Monday, February 22, 2010

Government of the corporations, by the corporations, and for the corporations

More than $3.47 billion was spent lobbying the Federal government in 2009, often driven by political issues central to the age: health care reform, financial reform, energy policy. That’s more than a 5% increase over $3.3 billion worth of federal lobbying recorded in 2008, the previous all-time annual high for lobbying expenditures.

In the 4th quarter of 2009, lobbying expenditures increased nearly 16 percent over 4th quarter levels from 2008. Those 4th quarter expenditures marked the first quarter in U.S. history that federal lobbying expenditures cracked the $900 million mark, hitting a record $955.1 million for the quarter.

At nearly $266.8 million, the pharmaceutical and health products industry’s federal lobbying expenditures not only outpaced all other business industries and special interest areas in 2009, but stand as the greatest amount ever spent on lobbying efforts by a single industry for one year.

Photograph shows the D.C. lobbying and law firm Patton Boggs New York office at the Stevens Tower, at 1185 Avenue of the Americas.

Sunday, February 21, 2010

Andrew A. Lacis on Climate Science

Andrew A. Lacis, the NASA climatologist whose 2005 critique of the United Nations climate panel was embraced by bloggers seeking to cast doubt on human-driven climate change, has sent in two more commentaries on the state of climate science.

Human-induced warming of the climate system is established fact.

How do we know this to be true? What does it take to get something established as fact? I will try to explain this quandary here the same way that I explain it to myself.

We have come to understand that nothing happens in this world except as allowed by the laws of physics. What this means is that for every physical action there is going to be a well-defined cause, and a well-defined effect. Quantum mechanical weirdness that operates at atomic scale does not invalidate this physical description of the macroscopic range that is of interest.

Human experience has demonstrated that it is through measurement and physics that we understand the world that we live in. The term “physics” includes also the mathematical description of these laws which permits mathematical models to be constructed to conduct virtual experiments of real-world situations.

In this way, by utilizing global-mean decadal-average quantities, we have come to understand that water vapor accounts for 50 percent of the (33 K, 60 deg F) greenhouse effect. Longwave absorption by clouds contributes 25 percent, and CO2 accounts for 20 percent. The remaining 5 percent of the greenhouse effect is split between methane, N2O, CFCs, ozone, and aerosols. Significantly, CO2 and the minor GHGs do not condense or precipitate at current atmospheric temperatures. This provides a stable reference temperature structure for the fast feedback processes to operate and maintain the amounts of atmospheric water vapor and clouds at their quasi-equilibrium concentrations. Hence the strength of the terrestrial greenhouse is sustained and effectively controlled by the atmospheric temperature floor that is provided by CO2 and the other non-condensing greenhouse gases. (More detail is contained in my Greenhouse Tutorial which is a related supporting commentary.)

The bottom line is that CO2 is absolutely, positively, and without question, the single most important greenhouse gas in the atmosphere. It acts very much like a control knob that determines the overall strength of the Earth’s greenhouse effect. Failure to control atmospheric CO2 is a bad way to run a business, and a surefire ticket to climatic disaster.

My earlier criticism had been that the IPCC AR4 report was equivocating in not stating clearly and forcefully enough that human-induced warming of the climate system is established fact, and not something to be labeled as “very likely” at the 90 percent probability level. It would seem that the veracity of the human-induced warming would hinge on establishing the pedigree of the observed increase in atmospheric CO2. On this point, the IPCC report is crystal clear. Pages 137-140 of IPCC AR4 describe high-precision in situ measurements of atmospheric CO2 at Mauna Loa, documenting the steady increase in CO2 along with its characteristic seasonal fluctuation. These measurements, supplemented by analyses of air bubbles trapped in ice core samples, show unequivocally that atmospheric CO2 has increased from a pre-industrial level of 277 ppm in 1750 to present day concentrations that are approaching 390 ppm.

The IPCC report also shows the corresponding decrease in atmospheric oxygen, thus providing irrefutable verification that the increase in atmospheric CO2 is linked directly to fossil fuel oxidation. In Chapter 7, the IPCC report states it clearly: “the increases in atmospheric carbon dioxide and other greenhouse gases during the industrial era are caused by human activities”. Undoubtedly, volcanic eruptions have contributed some atmospheric CO2, but this can only be miniscule as neither the 1991 Pinatubo eruption (largest of the century), nor the 1986 Lake Nyos CO2 eruption that killed thousands, so much as registered a blip in the Mauna Loa CO2 record.

