions to fill a book, I am going to start broadly and drill down in subsequent posts so that we can absorb the needed information in bites (bytes?) we can easily digest.

Let's start today with a definition.

At least once in their lives, the majority of U.S. grownups go through the process of getting a traditional mortgage to pay for the purchase of a home. We pretty much understand what it is: a bank lends the money to pay for the property; the borrower repays the loan at an agreed-upon interest rate over a set period of years.

It is not much more complicated than that.

Although there are different requirements and more caveats associated with a reverse mortgage, at its most basic level, it is just that – the reverse of a traditional (“forward”) mortgage: a bank loan, secured by your home, that gives you regular payments or a lump sum based on the value of your home at the time the reverse mortgage is made.

Interest is charged on the outstanding balance which continues to grow, due to continuing interest, even when you do not take out additional funds. But you owe nothing, make no payments until the loan is due when you permanently move out of the home through a sale or death.

Eligibility Requirements

You (or the youngest borrower, if more than one) must be at least 62 years old.

You must have sufficient equity in your home to pay off any traditional mortgage with the proceeds of the reverse mortgage, a requirement to obtaining the reverse mortgage.

That's it. Income, health, credit rating or score are not considered.

Your Obligations

You are required to keep homeowners insurance and property taxes paid and to keep the property in good repair. Failure to do so can result in the loan being called due.

Remember, you continue to hold the title to your home and no matter what rumors you've heard or what others have told you, as long as you keep up those three obligations, you cannot be thrown out of your home. Also, you pay nothing until you sell or move out and you will never owe more than the value of your home.

Types of Reverse Mortgages

Reverse mortgages come with various interest rates and differing up-front costs. Some fees may he high, but the interest low and vice versa. One kind, called proprietary, is designed for people with extremely high-value homes offered by a few banks and other lending institutions. If you are rich enough to qualify for one of these, you're on your own. In this series, I am concerned only with HECMs because that is the type I am considering.

About 95 percent of all reverse mortgages are HECMs (pronounced HECK um by those in the business), the acronym for Home Equity Conversion Mortgages – administered by the Department of Housing and Urban Development (HUD) and insured by the FHA.

The FHA insurance protects the lender if the sale price of a home (when you move out) does not cover balance of the loan. It also protects you, the borrower, so that if the lending institution that holds your reverse mortgage files for bankruptcy or otherwise stops servicing your loan, your reverse mortgage will not be affected.

HECMs are as safe and secure as traditional mortgages and you should not be afraid of them. There was a time, early in the program, when large lenders with many kinds of financial products could give you a reverse mortgage with one hand and lock you into an inappropriate annuity, for example, with the other. But that is no longer allowed.

Problems today are not with the mortgage lenders, but with how people use the proceeds from the reverse mortgages. We'll talk about this in a future installment.

Benefits of a Reverse Mortgage

These are the five most common reasons people give for taking out reverse mortgages:

1. To pay for ongoing medical treatments, prescription drugs or a large, one-time medical bill


2. To make home improvements, modify a home for aging needs or pay off a traditional mortgage


3. To pay off large, high-interest debts


4. To take a long-awaited, lavish, dream vacation


5. To supplement Social Security and/or other monthly income

Number four seems a frivolous reason to take on large, expensive debt, but who is to say what is important to each of us.

Number five is my reason. As I explained in Part 1, the financial collapse of 2008 took a huge chunk of my savings and I don't have the stomach now to reinvest what remains, so my income is uncomfortably reduced.

For me, a reverse mortgage will provide a cushion to pay for future medical or other unforeseen needs and therefore return some of the peace of mind I lost in the 2008 crash. It also will give me some breathing room around normal expenses and, maybe, allow for some modest travel now and then which I can't otherwise afford. I don't have expensive needs so mostly, it's that peace of mind I'm going for.

Disadvantages of a Reverse Mortgage

There are good reasons to think very carefully before taking out a reverse mortgage.

If you were planning on leaving your home to the kids or grandchildren, they may not be able to afford to pay off the HECM after you die.

If you live alone and need to stay in a rehab, assisted living or nursing home for more than a year, you are required to pay off the mortgage.

Costs are high. They include all the fees you paid when you purchasedd your home (title search and insurance, FHA appraisal, document preparation, flood certification, credit report, etc.) plus an origination fee to the lender based on the appraisal of your home. The least it can be is $2,500 and there is an upper cap of $6,000. And there is the MIP - mortgage insurance premium - for the FHA mortgage insurance which is two percent of the amount of the reverse mortgage up front and, annually thereafter, one-half of one percent of the loan amount.

Usually, closing costs and fees are tacked onto the mortgage, but keep in mind that you pay interest on that money throughout the life of the loan in addition to the lender's ongoing service fe which is $30 or $35 per month.

Recently, lenders have been offering reverse mortgages with low or no origination fees and lower service fees. I'll look into this and let you know details as this series proceeds.

This is a general overview, the basic information needed to think clearly and rationally about a reverse mortgage. More next week. If I have been unclear, please leave questions in the comments. You can leave other questions too that you would like answered in future installments.

