About.com won’t let me embed non-About videos, so I’m putting it here.

h/t The Worst Horse

Stuff to read –

Paul Starr, “Governing in the Age of Fox News”

David Greenberg, “The Honeymooners”

Paul Waldman writes about the chattering class’s fixation on “bipartisanship” over “results.”

Health care spending is growing faster than the economy.

Coming to textbooks at a school near you: creationism, global climate change denial, the denigration of the civil rights movement, and the rehabilitation of Joe McCarthy. Enjoy.

I want to make a brief comment on Hendrik Hertzberg’s “Um, Pathetic,” in which Hertzberg describes opposition to the health care reform bills in Congress coming from the Left as based in fallacy — read the article to appreciate which fallacy.

Hertzberg is saying much the same stuff I said in “Scorched Earth Politics.” Some on the Left are taking Hertzberg’s criticism as a call to STFU, but I don’t believe that’s true. It’s closer to “grow up,” or maybe “chill.” There is a huge middle ground between criticizing actions and policies — robust and snarky criticism, even — and resorting to over-the-top character assassination, and that’s a middle ground some on the Left need to find.

James Oliphant writes in the Chicago Tribune that the mandate is being opposed by many progressives as well as most conservatives. The article does a good job of presenting both sides of this argument. Here’s part of the pro-mandate argument:

The justification for the mandate seems simple: It reflects the basic concept underlying all insurance. A large number of people pay relatively modest premiums, creating a pool of money big enough to take care of those who need help. Having people of all ages participate is especially important with health care, analysts note, because the medical problems that result in big claims are found disproportionately in middle-aged and older Americans.

If younger, healthier people go without insurance, premiums for the others would be driven higher.

The objection is that, especially without the public option, people are going to be forced to purchase increasingly unaffordable insurance and thereby enrich the insurance industry.

To which the pro-mandate side might respond that insurance is becoming increasingly unaffordable as it is, and those who go without insurance not only put themselves at terrible health and financial risk, they are also driving up the cost for everyone else, because health care bills that are paid get jacked up to pay for people who can’t pay.

As it is, there is some incentive for young and healthy people to get insured, because once they have a pre-existing condition they may not be able to purchase insurance. However, under the current bill, beginning in 2014 insurance companies will no longer be allowed to refuse to take a customer because of his pre-existing conditions. This would make it a lot easier to just put off getting health insurance until one begins to need health care beyond an annual flu shot.

But that would be a disaster for the people who are paying for insurance, because if younger, healthier people are not paying into the risk pool, there are more claims against fewer dollars. And the cost of insurance goes up.

There is a real concern that people are going to be required to buy policies they cannot afford. However,

Under the Senate bill, all a person would have to do is pay $750 per year or 2 percent of household income, whichever is greater, in order to avoid the mandate. The House penalty is slightly higher. (This difference will be worked out in negotiations this month.) …

… Linda Blumberg of the Urban Institute says much of the public’s resistance stems from still-sketchy details about how the new insurance exchanges that would likely be established for those without job-related coverage would operate. People who earn just over 100 percent above the federal poverty line would become eligible for Medicaid — and those up to 400 percent would qualify for federal subsidies.

I would like to see Medicaid expanded even more, and I would like to see more subsidies, and that may be something we should work on. But killing the mandate is un-progressive, IMO. And yes, with single payer this wouldn’t be an issue. And if I had the money I’d move to a penthouse on Park Avenue.

See also Nate Silver.

It looks like Brit Hume:

For those who are video challenged, Hume said this about Tiger Woods:

“The extent to which he can recover seems to me depends on his faith,” said Hume. “He is said to be a Buddhist. I don’t think that faith offers the kind of redemption and forgiveness offered by the Christian faith. My message to Tiger is, ‘Tiger turn to the Christian faith and you can make a total recovery and be a great example to the world.”

I wrote a response to Mr. Hume on the other blog. See also Steve Benen.

Update: The righties immediately went on the offensive and complained that liberal criticism of Brit Hume is bias against Christianity. They don’t notice that Hume insulted Buddhism. See, for example, La Shawn Barber and the Gateway Pundit.