In view of all this, the IPCC AR4 Chapter 9 Executive Summary states that: “It is likely (66 percent probability) that there has been a substantial anthropogenic contribution to surface temperature increases in every continent except Antarctica since the middle of the 20th century.” How can this be considered anything other than inaccurate and misleading?

To understand climate change, it is necessary to know the radiative forcings that drive the climate system away from its reference equilibrium state. These radiative forcings have been analyzed and evaluated by Hansen et al. (2005, 2007). They include changes in solar irradiance, greenhouse gases, tropospheric aerosols, and volcanic aerosols. Of these forcings, the only non-human-induced forcing that produces warming of the surface temperature is the estimated long-term increase by 0.3 W/m2 of solar irradiance since 1750. Volcanic eruptions are episodic, and can produce strong but temporary cooling. All of the other forcings are directly tied to human activity. When it comes to radiative forcing of global climate change, it is abundantly clear that whether we like it or not, or whether we care to admit it, it is humans who are driving the bus.

Greenhouse Tutorial

In the context of global climate, absorbed solar radiation (about 240 W/m2, with 30 percent of the incident radiation being reflected back to space) is the energy source that keeps the Earth’s surface warm. The Planck radiation law determines that a temperature of 255 K (about 0° F) is needed to have energy balance with the absorbed solar radiation. If the Sun were suddenly turned on, the Earth would begin warming, and would keep warming until it reached a 255 K temperature, at which point it would be radiating 240 W/m2 of thermal energy out to space, in equilibrium with the solar energy input.

The global-mean surface temperature of the Earth is observed to be 288 K (60° F). Why is this so much warmer than the 255 K effective temperature of the thermal radiation emitted to space? The reason is that the Earth has an atmosphere that contains gases that absorb thermal radiation. These gases are distributed throughout the atmosphere, and they also must maintain energy balance on a local scale, meaning that the same amount of radiation absorbed (e.g., from the ground), must be re-emitted (in both upward and downward directions) so as to maintain constant temperature. This radiative process of localized absorption and emission of thermal radiation establishes a temperature gradient within the atmosphere, and in so doing, results in heating the ground surface to a higher temperature than would be the case with no atmosphere. This is the greenhouse effect, and it keeps the surface temperature of the Earth 33 K (60° F) warmer than it would otherwise be for the same 240 W/m2 of solar heating.

It is helpful to analyze the Earth’s energy balance in terms of global-mean and decadal-average quantities, so as not to be distracted by having to worry about local energy balance variations due to regional, clear-sky, cloudy-sky, diurnal, seasonal, and interannual fluctuations. A good climate GCM can be adapted to perform this task.

We know from direct measurement that there are atmospheric constituents that absorb thermal radiation. The most important are: water vapor, cloud particles, and CO2, with smaller contributions coming from methane, N2O, CFCs, ozone, and aerosols. We also know quite accurately the spectral absorption characteristics for the absorbing gases, and how cloud and aerosol particles interact with thermal radiation. This basic knowledge comes from a combination of laboratory measurements and theoretical analyses. This input data is tabulated in the HITRAN database for all significant atmospheric gases, and is available for use in radiative transfer calculations.

It is important to know the relative contribution of each absorbing gas to the total (33 K) greenhouse effect. Precise attribution is difficult because there is significant overlapping absorption with varying degrees of saturation, and there is the need to take into account the vertical structure and time-spatial distribution of absorbers, requiring a good climate GCM with good radiative transfer. The problem is akin to defining the actual weight that is borne by individual support columns of a bridge. We know that collectively the columns must support the entire weight of the bridge, but actual measurements removing one column at a time would be extremely problematic since the weight of the bridge would get redistributed among the remaining columns.

With good mathematical models that accurately represent the radiative interactions of atmospheric interest, we can conduct virtual experiments to determine the radiative contribution of each individual gas within the context of current atmospheric structure. We have performed such experiments for the principal greenhouse gases, clouds, and aerosols using the [Goddard Institute] climate model by systematically inserting, or taking out, each atmospheric constituent one at a time, and recording the corresponding radiative flux change.

