Taking Note

An Update on the De-Ba'athification Crisis

My post from last week on the Iraqi de-Ba’athification crisis (“An End to the De-Ba’athification Circus?) was titled with a question mark, meant to express a bit of hesitation in asserting that the pre-election vetting circus had truly come to an end. While there were at that time emerging indications that the electoral commission was unsure of the binding nature of the decision, it appeared that there were limited options in challenging the decision. This initial uncertainty was later amplified by a host of Shi’a politicians who were more forceful and explicit in their denunciations of the ruling (and U.S. interference), fueling a direct political intervention in the appeals process.

What Ukrainian election?

There has been a deafening silence about Ukraine's presidential election from the Beltway cheerleaders for NATO expansion, ever since the first round in January catapulted their long-time bête noire, Viktor Yanukovych, into first place with 35 percent of the vote in a field of eighteen candidates.  Voters ignominiously ousted incumbent president Viktor Yushchenko, one-time hero of the 2004 "Orange Revolution" and Ukraine's most vociferous champion of NATO membership, giving him barely five percent of their votes.

Maryland’s Health Care Solution

While health care reformers argue about what it would take to “break the curve” of health care inflation, the state of Maryland has done it, at least when it comes to hospital spending.

In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission.

When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients. For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson  at $984,  while letting  Johns Hopkins, in Baltimore Maryland, charge  $1,555. For a basic chest X-ray, St. Joseph's asks  $81 and Hopkins' is allowd to  charge  $155. The differences reflect Hopkins's higher costs as a teaching hospital and the fact that it cares for generally sicker patients.

Public Continues to Support Health Care Reform, but Needs Clarity on Congressional Bill

President Barack Obama in his State of the Union address doubled down on his commitment to health care reform, which disappointed conservatives who were hoping he’d run away from that commitment. And he left conservatives fuming about his claim that the health care reform plan in Congress suffered from a lack of clear explanation. How can he say that, the conservatives argue, when recent events like the Massachusetts Senate election show that voters have rejected the whole idea of comprehensive health care reform?

But the Massachusetts Senate election showed no such thing. In a Kaiser Family Foundation/Washington Post/Harvard Public Health follow-up survey to the Massachusetts election, voters in that election were asked their views on the Massachusetts Universal Health Insurance Law, a law “assuring that virtually all Massachusetts residents have health insurance.” Massachusetts voters said they favored that law by 68-27, and even conservative Scott Brown’s supporters backed the law by 51-44.

As for Obama’s claim that the public is not well informed about the health care reform bills and would support these bills more if they were clearly explained, he seems to be on very secure ground according to the latest Kaiser Health Tracking poll. In that poll the public’s reaction to 27 different elements of health care reform legislation was tested, and in 22 of those cases the public had a net positive reaction, with more people favorably inclined toward the measure than unfavorably inclined.

Autism and the MMR: Finally a Retraction

Are we finally ready to close the door on the much-disputed link between the MMR vaccine and autism?

On January 30, Britain’s General Medical Council ruled that Andrew Wakefield, a gastroenterologist, had acted “dishonestly and irresponsibly” in conducting his research that established a link between autism and the MMR vaccine. And yesterday, the British medical journal Lancet finally retracted the resulting 1998 study authored by Wakefield that helped drive MMR vaccination rates in the U.K. down to the point where in 2008, measles was officially declared “endemic” in the country.

The Lancet’s editor, Richard Horton, told The Guardian "It was utterly clear, without any ambiguity at all, that the statements in the paper were utterly false," he said. "I feel I was deceived."

An End to the De-Ba'athification Circus?

Welcome news today out of Baghdad—Iraq’s Higher Judicial Council announced that the electoral disqualifications by the controversial Accountability and Justice Commission (AJC) had been overturned by an appellate panel. While details are sparse, it appears that this legal ruling did not reach evidentiary issues, but rather threw out the decisions based on the lack of due process afforded those caught up in the AJC’s decisions. The silver lining to this entire affair is that an Iraqi legal body appears to have stepped in to stem a political crisis and that its decision is being accorded respect by the contending actors within a highly contentious, chaotic and politicized environment.

There are valid legal arguments to be made as to the legal fitness of the AJC to undertake vetting, but the process has been ad hoc and marked by opacity and lack of clear legal guidelines. Most problematic is the fact that the AJC attempted to game the system by using shaky evidence and timing its announcement for maximum political effect, leaving no possibility for a full and fair appellate process.

How the Public Really Feels About Obama’s Performance

There has been a lot of hyperventilating about  the January 19th election results in Massachusetts, with conservatives insisting that a massive repudiation of Obama and his agenda has taken place. Not so. In a Lake Research poll of voters in that election, Obama actually received a higher favorability rating than the victorious conservative candidate. And in the same poll voters said by 51-43 that Obama is taking the country in the right direction. By 52-41, they also said that “change takes time and things are beginning to move in the right direction” rather than “I am disappointed with the pace of change in this country since the 2008 election.”

Moreover, voters still recognize, despite their serious economic discontent, that current conditions are more the Bush administration’s fault than the Obama administration’s. In the latest Washington Post/ABC News poll, 67 percent assign a great deal or a good amount of blame to the Bush administration for the economic situation compared to just 36 percent who feel that way about the Obama administration’s efforts.

What's Next For News?

All across America this winter, there are news-gathering start-ups with an array of business models reflecting the energy of an industry in reinvention rather than the dying newspaper trade that has become—while worse-off than anyone would like—an exaggerated cliché. Nonetheless, my back of the envelope calculation of the total investment in this national transformation of the news business is still a fraction of the bonuses Wall Street is paying itself for surviving the government bail-out (and not a whole lot more than NBC paid Conan O’Brien to go away). So here’s an argument for those with the money to spend to do much more to support an entrepreneurial movement of enormous social potential.

Digging into one week’s worth of items culled from Romenesko (the indispensable aggregator of news about journalism) provides a glimpse of what is going on:

Medicaid Needs More Than A Short-term Fix

Health reform may be stalled in Congress, but you need only look to the overburdened Medicaid program to find evidence of the continued toll the current economic crisis is taking on Americans’ ability to afford and access medical care.

At the same time that states are experiencing huge budget deficits, more and more of their residents are unemployed; more and more are joining the ranks of the uninsured and clamoring for Medicaid benefits. The result: Even with emergency federal infusions of funding, state safety nets are being stretched dangerously thin.

Obama's No Child Left Behind Revisions

According to today’s New York Times, President Obama will propose a number of important changes to the Elementary and Secondary Education Act, which under the Bush Administration was known as No Child Left Behind.  The good news is that Obama plans to eliminate some of the most problematic features of NCLB.  The bad news is that he may introduce some new problems, drawing on the administration’s current “Race to the Top” education program.