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Monday, March 28, 2011

Billionaire self-pity and the Koch brothers


Glenn Greenwald


Drill, Brazil, drill, says the U.S.


WHEN WAS the last time an American president stood before an audience in a foreign country and announced that he looked forward to importing more of its oil? Answer: Just over a week ago, when President Obama joined political and business leaders in Brasilia in hailing the fact that their newly discovered offshore petroleum reserves might be twice as large as those in the United States. Americans “want to help with technology and support to develop these oil reserves safely, and when you’re ready to start selling, we want to be one of your best customers,” Mr. Obama said.
Brazil is probably a more stable, secure supplier than, say, Libya. Still, the president’s words were ironic. Brazil already produces vast quantities of a fuel — ethanol — that the U.S. government, under a policy long supported by presidents and farm-state members of Congress from both parties, has promoted as a green alternative to gasoline. But the United States, protecting its own heavily subsidized ethanol industry by means of a 2.5 percent tariff and a 54-cent-per-gallon duty, prevents Americans from importing all but trivial amounts of the stuff from Brazil. Therefore, we need more oil — much of it imported. In Brasilia, Mr. Obama spoke of strengthening U.S.-Brazilian technical cooperation on ethanol but did not propose allowing U.S. protectionist measures to lapse after their scheduled expiration on Dec. 31.
As for offshore drilling, Mr. Obama’s enthusiasm for punching holes in the ocean floor off Brazil is hard to reconcile with his decision, announced Dec. 1, to keep the waters off the East and West coasts and the eastern Gulf of Mexico off-limits to exploration indefinitely. His policy was a reversal of an earlier decision he had made to open some of those areas. We can understand that reversal, after the massive oil spill in the western Gulf last year. And, demonstrating a measure of flexibility even after the disaster, the administration has announced five deep-water drilling permits in the western Gulf since the spill.
The vast majority of U.S. shores, however, have remained off-limits for decades. This, too, is a policy made by two parties, with Republicans opposing drilling when it suited them; President George W. Bush prevented drilling off the Florida Gulf Coast in part to boost his brother Jeb’s 2002 run for a second term as governor. But it is tough to reconcile with U.S. eagerness to “help” Brazil pump oil off its coasts and ship it here. U.S. companies, enticed by government loan guarantees, are already lined up to sell Brazil drilling equipment and services. Forget the implications for U.S. dependency on foreign sources. What does this posture say about American regard for the natural environment outside U.S. territory?
Privileged residents of scenic landscapes in America have long cried “NIMBY” — “Not In My Back Yard” — to stave off unwanted but necessary projects, from railway tracks to wind farms to power lines. Now NIMBY-ism, it seems, has become U.S. policy on offshore oil production. But the Nigerias, Angolas and Brazils of the world do not have that luxury. This makes no sense, economically or environmentally, and, sooner or later, a more balanced view must prevail.

Rhode Island's Medicaid Lesson

 MARCH 28, 2011

A case study in how waivers for state innovation can work.