Reverse Mortgage Series
Part 1: One Reason For a Reverse Mortgage

TIME GOES BY | Reverse Mortgages – Part 2: The Basics

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Disability.gov: A New Federal/Private Model Promotes Financial Well Being for Americans with Disabilities

By Guest Blogger Dr. Johnette Hartnett, Director of Strategic Partnership Development, The National Disability Institute’s Real Economic Impact Tour and Burton Blatt Institute, Syracuse University

Imagine an unlikely partnership between federal agencies, private sector partners, universities and nonprofits, collectively championing the rights of taxpayers with disabilities.

Now, what at first seemed improbable has become reality. Over the past six years, the National Disability Institute’s Real Economic Impact Tour has established a groundbreaking federal/private model for promoting tax education and financial well-being to Americans with disabilities nationwide.

Thanks to key sponsors like Bank of America, AT&T, Walmart, Acorda Therapeutics, Inc. and others, we've delivered funding and asset-building programs to cities in all 50 states. Since 2005, our partnerships with the IRS and 100 community-based organizations have resulted in free tax filing assistance for more than 650,000 taxpayers with disabilities – representing more than $600 million in returns and more than $120 million in saved preparer fees.

Yet, while we’re pleased to celebrate the above milestones as part of the 20th Anniversary of the ADA, we know there’s much work ahead to ensure that all Americans with disabilities have access to the economic mainstream. Especially considering the following:

• 37 million Americans live in poverty, and 13 million are children less than 18 years of age
• 38 million Americans subsist on food stamps
• 50 million Americans, in any given month, are on Medicaid
• 57 percent of unemployed Americans receive unemployment compensation compared to 40 percent before the recession
• 61 percent is the increase in homelessness in America since December 2007
• 40 percent of Americans accessing food shelters and pantries are people on Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)
• 65 percent of Americans experiencing long-term poverty (greater than a year) are persons with disabilities

The above 65 percent translates into more than 54 million Americans – clearly, not a niche market. In fact, it's a market larger than the United States’ African-American, Latino and Gay markets combined; a market that wields 17 times the spending power of tweens 8-12 years old. It's a market not to be ignored.
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Bad Investment Advice Can Turn a Free Meal Costly - NYTimes.com

By MILT FREUDENHEIM

While the advisers deny misleading the Johnsons, Mrs. Johnson said she and her husband were not in a position to make well-informed decisions.

“We were frugal but not very smart about money,” she said. “We didn’t have the right knowledge to ask the right questions.”

The Johnsons, who were living on his retirement, lost most of their money. They were hardly alone.

“Financial fraud is the No. 1 consumer protection issue for AARP,” said Andres Castillo, who heads an AARP program that monitors free lunch seminars and similar presentations. In an AARP survey last year of people 55 and older, 9 percent said they had attended a free financial seminar within the last three years. That translates into approximately 5.9 million people, the group said.

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Reform Would Increase Healthcare Spending, But Millions More Would Have Insurance, Says RAND

by Janice Simmons, for HealthLeaders Media

In just over a week, congressional leaders will meet on Feb. 25 with President Obama in a televised healthcare reform summit

As a way of anticipating questions about the two reform bills passed last year by the House and the Senate, RAND researchers have been examining the impact of the bills, with a focus on access, quality, and cost.

Their analysis was done using "micro simulation" methods, which provide a "way of quantifying how well a policy option will achieve its goal," said Elizabeth McGlynn, associate director of RAND Health and co-leader of the RAND Compare initiative. These methods are similar to the methods "used by the Congressional Budget Office to provide Congress with estimates of the effects of proposed legislation on federal spending."
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10 things you need to know about Social Security - Burns on Business

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by Greg Burns

It is among the most popular and important social programs in America, yet many Americans have only a vague idea about how it works. What nearly every American knows is that it's in trouble.

"This program affects hundreds of millions of Americans," said Jason Fichtner, chief economist at the Social Security Administration. "They're paying for a system that they expect to be there for them."

Is Social Security going under? How could it be fixed? Should everybody worry?

This report addresses Social Security, explaining what you need to know and how the system may change in years to come. The good news: Social Security can afford to pay benefits for decades. The bad news: After that, without reform, it's up for grabs.
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Let’s Talk Health Care: Payment Reform and Unit Costs

by Bruce Bullen in Health Care Costs, Health Care Reform

The major driver of commercial health care premium increases is not the use of health care services, which accounts for less than a third of annual premium increases, but unit costs. In other words, the price of health care is driving up commercial costs more quickly than overutilization of services.
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American health care: What a waste | The Economist

From the Economist Print Edition

Barack Obama’s reforms should avoid squandering a rare opportunity, but probably won’t

LAST year, when he was still the head of the independent Congressional Budget Office, Peter Orszag used to warn bleakly that the rising costs of health care would, if not subjected to radical reform, one day bankrupt the government. Over the past few decades, these costs have risen at a consistent 2.5 percentage points above the growth rate of the economy. Projected out to 2050, he reckoned, Medicare and Medicaid (the government schemes that insure the elderly and the poor) would together consume some 20% of America’s GDP, almost as much as the entire federal budget of today.

