The Indy Star (and lots of others) are reporting that the Senate has passed a health care bill. It still needs to be reconciled with the House bill. In all likelihood, the final product will look more like the Senate bill. The liberal Democrats and the Blue Dog Democrats are like a dysfunctional couple. The person who wants the relationship least has the most power. The Blue Dogs are the most satisfied with the status quo and, therefore, have enormous leverage. This is Joe Lieberman and Ben Nelson’s bill. The Republicans have chosen not to have a role in shaping the policy because they would rather have the health care bill as a campaign issue than help craft its contours. Any Senate Republicans who chose to break ranks would have a lot of power to demand changes of various kinds and would, at the same time, reduce the leverage of Lieberman and Nelson.

I’m torn. The status quo is broken. As a nation, we spend an average of $7,200 per person per year on health care compared to about $3,600 in countries with health care models that are “too expensive.” We spend 16% of our GDP compared to much less in other countries. Our pricing system is opaque. We will provide charity care when people show up at the emergency room with critical, expensive health problems; but there is no real process for treating people earlier in their illnesses when outcomes could be better and cost less. There is every incentive for someone facing a ruinous health care bill to try to cast blame on someone else and litigate in efforts to get their bill paid rather than lose their house or file bankruptcy.

On the other hand, the “fiscal conservatives” have seemingly opposed most of the measures that could be expected to contain costs. There is no public option to hold the profit-motive of insurers in check. There is no provision for the government to negotiate rates with pharmaceutical companies.

What I fear is a forced transfer of wealth from the public to insurers with no reduction in health care costs or improvement in treatment or outcomes, just another one of Taibbi’s great vampire squids wrapped around the face of humanity.

Still, I get the sense that the Senate bill is essentially as good as it’s going to get. It’s either that or the status quo. Which is preferable?

I won’t comment too much on this since I’ve been known to practice a bit of hog-related litigation, and if this ends up being as big as the article hypes it up to be, I guess it’s not out of the question that I could get drawn into it one way or another.

But, Seth Slabaugh, writing for the Muncie Star Press reports on “multiple lawsuits” that are planned by individuals seeking to challenge the confined feeding business model.

Neighbors who are fed up living next door to factory farms have found three high-powered trial lawyers who vow to make Randolph County “ground zero” in a courtroom food fight over how Indiana produces pork and milk.
. . .
The trial lawyers are bringing multiple lawsuits challenging Indiana’s industrial or factory model of producing milk and pork in concentrated animal feeding operations (CAFOs) promoted by Gov. Mitch Daniels’ agriculture department.
. . .
The defendants include Vreba Hoff Dairy, an Ohio-based firm that has brought large Dutch dairy farms to Indiana, Ohio and Michigan; Maxwell Foods/Maxwell Farms, a leading, North Carolina-based pork producer that has been expanding into Indiana; Harrisburg, Pa.-based pork producer Country View Family Farms, and various local operators. Most of the cases are being filed in Randolph County, though one is being filed in federal court in Indianapolis.

I was researching something and stumbled across some more florid than usual language by Judge Mote in an Indiana Supreme Court case from 1967:

This Nation and its local units of government have come upon hard times. Depressions, wars, lack of exercise of governmental talent, political, social and economic maneuvering have taken their toll. Increased spending, waste and outright mismanagement, or worse, by the Central Government almost have crushed the back of the American taxpayer in attempting to satisfy the voracious appetite of the bureaucrats who appear to have produced a super government and have become untouchable. As a result, the physical plants of our local governmental units-our schools, highway systems and streets, public buildings, sanitation departments, water resources and almost every enterprise of such nature-are completely inadequate or worn out. Necessity for finding new means of providing continuously inflated dollars to maintain and improve the local public facilities for an ever expanding and demanding population has created almost insurmountable problems. The final outcome may be doubtful, but we now find ourselves on a treadmill from which there appears to be no escape until and unless the hearts and minds of men and women resolve honestly and sincerely, with a really dedicated purpose, affirmatively to do whatever may be necessary to halt the changes in governmental concept now so apparent to objective thinkers. This will not be easy; it will be worth the effort.

Hawkins v. City of Greenfield, 230 N.E.2d 396, 411 (Ind. 1967).

The case was brought by a taxpayer seeking an injunction against Greenfield and its Economic Development Commission preventing the appropriation of funds for the economic development commission, the issuance of economic development bonds, and a variety of other expenses associated with the economic development commission. The Court refused to grant the injunction finding that the economic development activity was within the authority granted by the legislature and not in violation of the Indiana or U.S. Constitutions.

The Associated Press has an article on an Indiana Department of Correction program administering a federal grant to train inmates as coal miners.

Vincennes University will hold coal mining classes for three to 15 students at the medium-security Branchville Correctional Facility in southern Indiana.

The state Department of Correction said the school will offer classes in underground and surface mining. Prison staff will review inmate records and assess career interest surveys to determine which offenders can participate.

I don’t know that coal mining is the most flexible skill set you could give a guy, but it is important to make sure prisoners are employable when they get out. I say this, not out of sympathy for them especially, but because the rest of us are better off when folks who are willing to commit crimes when they get desperate have some chance of becoming productive members of society instead. Additionally, it seems to me that a fair amount of these folks get into trouble simply because their lives are so chaotic. Jobs provide structure for those who can muster up the discipline to stick with them.