Medicaid is the major cost driver in state budgets these days, so several Governors have proposed a deal to the White House and Congress: They'll take less money in return for the flexibility to run the program with fewer federal strings. A case study in the potential benefits is coming from liberal Rhode Island, of all unlikely places.
Here's the story: In 2008, then-Governor Don Carcieri asked Washington for a Medicaid waiver and block grant to reform a program that consumed 30% of its budget. The state encountered months of federal foot-dragging and, according to one of Mr. Carcieri's deputies, at one point a health administrator in Washington asked: "If you get this waiver, what will our job be?" In January 2009 during the final days of George W. Bush's Presidency, the feds finally gave the Ocean State a sweeping Medicaid waiver.
Rhode Island agreed to a global cap on expenditures over five years of $12.075 billion in exchange for broad reform authority. The waiver is not a pure block grant, because the state agreed not to drop coverage for anyone eligible under federal Medicaid rules and retains the federal-state cost sharing for Medicaid expenses.
The results? After 18 months, Rhode Island's Medicaid spending, which was projected to reach $3.8 billion, has declined to $2.7 billion, according to a report by Mr. Carcieri's Office of Health and Human Services. The state implemented a blizzard of reforms, including wellness programs, co-payments, audits of hospitals and nursing homes, fraud prevention, and letting seniors move from nursing homes into home and community care. The state has also saved a bundle by replacing federal "any willing provider" rules—which require that Medicaid dollars flow to any federally approved doctor or hospital regardless of cost—with competitive bidding.
Not every Rhode Island reform has worked, and some critics question whether the savings are as large as advertised. The state HHS is studying that issue now. But what almost no one challenges is the improvement in the quality of patient care.
The Providence Journal investigated the program and acknowledged last year: "To the surprise of many, everyone involved seems satisfied with the way the state's much-debated 'global Medicaid waiver' is working—at least for now."
Kathleen Connell, the head of Rhode Island AARP, says her group supports the waiver because "Seniors have absolutely benefited from being moved out of nursing homes into home and community-based care. The program is moving in the right direction for seniors."
Steven Costantino, the state's new Medicaid director and former Democratic chairman of the state's House Finance Committee, says "The trend rate of spending [in Rhode Island] has been 7.6% per year, and that's not sustainable. I do believe that the waiver offers us the flexibility to make the necessary policy changes to transform the system."
That isn't what liberal advocacy groups said when they ran ads showing Mr. Carcieri pushing seniors in wheel chairs down the stairs. The usual suspects in the poverty lobby called the waiver "radical," "ideologically driven," and setting a "dangerous precedent" by capping expenditures.
Liberals also claim that $400 million in stimulus cash saved Rhode Island Medicaid's program, not the waiver. But that ignores that the stimulus has forced Rhode Island and other states to spend more on Medicaid because of "maintenance of effort" rules that forbid states from cutting the program. The Obama Administration also insisted that Rhode Island drop its plans for medical savings accounts for Medicaid patients, which also might have saved money.
Rhode Island's experiment highlights the perverse Medicaid incentives that could be fixed with a more complete block grant. The states and the feds share the cost of Medicaid, with the federal government covering between 50% and 70% of a state's Medicaid bills. This rewards states for wasting health-care dollars, because every dollar spent brings another 50 cents or more via taxpayers from other states. Spending caps can be abused when they are used to limit care, but combined with flexibility in this case they improve care.
At least a half a dozen Governors are now asking Washington for a Rhode Island-style waiver, including Haley Barbour of Mississippi, Tom Corbett of Pennsylvania and Rick Scott of Florida. Waivers like this are how Governors like Tommy Thompson of Wisconsin and John Engler of Michigan led the way in reforming welfare in the 1990s. If Congress and the White House are serious about reducing the cost of entitlements, they'll grant a Rhode Island-style waiver to any state that requests one.

Opinion Journal: Politics of a Government Shutdown

 3/28/2011 5:05:02 PM

OpinionJournal.com columnist John Fund on Washington's showdown over spending.

Opinion Journal: How Do We Pay for All This?



 3/28/2011 12:57:00 PM

OpinionJournal.com columnist John Fund breaks down the Libya budget math and Washington's showdown over spending

The Libya Mission Was 'Never About Regime Change'


Defense Secretary Gates says Iran isn't winning in the Middle East and explains why he regrets a much-quoted line in his recent speech at West Point.

 

Aboard the National Airborne Operations Center


Robert Gates is a compact and unassuming man, but a U.S. secretary of defense does not travel in compact or unassuming ways. The National Airborne Operations Center, a.k.a. the "doomsday plane," is a giant, windowless fortress of an aircraft built during the Cold War and designed to survive a nuclear war. In just five days the 67-year-old secretary has flown it to St. Petersburg, Moscow, Cairo, Tel Aviv (with a stop in Ramallah) and Amman, and held parleys with two presidents, three prime ministers, three ministers of defense and a king.






By the time it's my turn to step into the plane's conference room, Mr. Gates, tieless and in blue jeans, looks bushed. He has just wrapped up a nearly two-hour phone call on Libya with President Obama and the National Security Council. NATO is about to assume primary responsibility for enforcing the no-fly zone. Benghazi has been saved by Western intervention, but it's far from clear whether other besieged cities will have equal luck.