These experiments show that water vapor accounts for about 50 percent of the total greenhouse effect. Longwave absorption by clouds contributes 25 percent, and CO2 accounts for 20 percent. The remaining 5 percent of the greenhouse effect is split between methane, N2O, CFCs, ozone, and aerosols. It is significant that CO2 and the minor GHGs do not condense or precipitate at current atmospheric temperatures. This provides a stable temperature structure for the fast feedback processes to operate and maintain the quasi-equilibrium amounts of water vapor and clouds. Hence, the strength of the terrestrial greenhouse effect is effectively sustained and controlled by the atmospheric temperature structure provided by CO2 and the other non-condensing greenhouse gases.

The bottom line is that CO2 is absolutely, positively, and without question, the single most important greenhouse gas in the atmosphere. It acts very much like a control knob that determines the overall strength of the Earth’s greenhouse effect. Failure to control atmospheric CO2 is a bad way to run a business, and a surefire ticket to climatic disaster.

Dr. Andrew A. Lacis
National Aeronautics and Space Administration
NASA Goddard Institute for Space Studies
B.A., Physics, 1963, University of Iowa
M.S., Astronomy, 1964, University of Iowa
Ph.D., Physics, 1970, University of Iowa

Thursday, February 4, 2010

Rebuttal to “Government Takeover Won't Fix Health Care”

Republican Doc Hastings receiving his instructions from the Republican Caucus, had an op-ed published in Mid-Columbia Voices, Tri-City Herald, January 29, 2010. The following is a rebuttal. RH: Our health care system is in need of reform so that Americans get the care they need when they need it at a price they can afford. This is the one sensible thing Congressman Richard ‘Doc’ Hastings says in his opinion piece.
RH: I'm working to stop bills moving through Washington, D.C., right now because these bills are taking us in exactly the wrong direction. The trillion-dollar government takeover of health care must be scrapped and Congress should start over on reform that is focused on lowering costs.
While Republicans have been doing everything possible to obstruct health care reform this year, we’ve spent enough on Iraq and Afghanistan (about $12 billion per month) to fund the first year of a robust health care reform program and still have enough left over to help families avoid defaulting on their mortgages.
RH: The House of Representatives and the Senate have approved different health care bills. Now, congressional Democrats and the White House are behind closed doors cutting deals and negotiating in secret with special interests to get the votes they need to pass their massive plan for government control of health care.
“Government takeover of health care” is a consistent Republican theme. It’s an attempt to portray health care reform proposals in the House (H.R. 3962) and Senate (H.R. 3590) as the imposition of publicly financed health insurance for all Americans, i.e., a single payer system. Neither of the bills does any such thing.
RH: At its most basic, the bills moving through Congress create a government-run health system that restricts private options and forces Americans to purchase coverage from a government-controlled program. I oppose this $1.3 trillion government takeover of health care. Instead, Congress must fix what doesn't work, find ways to lower costs while maintaining quality, increase choices and protect the doctor-patient relationship.
To repeat, neither the Senate bill (H.R. 3590) nor the House bill (H.R. 3962) “create a government-run health system.” Both bills build on and improve the current system.
RH: First, I want to share some details about what we should do. I support lowering costs by expanding health care choices and tools like health savings accounts that help families save. Individuals should have the same tax benefits that employers receive for purchasing health insurance. Small businesses should be allowed to band together and purchase health insurance at the same rates big corporations can - and these policies should be portable. Americans should have the choice to purchase cheaper prescription drugs from Canada, and lawsuit abuse that drives up costs for everyone must end.
Health savings accounts (HSAs) are a favorite diversion of Republicans. Ask yourself where the money goes that we invest in HSAs. It goes to Wall Street --the very people that took such good care of your 401k and IRA. According to the Kaiser Family Foundation, health care insurance premiums increased by 131% over the last ten years. Where do you think you’re going to earn an average of 13.1% on your HAS?
