Across the Great Divide

Question for Kersten: How Does $250 Swing an Election?

I was going to give Katherine Kersten a rest. Really I was. Once she had her makeover and moved to a Sunday-only opinion column, I was going to  move on to better things and let her bloviate.

But when she builds an entire column on a purposefully misleading premise, I just have to call BS.

Here's the piece.

Defenders of marriage face an external foe.
 A single-issue outsider from Colorado pours money into sleepy state races.

In 2006, State Sen. Mady Reiter -- a two-term Republican from Shoreview -- was defeated by DFLer Sandy Rummel in a tight race.

Was it just another case of a Republican losing in a down year for the GOP? Perhaps. But if Senate District 53 voters had read through the list of Rummel's donors, they might have scratched their heads and asked if something more was going on. A substantial number of Rummel's donors hailed from glamorous, faraway places such as Hollywood, Boston, New York City and Coral Gables, Fla. In fact, out-of-state donors made up about 48 percent of Rummel's itemized individual contributions.

Only a real political insider would have focused on one name -- Tim Gill -- and grasped what was afoot.

Kersten goes on to paint a picture of a gay plot to overturn traditional marriage by, as the subhead implies, pouring money into sleepy state races.

How could a flood of money influence a contest over a suburban state senate seat? Where were the funds directed? How much would it take to tilt a close election?

I was genuinely curious, because the idea of money being a swing factor in such a race seemed unlikely. And of course I was suspicious of anything written by this woman who has made a good career out of being intellectually dishonest in service of traditional values.

The reason Kersten didn't answer these questions was because the facts would have dashed her entire construct. Tim Gill contributed $250. He wasn't even the largest donor to a campaign that reported $8,250 in individual donations. (Counting individual and PAC contributions, Rummel received 17 larger checks, 26 smaller and 11 the same as Gill's.) 

What's really shameful here is that by putting Kersten on the op-ed page, the Strib has put her beyond even minimal standards of fact checking or editorial queries.

You can look here at the data Kersten — or whatever "real political insider" who fed her this — had to have seen.

What if the Free Market Picked Socialized Medicine?

In my prior post, I quoted a New Yorker article I hadn't yet digested. Since then, I wrote this summary of it for my other blog, which asks the question:

What if the free market chose something that looked more like "socialized medicine" — and it worked?

One of the persistent health care reform canards is that the free market will produce better-quality, lower-cost medical care than "socialized medicine." (Socialized medicine seems to mean any system that involves the government or seeks to reduce the 70 percent of the health care dollar paid to middle men and pharmaceutical companies.)

Well, the free market has not done all that well for America, since we have higher costs and more middling outcomes than other more socialized systems. (Cue Jeff: "It's not a free market!") Nor has it produced anything approaching consistent performance across the country. The New Yorker article looks at similar western states markets and finds very divergent outcomes and costs.

From the post at Growth & Justice blog:

The difference between McAllen [Texas] and Grand Junction, Colorado, one of the nation's lowest-cost markets with some of the highest quality-of-care scores, may be the difference between a culture focused on money versus one focused on a healthy community.

Or, one might say, on the individual entrepreneur over collectivism.

Over the last two weeks, I've had three illustrative and distinctly different experiences with health care delivery systems.

In one, I accompanied a cancer patient who spent a frustrating three and a half hours in a not very busy hospital ward, waiting for a piece of equipment we didn't need to administer a routine treatment. It  should've taken half the time, and I can't even imagine how much it cost. After a series of these experiences, and based on his own initiative, he now has a $90 do-it-yourself setup he can use at home.

Also this week, I interacted with two veterinary clinics and received, without asking, cost estimates for a range of potential treatments before I made a decision for a gravely ill pet. An example of consumer-driven care? Hardly. Circumstances didn't allow price shopping and more cost information didn't make me a smarter consumer of the services offered. It actually complicated the decision process and made it difficult to relate to a new clinician who started out talking about costs instead of the patient.

Finally, in a testament to the article's claim that care in Grand Junction is more patient-focused, I called a clinic there and spoke to a physician there who had seen me only one time regarding a throat condition that was already starting to heal on its own. Over the phone, I was able to get two medications prescribed here in Minnesota to treat a flare-up that occurred right before I was to sing at a wedding. And he received no payment for taking my call.

The free market has certainly allowed experiments like the Mayo Clinic and Grand Junction's "accountable care" models to emerge. But it also is spawning more money-oriented medical cultures like the one described in McAllen, Texas, where one doctor said of consumer-choice models: “Any plan that relies on the sheep to negotiate with the wolves is doomed to failure.”

Medicare, Quality of Care and New Models.

Skeptics saw the Mayo model as a local phenomenon that wouldn’t carry beyond the hay fields of northern Minnesota. 

When I see a writer talking about the hay fields of swampy northern Minnesota when referring to the Mayo clinic (located in the southeast corner of the state), I wonder how much else in this New Yorker story might be a bit under-researched.

In the next paragraph, my home town crops up. It describes how local doctors worked together to create a more accountable, less costly medical care system.