I begin by asking Mr. Gates the same question House Speaker John Boehner recently put to Mr. Obama: Is it acceptable for Moammar Gadhafi to remain in power after the military mission concludes?


"This mission was never about regime change," Mr. Gates says. "Certainly it was not one of the military objectives." He recites the mandate of U.N. Security Council resolutions—to establish a no-fly zone and protect civilians—and concludes: "I think we've come pretty close to accomplishing those objectives."


Does that mean "Mission Accomplished"? Even as we spoke, the besieged Libyan city of Misurata was without water and electricity and running low on food and medicine. Yet Mr. Gates is sanguine, though perhaps less about the outcome for Libya than for the U.S. The imposition of the no-fly zone, he says proudly, was "a textbook case."


He appears even more pleased by the benefits to the Pentagon of the transition to NATO control: "The resources that we're going to commit to it are, I think, almost certainly going to diminish," he says, describing a U.S. support role that includes "electronic warfare" and "tanking fighters [aerial refueling] from other countries."


But where does all this leave the Libyan people? Twice Mr. Gates stresses that "at the end of the day this needs to be settled by the Libyans themselves," adding that "I don't think we ever had illusions about the ability to reverse the gains [Gadhafi had made] on the ground, other than stopping him from doing more and stopping him from slaughtering civilians." But he also says that if Gadhafi "were to send a big column toward Benghazi there would be the authority to take it out." The suggestion here is that NATO will not do very much to help the rebels to win, but it will backstop them to keep them from losing.





Zina Saunders







It's hard to deny the virtues of this approach: It does not overcommit the West, either militarily or financially; it stems the bloodletting even if it doesn't halt it; and it asks the Libyans to win their own freedom. But it's equally difficult to deny its drawbacks, not the least of which is that the longer Gadhafi hangs on to power the longer the crisis will roil Western politics and consume Western resources.


Here again Mr. Gates seems fairly optimistic. "The idea that [Gadhafi] needs to go . . . goes without saying," he says. "But how long it takes, how it comes about, remains to be seen. Whether elements of the army decide to go to the other side, as some small elements have, whether the family cracks—who knows how this is going to play out."


He is less persuasive when he starts naming the various nonmilitary tools, such as economic sanctions and indictments from the International Criminal Court, that the West could use to bring further pressure on Gadhafi. Saddam Hussein survived a dozen years under sanctions and a no-fly zone, and Sudan's Omar Bashir has more or less laughed off the ICC indictments against him for genocide.


A larger consideration for Mr. Gates is how the crisis in Libya fits into American interests. "There are American national security interests and American vital interests where, in my view, we need to act decisively and if necessary act unilaterally," he says. "This is not one of them."


Then again, neither does Mr. Gates think that the crisis in Libya amounts to little more than a strictly humanitarian tragedy, on a par with, say, last year's earthquake in Haiti. "It is a concern of ours if more than a million Egyptians in Libya decide they have to immigrate home. It is a concern if civil war contributes to destabilization in either Tunisia or Egypt." Libya, he concludes, "is not a vital national interest of the United States. But it is an interest."


Mention of Egypt turns the interview to the broader changes throughout the Middle East. Mr. Gates call them "tectonic . . . frozen for 60 years and now all of a sudden they're all moving." His counsel is to deal with countries as they are and situations as they come—"our reaction in Libya will be very different than our reaction in Tunisia or in Egypt or Bahrain"—but he also sees lessons.


"Maybe the Syrians can take a lesson out of what happened in Egypt, where the army stood aside and let the people demonstrate," he says when I ask what he makes of the growing domestic opposition to the regime of Bashar Assad. But as for whether he would favor regime change in Damascus, he strikes a more cautious note: "No, I'm not going to go that far."


Mr. Gates also rejects the view that the ultimate winner from the upheavals throughout the Middle East is Iran. He notes the "very stark" contrast between the "repression of any dissent, any protest, compared with what is going on in any number of other countries in the region." Over the longer term, he says, "this is a hugely negative message in terms of Iran and what Iran is trying to do."