Perhaps Mr Orszag, now the budget director in Barack Obama’s White House, is about to storm out of his grand new office. For the health bill that this week moved a big step closer to Mr Obama’s desk (see article) fails—not completely, but very largely—to address the government-exploding problem of cost inflation. Instead, its focus rests squarely on the long-cherished Democratic Party goal of making sure that virtually everyone in America has some form of health coverage; at the moment, over 46m people have none. Even on this score, the plan that finally emerged from the Senate Finance Committee on October 13th looks incomplete . . .

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The Sunstein-Thaler Version Of The Public Option? | The New Republic

Suzy Khimm

The Huffington Post has broken the news that yet another incarnation of the public could be coming into favor with Senate Democrats: a plan that would begin with a robust, national public plan, but allow state governments to “opt out” of the system should they chose. It’s worth noting that the compromise carries echoes of the Cass Sunstein-Richard Thaler school of policy design—the government would try to nudge things in the right direction by making the public plan the default option, but gives states the ability to opt out if they had the impetus, energy, and will to exclude themselves. It seems like the kind of choice that might appeal to Peter Orszag, the White House’s resident disciple of behavioral economics.
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Report Paints Dark Picture of Health-Care Costs in 2019 - Health Blog - WSJ

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By James A. White

f you think U.S. health-care spending is out of control today, just wait a decade. A report out today gives a state-by-state projection that concludes of how the number of people without health insurance will increase, spending on Medicaid and children’s health-care programs will balloon and out-of-pocket health costs for individuals and families will jump.

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Health Reform: ‘Income Redistribution’ or Safety Net? - Health Blog - WSJ

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By Shirley S. Wang

Efforts to provide universal health insurance will result in higher premiums for the young and healthy in order to subsidize the older and sicker, according to an op-ed piece in today’s WSJ.

Such a move is essentially income redistribution, argue the authors Michael Leavitt, former secretary of Health and Human Services, and Al Hubbard and Keith Hennessey, who both served as past directors of the White House National Economic Council.
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The Health Care Blog: Health care reform: econo-think, democracy and sustainability

By LAWRENCE W. ARRINGTON

Most Americans place high value on our economic system with its emphasis on free enterprise, entrepreneurship and competition. But history teaches there are circumstances when public interest must be protected against business practices that damage society, the natural environment or the economy.

Sustainability provides a superior moral compass that stands in contrast to econo-think, and enables us to recognize that we live in a society and a natural world as well as in an economy.

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How Does Baucus Protection Stack Up? | The New Republic

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by Jonathan Cohn

One of the big questions about the Baucus proposal is affordability--that is, what protection it provides and at what cost. The best answer I've seen, so far, comes from Nicholas Beaudrot. He had the good sense to compare the provisions of the Baucus bill to those now available in Massahcusetts, under its newly reformed system. Better still, he put the results on a chart:

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The Health Care Blog: Getting Rid of “Friction” in Health Care

By FLETCHER LANCE

Friction occurs when an object moving through space encounters resistance, slows down and has its forward energy diverted. In the world of health care, friction is a term that has become synonymous with paperwork.

Today, the U.S. spends $2.3 trillion on health care, and the U.S. Health Care Efficiency Index estimates that we could reduce this cost by $30 billion if we could eliminate the friction of phone-based and paper-based systems.

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StumbleUpon WebToolbar - It’s Time for a Better Poverty Measure

By Mark Greenberg
The federal poverty measure shapes our understanding of how many people are in poverty, who is in poverty, and how much poverty goes up or down when economic conditions and policies change. But the official measure is deeply flawed. The dollar figures used to determine if families are in poverty are low and in many ways arbitrary. The rules don’t consider some resources, such as tax credits and food stamps, and some key family expenses that determine a family’s available income. As a result, the poverty measure often doesn’t show the impacts of important policies that are intended to improve the economic well-being of families. It needs to be updated and improved.
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Fiscal Responsibility and Health Care Reform | Health Care Reform 2009

Robert A. Levine, M.D. in NEJM
It has been clear for some time that the primary hurdle to enacting health care reform is figuring out how to pay for it. Virtually all Republicans and some Democrats have been unwilling to sign on to increasing taxes on high-income Americans as a partial answer. The idea of taxing the most generous health insurance benefits has met with resistance as well. The use of electronic health records and an emphasis on prevention and early treatment of illnesses have been ballyhooed as ways to generate savings to help pay for reform, but there is no solid evidence that these measures will reduce spending anytime soon, although they might improve care. Unfortunately, legislators are ignoring the option of funding reform by harvesting available savings from within the health care system itself. I believe Congress must go back to the drawing board. Given the state of the economy and the continuing rapid growth in health care expenditures, lawmakers need the political will to devise a plan that will control accelerating costs and be budget-neutral — and to disregard the expected backlash from stakeholders (organized medicine, the insurance companies, the pharmaceutical industry, and the trial lawyers) and an uninformed public.
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