Furthermore, Hastings throws out a number of Republican proposals without providing any detail about how they would be implemented, what their impact would be, or how they are related to the whole complex of health care components that make up what is a very complex system. Their “solutions" may seem appealing on the surface, but they turn out to be simplistic and unsupported by policy or cost/benefit analysis.
RH: These goals can be achieved without plunging our nation deeper in debt or putting the government between you and your doctor - but that won't happen if the bills written by those who control Congress become law.
What’s plunging this nation into debt is massive, unsustainable Defense spending, $708 billion of the $1.3 trillion 2011 president’s budget. U.S. spending over the last decade is more than the next 45 countries combined.
To date, if you include all the costs of war, including caring for our wounded soldiers and taking care of the families of soldiers killed in action, the U.S. has spent well over a trillion dollars, that’s a million, million dollars, on the war in Iraq since 2001. One estimate, by a Nobel prize-winning economist (Joseph Stiglitz), puts the cost at three trillion dollars, that’s $3,000,000,000,000. This is for a war many think was unwarranted, and for which Republicans under the Bush Administration said we would pay only $50 to $60 billion in total, so it’s somewhat ironic to have Republicans like Hastings complaining about debt.
RH: The misguided proposals in Congress aren't about lowering costs - they're about bigger government and higher spending. As the nonpartisan Congressional Budget Office has stated, these bills will increase the deficit, add to our debt and increase long-term health care costs.
This is just isn’t so. The CBO and the Joint Committee on Taxation estimate that the direct spending and revenue effects of enacting either of the bills would yield a net reduction in federal deficits, $132 billion for the Senate bill and $104 billion for the House bill, over the 2010-2019 period.
RH: According to a report by the Obama administration's Department of Health and Human Services, health care costs would increase under the House-passed bill.
Here again, Hastings is misleading us. The Office of the Actuary for the DHHS Centers for Medicare & Medicaid Services states that according to their estimates the Senate bill (H.R. 3590) would postpone the exhaustion of trust fund assets by nearly 10 years—that is, from 2017 under current law to early 2027 under the proposed legislation. Furthermore, the combination of lower Part A costs and higher tax revenues results in a lower Federal deficit.
As for the House bill, provisions in H.R. 3962 in support of expanding health insurance coverage (including the Medicaid eligibility changes) are estimated to cost about $935 billion through fiscal year 2019. The net savings from the Medicare, Medicaid, growth-trend, CLASS, and immediate reform proposals are estimated to total $529 billion, leaving a net cost for this period of $406 billion before consideration of the increase in Federal income and other tax revenues that would result from the surcharge on high-income individuals and families and other revenue provisions.
The CBO and JCT have estimated that the total net amount of Medicare savings and additional tax and other revenues would offset the cost of the national coverage provisions, resulting in an overall reduction in the Federal deficit through 2019.
RH: Aside from a staggering price tag for a bill that won't lower costs, these proposals would have serious impacts on Tri-City families, farmers, seniors and small businesses.
Yes, the House and Senate health care reform bills would impact Tri-City families, farmers, seniors, and small businesses. Families would be able to buy affordable health insurance that can’t be denied based on pre-existing conditions. Ditto for farmers, involved in one of America’s most dangerous occupations, and generally not covered by an employer. Seniors would be assured of the continued viability of Medicare. And businesses with less than 50 employees would be exempted from most provisions of the bills, plus those that do offer their employees health insurance would receive a tax credit.
RH: The government would decide which health care plans are acceptable. A federal commissioner would determine which benefits are offered and how much is charged. This would force many Americans out of their existing plans and require everyone to sign up for a government-approved health plan or pay a fine. Think about that - Americans would be fined for not participating in a government-approved plan.
Nothing Hastings says in the first part of this paragraph makes a hill of beans – it’s all nonsense and has been refuted many, many times before (remember the “death panels” scare tactic?).