Still, Mr. Gates awards the Biggest Loser trophy to al Qaeda, which he believes is "being rendered irrelevant, at least in a political sense." Al Qaeda's basic political pitch, and the source of its popular appeal, rests on the idea that the only way of replacing corrupt Muslim governments with better ones is through violence. Now, the examples of Tunisia, Egypt, Jordan and elsewhere "show that these are countries that are tolerating demonstrations." In that sort of atmosphere, Mr. Gates seems to think, the appeal of the bullet or bomb is bound to wane, while the appeal of the ballot box will grow.


More Gates optimism. Is it justified? Al Qaeda has never lacked for excuses, or recruits, to mount terrorist attacks, whether against despotisms or democracies. In Egypt, last week's referendum on a package of constitutional reforms that pave the way toward early parliamentary and presidential elections was a huge win for the Muslim Brotherhood, which stands to gain from going to the polls before its secular opponents can organize. The Iranian "political model" may be out of vogue on the Arab street, but that doesn't mean that all of Tehran's regional ventures—including support for Hamas in Gaza and Hezbollah in Lebanon—are unsuccessful or unpopular.


As our interview nears its end, I turn to a speech Mr. Gates gave last month to the cadets at West Point. In widely quoted remarks, he said that "Any future defense secretary who advises the president to again send a big American land army into Asia or into the Middle East or Africa should 'have his head examined,' as Gen. MacArthur so delicately put it." I ask him whether that line should be taken to suggest that the United States should never have entered the wars it is fighting in Iraq and Afghanistan.


"To tell you the truth, I wish I hadn't even had that sentence in the speech," he confesses. "I should have taken it out because it was a distraction from the larger message in the speech, which was the importance of the flexibility of the American military to deal with a range of threats."


Mr. Gates clearly seems pained by the subject and eager to clear the record. "I'm the guy who not only increased the end strength of the Army and the Marine Corps, but pressed for the increase in the number of troops in Afghanistan. I totally believe in the mission that we're in in Afghanistan. And so, you know, I was really dismayed to see that what I had said was interpreted as questioning the mission in Afghanistan, because I absolutely do not. I totally believe in it."


Again, Mr. Gates circles back to his point: "I believe we have a winning strategy. So I am totally committed in that respect. And just to repeat, I was just really dismayed that what I said was misinterpreted that way."


Mr. Gates has made it clear that his tenure as secretary will end this year, and his trip last week—particularly in St. Petersburg, where he addressed naval officers and reminisced about the Cold War—had a wistful, valedictory quality. It seems appropriate to ask him to define his legacy.


"I have a feeling I'm going to get asked this question a lot," Mr. Gates says, laughing.


His answer comes in two parts. "When I took this job," he says, "everybody—meaning journalists, politicians and so on—had said I would be judged on the outcome in Iraq, and I testified my agenda in this job is Iraq, Iraq, Iraq. And so I think that the partnership with [Gen.] Dave Petraeus and having Iraq be the place it is—that'll be one of the principal evaluations that I think are made of my time in office."


Then he comes to the second part: "The thing that would mean the most to me when I leave this job is if those kids in uniform remember they had a secretary of defense who, from the first day, they knew had their back."


Mr. Stephens writes the Journal's Global View column.

