Taking Note

Wal-Mart Goes Green

Wal-Mart just made what could be the biggest-ever step forward for sustainable business – a revolution in labeling that might permanently alter the way you shop.

Wal-Mart will assign “green” ratings to every product on its shelves, starting in two to five years. While the metrics have yet to be determined, the labels will factor in greenhouse gas emissions; waste output and water use; raw material purchasing; and “ethical production.” If all goes well, this process will spit out an easy-to-understand, readily comparable tag attached to every item in the store.

The Health Reform Bills and Obama's Priorities

On Wednesday, the the Senate Health, Education, Labor, and Pensions (HELP) Committee passed its reform bill on a party-line vote, thirteen to ten. Tuesday, the three House committees writing health care legislation released the final text of their bill. Meanwhile, the Senate Finance Committee remains bogged down as Committee Chairman Senator Max Baucus vainly struggles to engineer a “bi-partisan bill.”

What’s most interesting about the two pieces of legislation put forward by HELP and House Democrats this week is what they tell us about President Obama’s priorities:

A Foot in the Door Toward Federalizing Medicaid

One encouraging element of the health care reform bill released today by three House committees is that it would finance expanded eligibility for Medicaid entirely with federal money. Since its inception in 1965, Medicaid’s financing has been shared jointly between the feds and state governments. That arrangement has much to do with Medicaid’s huge shortcomings: wide state-to-state variations in eligibility rules and benefit levels, chronic under-funding, and limited medical options for beneficiaries. Because the program primarily covers individuals with low incomes, along with nursing home residents, it has never benefited from broad political support.

The House bill would not require state contributions to pay for expanding Medicaid eligibility to 133 percent of the federal poverty level because, the committees correctly note, state budgets are already overwhelmed due to the recession. But a potential long-term payoff to this reform would be to open the door to federalizing the program entirely down the road. Federally run insurance programs like Social Security and Medicare are vastly more efficient and effective than federal-state counterparts like Medicaid and unemployment insurance. Economies of scale, uniform national rules, and the inability of 50 state governments to each do mischief to the programs have demonstrably led to far superior results for national social insurance.

Here’s the Cart. Where’s Our Horse?

To stop global warming, we need China and India on board. But they aren’t getting on quickly: last week, big developing nations refused specific emissions cuts by 2050. A big part of the problem is that there doesn’t seem to be an easy answer to growing an economy and keeping emissions low at the same time.

A new report has the cart in place to get the U.S. and E.U. to help developing nations fight global warming. But it doesn’t provide a horse – an effective technological fix to climate change. Until China and India see the green tech along with the green talk, it will be hard to get them to commit to cuts.

“Breaking Through on Technology,” from the Center for American Progress (CAP),  says that moving technological advances from developed to developing countries will be critical in fighting climate change. As soon as “Green Motors” builds the electric car, we should ship its guts over to China so that it can replace those smog-machine Buicks.

Should Generous Health Insurance Benefits Be Taxed?

Some observers have suggested that if we tax the gold-plated insurance that some employers offer to their employees, insurance that encourages over-utilization of health care would begin to disappear. To avoid the tax, employees would settle for more basic, less expensive plans. Others propose giving consumers a larger menu of plans to choose from, so that they have an opportunity to pick more modest plans that don’t cover so many unnecessary treatments.

Both ideas suffer from two problems. First, they assume that less expensive insurance plans cover effective care—and eschew unnecessary care. Second, they’re  proposing a crude across-the-board solution to a complicated problem. As I have said in the past, the waste and “fat” in our health care system is not hanging out around the edges of the steak. It is marbled through the meat. Eliminating it means using a scalpel to discourage use of specific tests, treatments and products that provide no benefit for patients who fit a particular profile. Simply taking a whack at expensive insurance plans does not do the trick.

Age Discrimination in Health Care Reform ?

While we need an individual mandate, I am concerned that the House version of health care reform lets insurers charge older customers twice as much as younger customers. At this point, the Senate Finance Committee also allows insurers to discriminate by age. This could make it very hard for 50-somethings who don’t qualify for subsidies to afford a family plan. Under the House bill, a couple with joint income of $75,000, before taxes, would not receive a subsidy. And if they are self-employed, and receive no help from an employer, the premiums that they would be expected to pay could easily run as high as $13,000 a year. After taxes, if they live in a high-tax state, they might take home $65,000 a year—or less. This means that health care premiums would eat 20 percent of their income—or more.

I don’t think it makes sense to suggest that a young couple, earning $150,000, jointly, shouldn’t pool their resources with a 50-something couple earning $75,000.  Don’t younger Americans want to help pay for the health insurance that their parents need? These days, as more 50-somethings become unemployed, it’s not that unusual for college-educated 20-somethings and 30-somethings living in two-income households to earn  significantly more than their middle-class parents.

The African Union, the Law, and Bashir

In March, the International Criminal Court ordered the arrest of Sudan’s President, Omar al-Bashir, for war crimes and crimes against humanity. Although politically controversial, the first arrest warrant for a sitting head of state may seem to mark progress for international law. That progress, however, is in doubt given that last week’s resolution by the African Union to defy the ICC’s orders by refusing to arrest President Bashir might be legally sound.

This paradox is a bizarre reality of contemporary international law, and it raises serious questions about the young ICC and the so-called emerging global legal order.

Secretary Duncan: Keep Charters out of the Muck, Please

Secretary Arne Duncan used his speech before the National Alliance for Public Charter Schools to spotlight the “bottom 5%” of America’s public schools.  Numbering about 5,000, Duncan urged the charter school community to consider taking on some of these schools and turn them around.  He was clear that not every charter school operator is up to this challenge, naming a few multiple-site groups like KIPP and Green Dot as possible candidates.

Wrong audience.  Bad idea.

Wish List for Stimulus 3.0

In a slow summer week, talk of a third stimulus is beginning to make the rounds, especially after dismal unemployment numbers and a dose of reality from some of President Obama’s advisers. Just don’t call it “stimulus” – voters are not excited about any more spending.

Most of the money from Stimulus 2.0 will actually be spent in fiscal year 2010, but even with that extra jolt to the economy, recovery won’t come quickly, says Paul Krugman. What should be included in Stimulus 3.0? Here are some ideas:

Public Backs Sotomayor for the Supreme Court

Conservatives are doing their level best to derail the nomination of Latina Sonia Sotomayor to the Supreme Court, targeting her race and views on abortion in particular. But these culture wars appeals are having little effect on the public’s views.

In a just-released ABC News/Washington Post poll, 62 percent of the public says Sotomayor’s nomination to the Supreme Court should be confirmed by the Senate, compared to just 25 percent who think she shouldn’t be confirmed. This level of support is among the highest recorded for recent Supreme Court nominees.

Consistent with this result, just 22 percent of Americans think Sotomayor’s racial and ethnic background plays a negative role in her decisions as a judge, compared to 52 percent who think her background plays no role and 16 percent who think it plays a good role.