"The biggest issue is the euthanasia part of this" ('Doc' Hastings, September 6, 2009)

It’s the last part of the paragraph that bears scrutiny.
Hastings is unable or unwilling to consider the various health care reform measures in the House and Senate bills in context, i.e., as an interrelated whole. Like the song says, “This I tell you brother. You can’t have one without the other.”
Bills before Congress will preclude insurers from denying coverage for pre-existing conditions. Everyone (except insurers) feels this is necessary. But you can’t do this without requiring that everyone have insurance. Why? Because otherwise no one would buy insurance until they needed care, i.e., had a pre-existing condition.
People can opt not to carry coverage, in which case they’ll pay a tax penalty that amounts to 2 percent of a person’s adjusted income. The penalty may be waived in certain circumstances. The penalty money would be used to defray the costs of the uninsured on the public health system.
Hastings fails to tell us that if a family is now covered through an employer and pays taxes, they are already paying approximately $1,000 dollars every year for the uninsured. They will no longer pay this hidden tax under the health care reform packages being considered in Congress.
Furthermore, the requirement that people have acceptable coverage comes with subsidies that make coverage dramatically more affordable for working people. Millions of people who would otherwise not be able to afford health insurance will now be covered -- something like 31 million people.
RH: Job-creating businesses would face tax increases, fines and mandates - making it harder for them to offer benefits. Tools like health savings accounts and flexible savings plans would be restricted, and $500 million in Medicare cuts would eliminate existing options for seniors.
Hasting has mashed together several things in this paragraph. It makes it tough to determine what he’s referring to in the bills. But let’s take it one step at a time. Employers with more than 50 employees will be expected to offer health benefits. If they don’t, they’ll be expected to pay into a fund to help defray insurance costs. That levels the playing field. It’s a fair and reasonable provision.
The reform bills would permit only prescribed drugs to be paid for out of Health Savings Accounts (HAS), and would increase taxes on disbursements from HSAs not used for qualified medical expenses. Makes sense to me.
I have to laugh when I read Republican objections to health care reform because of its impact on Medicare. Yes, we seniors sometimes forget where we left our eyeglasses, but we don’t forget that under Ronald Reagan, Republicans tried their best to defeat the very bill creating Medicare. Health care reform is endorsed by the AARP. Here’s what it says, “Health reform will help all generations of Americans, saving money and improving care for all ages. Medicare would be a stronger program, with less waste, an improved drug benefit, and better coordination among doctors.” I’ll take their word over that of the Republican Party any day.
As for details, the health care reform bills being debated in the House and Senate both aim to reduce the ballooning costs of Medicare in order to keep the program solvent. They would root out waste, fraud, and abuse. The House health care proposal would reduce projected increases in Medicare payments to some health care providers by more than $500 billion (not $500 million, as Hastings says) over 10 years. Some of that money would be put toward avoiding cuts in payments to doctors so seniors have better access to physicians. The bill would reduce payments to private providers in programs such as Medicare Advantage, which is operated by private insurance companies and bought by seniors to fill gaps in coverage. Some of the savings from Medicare would be used to cover uninsured workers who pay Medicare taxes.
RH: Top-quality hospitals like the Wenatchee Valley Medical Center would be arbitrarily penalized and barred from expanding simply because they are doctor-owned.
Hastings statement that the Wenatchee Valley Medical Center (WVMC) “would be arbitrarily penalized and barred from expanding simply because they are doctor-owned" is erroneous; there’s nothing arbitrary about it.
Many physician-owned hospitals are known as “specialty hospitals.” According to an article in Time Magazine, they tend to sell themselves on the promise of comfort, if not luxury. About half don't have any kind of emergency department and of those that do, more than half have only one bed available. Despite being physician-owned, only about 30% have a doctor on site at all times, and about two-thirds actually tell staff to call 911 in case of an emergency. It's all so entrepreneurial. And profitable. And it's a conflict of interest, e.g., your doctor sending you to a lab he owns for a blood test, an MRI, a CAT Scan, you may not need, and admitting you to a hospital in which he owns shares.
The Senate and House bills would require disclosure of financial relationships between health entities, including physicians, hospitals, pharmacists, other providers, and manufacturers and distributors of covered drugs, devices, biologicals, and medical supplies.
Yes, health care reform as currently crafted includes a moratorium on building or expanding physician-owned specialty hospitals, but hospitals with a provider agreement in effect as of February 1, 2010, will be grandfathered-in under the policy provided they meet certain requirements.
WVMC, chartered in 1940, is the only physician-owned hospital of this nature in the State of Washington. It's an important asset to the region. And it just so happens that Maria Cantwell and Patty Murray joined Doc Hastings in a tour of WVMC and held a press conference there in August 2009, and agreed on language to go into the House and Senate bills that would allow WVMC to continue to operate under either bill, although they wouldn’t be able to expand the number of operating rooms, medical procedures, or patient rooms. The CEO of WVMC stated that the two Washington State senators “advocated strongly” for WVMC.
RH: These are all consequences of putting the federal government in charge of deciding how, where and when we get care. This is something I fundamentally oppose. In my experience, putting the federal government in control of a program rarely has the desired effect of making that program cheaper, faster or smoother. It's time to reverse course and work toward reform that increases choices and drives costs down.
I understand the conservative viewpoint that less government is better government and that states should have more say over certain policy matters than the federal government. One can have a reasonable debate concerning where to draw the line. But Hastings isn’t doing that in his remarks. He’s purposely misleading us, and I object to that.
Health reform is a complex matter and getting it right is imperative. The health of Americans and the health of the American economy depend on doing so. I urge all Americans to do their homework. The Kaiser Family Foundation put together a very helpful table comparing the many provisions of the House and Senate bills. Read it. Study. Get informed. And you'll understand how badly Republicans are misrepresenting the nature of these bills.