Time has labeled the 00s as the Decade from Hell. And, for the U.S. on a macro level, that’s pretty accurate. As the article points out, the economy was book-ended by recessions, we inflicted that god awful 2000 election upon ourselves, we lost the World Trade Center and 3,000 lives on 9/11/01, Katrina mostly destroyed New Orleans, we invaded Iraq for no good reason, and our economy continued to rearrange itself in less than pleasant ways – housing bubble burst, some enormous Ponzi schemes, and general high level looting. It was bad enough that Anthrax and Afghanistan almost became afterthoughts.

Nevertheless, I can’t help but look at how my own life has changed in the last decade and call it a win for me personally. I married well and became the father to two wonderful children. I became a partner in my small law firm. I became a home owner. I started this blog. I ran a couple of half marathons and climbed a couple of 14ers. Those are the highlights. Sure, there has been day-to-day frustration, and I’m certainly omitting any number of life’s small joys which are probably more important, ultimately, than some of the benchmarks.

So, there you have it, the aughts were generally a bad decade for America and a good decade for me. Stealing a page from Sen. Franken, maybe we should make the 10s the Masson Decade and see where that takes the country? Probably a bad idea.

Indiana is the 47th happiest state.

A new study found that a person’s self-reported happiness matches up with objective measures of state-level happiness.

The results are based on an examination of two data sets, one that included personal reports of happiness for 1.3 million Americans and the other that included objective measures, such as how crowded that state is, air quality, home prices and other factors known to impact quality of life.

Less happy: 48. Michigan; 49. New Jersey; 50. Connecticut; 51. New York. (There are 51 because D.C. (#37) is included. The happiest states: 1. Louisiana; 2. Hawaii; 3. Florida; 4. Tennessee; 5. Arizona.

Reverent & Free flags a Kevin Leininger column about an applicant to the Indiana bar who is apparently being denied admission based on mental illness manifesting itself in the form of zealous religious beliefs. Leininger says it raises “alarming questions.”

I disagree. The questions are only alarming if Leininger is suggesting there is no fundamental difference between mental illness and deeply held religious belief. Leininger seems to be suggesting that, when mental illness masquerades as religious belief, the bar admission process should ignore it.

The headline – “Hospital: Solve bigger problem // Medicare payment system is broken, Reid chief says”

From this headline, I took away that the hospital executive said that Medicare was the problem. What he (Reid Memorial Hospital President Craig Kinyon) actually said was:

KINYON: We have gone from trying to fix the uninsured, to expanding Medicare, and we still have a broken Medicare system of reimbursement. Uninsured (bad debt and charity care) are about $36 million a year at Reid. Health care reform costs to fix this nationally are about $1 trillion. Medicare and Medicaid write-offs, NOT paid by Medicare/Medicaid and/or the patient are over $180 million per year.

There is NO mention of relief for this bigger and out of hand problem.

For the insured patient, 47 cents on every dollar we charge goes to pay for Medicare/Medicaid, bad debt/charity writeoffs.

So, what he actually said, apparently, was that when lumped together Medicare, Medicaid, bad debt, and charity adds $0.47 to the cost of privately insured patients. We don’t know whether Medicare is a substantial factor in this write-up. (It’s kind of like the joke about how, when Bill Gates walks into a bar, the average patron is worth millions.) If, for example, Medicare was a small part of the problem in the equation, and the uninsured were a big part of the problem, then moving a bunch of the patients from the “uninsured” column to the “Medicare” column, that $0.47 would go down.

And if Medicare is such a problem, I guess I don’t understand why every medical provider doesn’t opt out, charge the remaining patients 1/3 less, and corner the market.

For some reason, the Reel Big Fish song, “Sell Out” is going through my head.

Sell out, with me oh yea, sell out, with me tonight
Record company’s gonna give me lots of money
and everything’s gonna be (all right).

Matt Taibbi notes that the evidence suggests single payer as the solution to most of the bigger problems with our health care system but that was off the table from the start, for some reason. Apparently the Democrats thought they could start in the middle and negotiate down from there. In any case, he further notes that one of the biggest complaints about the system is bureaucracy and paperwork. The proposed compromise seems to do exactly nothing about that.

[T]he name of this game is passing something the Obama administration can call health care while preserving massive subsidies to the insurance and pharmaceutical industries. In that regard, the government under the new plan will continue to be barred from negotiating bulk rates for pharma purchases for Medicare, while insurance companies won’t have to trim profits or paperwork to compete with a real public option. The Obama administration also recently reversed itself on yet another campaign promise and decided to come out against plans to allow pharma purchases from Canada, further protecting the pharma industry.

So the old system of inefficient bureaucracies and artificially high prices has basically been completely protected.
. . .
If expanding Medicare is good for people aged 55 and up, why isn’t it good for everybody? Why isn’t it a good idea to provide cheaper insurance for people in their preventive care years, so that they cost Medicare less as they do get older?
. . .
This isn’t a health care strategy, it’s a big baby that’s been hacked up into parts and fed in descending size order to the administration’s weightiest political lobbies.

Angela Mapes Turner, writing for the Fort Wayne Journal Gazette, has an article reporting that Indiana has the third lowest threshold in the country for taxing low income families.

The state’s income tax threshold last year for a two-parent family of four – the lowest income at which a family has state income tax liability – was $15,500, third lowest in the nation.

A two-parent family of four at the federal poverty line, or earning $22,017, owed $263 in Indiana income tax last year. That same family would have owed $214 in Illinois, $168 in Ohio and $89 in Kentucky, according to the report.

Alabama taxes low-income families the heaviest. The system starts to look dysfunctional in those situations where you tax their income on one hand but then turn around and provide subsidies on the other, through food stamps, medicaid, TANF, or whatever.