Republicans Are Winning the Budget Fight


Some of the most disgruntled folks in Washington these days are conservative Republicans in Congress. They believe their party has abandoned the cause of deep spending cuts that spurred the Republican landslide in the 2010 midterm election. They say their leaders are needlessly settling for small, incremental cuts.
Moreover, this demand for bigger cuts and defunding of liberal programs—immediately—comes from prominent members of the House, not just excitable freshmen. "This is our mice or men moment," according to Rep. Michele Bachmann of Minnesota. Allowing Democrats more time to negotiate "will only delay a confrontation that must come," said Rep. Mike Pence of Indiana. Rep. Jim Jordan of Ohio, chairman of the House Study Committee, added: "We've made some solid first downs. Now it's time to look to the end zone."
The end zone is far away, however, and impatience won't get Republicans there. Impatience is not a strategy. It may lead to a government shutdown with unknown results. To enact the sweeping cuts they desire, Republicans must hold the House and capture the Senate and White House in the 2012 election. Then they'll control Washington. Now they don't.
In the meantime, the incremental strategy is working. Republicans have passed two short-term measures to keep the government in operation since early March while slashing $10 billion in spending. At this rate, they would achieve the target of GOP congressional leaders of lopping off $61 billion from President Obama's proposed budget in the final seven months of the 2011 fiscal year.
Martin Kozlowski
There's every reason to believe the incremental strategy would continue to succeed. Democrats are flummoxed by it. They'd like to block more cuts, but they've been unable to explain why spending reductions of a few billion dollars at a clip are unacceptable. Senate Majority Leader Harry Reid tried, only to embarrass himself by saying Nevada's cowboy poetry festival might be jeopardized. Mr. Obama has prudently declined to wade in.
Democrats have themselves to blame for their predicament. They failed to pass a 2011 budget last year, and this year Republicans are taking revenge. By sticking together at the lame duck session in December, Senate Republicans managed to keep spending at last year's levels. Now the GOP is cutting from that baseline.
The latest extension expires on April 8, around the time Paul Ryan, chairman of the House Budget Committee, releases the Republican budget for 2012—giving the GOP another opportunity for a serious whack at spending. And in May or June, Mr. Obama will ask for a hike in the debt limit, one more juncture at which Republicans can press for spending cuts and budget reforms.
Nevertheless, Republican dissidents fear jumbling proposed budgets with the debt issue will confuse voters and allow Democrats to block cuts. It might. At the same time, Republicans would be looking at a target-rich environment for cuts that reduce the size and reach of Washington. This is all the more reason for the GOP not to provoke a government shutdown. Yet dissatisfied Republicans are willing to risk one by opposing further short-term extensions of spending. Fifty-four House Republicans voted against the three-week extension passed on March 15. "Nobody wants a government shutdown, but unless we take a stand, we will shut down the future of our children and grandchildren," Mr. Pence said.
Would a shutdown give Republicans more muscle in negotiating for cuts? Some Republicans speculate it would "clarify" the sharp differences between what Republicans are seeking and what Democrats want, prompting most Americans to side with Republicans. Maybe it would. But it might not.
One thing Republicans know for sure is how to cause a shutdown: Demand more than Democrats will ever agree to. So long as they control the Senate and White House, Democrats will reject massive cuts. Republicans also want to bar spending for Planned Parenthood, the Corporation for Public Broadcasting, and Mr. Obama's health-care program. Attach any of these prohibitions to a spending measure and Democratic opposition is certain. Should Republicans insist, we'll get a government shutdown.
This is a big gamble. While some Democrats are leery of the political reaction in the country at large, others see it as their best hope. Indeed it might discredit Republicans and boost Mr. Obama in the same way the shutdown in 1995 hurt Republicans and lifted President Bill Clinton out of the doldrums. It could alienate independent voters so critical to the Republican triumph in 2010.
True enough, the political atmosphere is more favorable to serious spending reductions than it was 16 years ago. And though Mr. Obama has the biggest megaphone, he's often unpersuasive. So a shutdown might be easier for the public to swallow today. But why take a chance?
One answer: A good chunk of the conservative movement is egging Republicans on. The House speaker has been accused of playing a weak hand. "I think John Boehner has basically climbed into the Bob Dole suit," columnist Mark Steyn told talk radio host Hugh Hewitt. "Arguing over itsy-bitsy, half a billion here and half a billion there . . . is preposterous."
But it may not be if it's the most you can get under current circumstances. What's unsatisfying to many conservatives is most likely the best Republicans can achieve in 2011. "Public opinion seems to support Republican efforts to cut spending without shutting down the government," notes Keith Hennessey, former domestic policy adviser to President George W. Bush, and some recent polls back him up. Mr. Hennessey supports a gradualist strategy. "Don't change tactics," he says. "Just ratchet up your demands a little."
That makes sense. What doesn't is sacrificing spending cuts you can get on the altar of those you can't.