In other words, when a national news personality insults Buddhism, that’s OK; when a blogger calls out the national news personality for insulting Buddhism, that’s an attack on Christianity, and unforgivable.

To get an idea why health care costs are insane, check out this article from the Sarasota, Florida, Herald Tribune. A boy banged his head on a bookcase during a pillow fight. The scalp laceration wouldn’t stop bleeding, so his mother took him to a hospital emergency room. A doctor took a quick look at the boy’s scalp and closed the superficial wound with one small staple.

“The doctor came in for all of five seconds, said he needed a staple, and then told us to go to a pediatrician to take it out,” Tobio said. “We saw the doctor for three minutes total.”

The bill: $1,654.

The boy’s mother wanted to know how one staple cost $1,654, so a reporter, Anna Scott, contacted the hospital to find out. It turns out the staple itself, the staple gun used to apply it, a bandage, and a topical anesthetic cost $274. The gun holds 35 staples, but it can be used only once even if only one staple is used. Then it is thrown away to avoid spreading infection. Whatever happened to sutures?

Note this part:

The staple is helping pay for about $60 million the hospital loses every year from people who are uninsured or cannot pay for treatment, said the hospital’s chief financial officer, David Sullivan.

When the hospital staff says the staple costs $274, they are accounting for the fact that they only receive, on average, 30 cents for every dollar they charge. That includes deals brokered with private insurance companies, too, deals current health care bills do not propose regulating directly.

I keep harping on this, but it’s obvious to me that — within the confines of the current health care reform bills — getting costs hauled back into Reality Land requires getting as many people insured as possible. I fully appreciate that paying for insurance can be a real hardship. I’ve been there. But what’s happening is that people who aren’t insured are running up bills that are being paid by people who are insured, which is one reason why insurance costs so much. Getting more people insured — especially more younger and healthier people — should help. That’s why I support mandates.

The doctor’s charge to do the stapling was $951: $480 for the visit and $471 to repair what the bill calls “a superficial wound.” … Because hospital doctors are usually private contractors, the hospital does not control what they charge.

Now, I suspect the doctor has to jack up his charge for the same reason the hospital does — he doesn’t always get paid for what he does. But I’ve read in several articles that hospitals that pay physicians a fixed salary do a lot better job of keeping cost down, at no loss of quality. However, I suspect that’s the sort of thing we probably can’t do much about until we get closer to a single payer system.

After a few seconds of medical care, the boy’s mother spent about an hour filling out forms. A recent PriceWaterhouse study found that $210 billion is wasted each year on medical paperwork, mostly having to do with insurance. I believe there’s a provision for uniform insurance forms in the House and Senate bills.

In the case at hand, apparently when the boy smacked his head his pediatrician’s office was closed, so the mother took him to an emergency room. That’s what uninsured people do, of course, which is the most gawd-awful cost-inefficient way to provide health care possible, because emergency rooms have horrifically high overhead. A system of neighborhood walk-in clinics for non-critical medical problems would provide care at a lot lower cost.

For his vote on the Senate bill, Sen. Bernie Sanders got an increase of $10 billion in funding for nonprofit community clinics to provide basic health care and pharmacy services, billing on a sliding scale. For this, lots of progressives blew up in outrage and threatened to campaign against him in the future.

And that’s the story of the $1,654 staple.

2009 was an extreme year for me; lots of highs and lows. I want to give my heartfelt thanks to all of you who helped me through the rough patches, and also all of you who drop by here to comment. Other blogs may attract more comments, but the Mahablog comment threads beat everyone in sheer smarts. I feel privileged.

So far my I Ching readings for 2010 have been pretty gloomy, speaking of frustration and obstacles, which suggests that the pattern of the last few months will continue for the next few months. Bummer.

I’ve been looking for a funny video to cheer me (and us) up, but the best I could find was a dancing cockatoo. Feel free to nominate something in the comments. And try to have a happy new year, anyway!

Update: At least, enjoy the music.