The Mayo Clinic is not an aberration. One of the lowest-cost markets in the country is Grand Junction, Colorado, a community of a hundred and twenty thousand that nonetheless has achieved some of Medicare’s highest quality-of-care scores. Michael Pramenko is a family physician and a local medical leader there. Unlike doctors at the Mayo Clinic, he told me, those in Grand Junction get piecework fees from insurers. But years ago the doctors agreed among themselves to a system that paid them a similar fee whether they saw Medicare, Medicaid, or private-insurance patients, so that there would be little incentive to cherry-pick patients. They also agreed, at the behest of the main health plan in town, an H.M.O., to meet regularly on small peer-review committees to go over their patient charts together. They focussed on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates. Problems went down. Quality went up. Then, in 2004, the doctors’ group and the local H.M.O. jointly created a regional information network—a community-wide electronic-record system that shared office notes, test results, and hospital data for patients across the area. Again, problems went down. Quality went up. And costs ended up lower than just about anywhere else in the United States.

Grand Junction’s medical community was not following anyone else’s recipe. But, like Mayo, it created what Elliott Fisher, of Dartmouth, calls an accountable-care organization. The leading doctors and the hospital system adopted measures to blunt harmful financial incentives, and they took collective responsibility for improving the sum total of patient care.

Is there more to it? No doubt, but I can't claim any special knowledge here. But the example shows there may be community-based approaches that can work.

If Minnesota's a Welfare Magnet, then is Marty Seifert a Chick Magnet?

House Republican Minority Leader Marty Seifert, R-Marshall, cited an analysis by the Minnesota Department of Human Services of welfare applications showing that 13.9 percent of applicants moved to Minnesota from another state or nation within 12 months of submitting an application.

— "Legislators aim to end 'welfare magnet' reputation"

When I said Minnesota's public assistance spending is only 1.4% of the state's budget compared to the 1.8% national average for all states, I was much too nice to Gov. Pawlenty — and far too oblique in correcting his inference about welfare recipients in Minnesota and their impact on the budget.

He worded his sop to the anti-welfare crowd very carefully.

"In the welfare area, there's increasing concern about people coming from other parts of the country for our welfare system."

Okay, there's increasing concern, primarily among Republicans who want to justify cutting health and human services spending. But what are the facts?

Let me be clear about the headline: It's about the GOP penchant for detecting invisible forces and making outrageous claims based on scant evidence. I have no evidence that Rep. Seifert is a chick magnet, so naturally, I would never make such a claim.

As Dave Mindeman has noted, the Pioneer Press skewered the governor's suggestion that Minnesota is a welfare magnet. The story says:

• State spending on the Minnesota Family Investment Program, the state's main welfare program for families, is down 43 percent over the past decade, when adjusted for inflation.
• While 14 percent of welfare recipients have lived outside of Minnesota in the past year, twice in the past 15 years the state demographer has looked into whether people migrate to Minnesota for benefits and has found no evidence to support that oft-repeated suggestion.
• Minnesota spends a smaller percentage of its general fund on welfare programs than the national average, according to the National Association of State Budget Officers.
• Urban counties, where newcomers might be expected to settle after moving here, do not have the highest per capita populations of people enrolled in the Minnesota Family Investment Program. That title belongs to Beltrami County and others that are home to large American Indian reservations.

Republicans have tried various media ploys to demonize welfare recipients, but when you look at the facts, "welfare" spending is a small and shrinking part of the budget that will benefit ever-fewer Minnesotans — whether they were born here, moved back here, came from another state or immigrated.

Absolutely Wonderful!

“We sold 200 boxes in two-and-a-half days,” he said. “I’m the first to tell you that business is absolutely wonderful. It seems to be recession-proof.”

I'd been hearing about shortages when I was in Colorado. Local stores sell out as soon as a new shipment arrives.

Retailers are giving the president some of the credit for their upswing.

What's the product?

Memorial Day: Dennis Dumm's Last Ride.

A meeting today allowed me to retrace part of Dennis Dumm's last ride down Park Avenue.

 1. Here's the view down the bike lane nearing the fateful intersection. Note the standard bike lane sign. 

The Strib news report said:

Ryan Moffett, of Minneapolis, said he had been riding behind Dumm for several blocks before the accident and saw him waiting for a stoplight in a bike lane next to the truck.

2. Accident reconstruction marks on the pavement seem to confirm that account.

They show the paths of the cyclist (left) and the rear wheels of the truck's trailer.

Dennis appears to have started from somewhat behind the crosswalk. He was barely in the intersection when he was struck. [Click to enlarge.]

3. Two blocks farther down Park, near the reddish billboard seen in the earlier photos, signs clearly signal where left turners should move into the turn lane.

This is at 11th Street, the first one-way artery into downtown, and a more likely place for left turn traffic to intensify. There was no designated turn lane at the intersection where the accident occurred.

4. This style of sign is seen elsewhere on one way streets downtown where the bike lane is on the left.

The yellow background indicates caution, and the graphic serves as a warning of the danger to bikes and vehicles.

5. A right-lane version of the same yield sign design, from St. Paul.

From reading comments and message boards such as Minneapolis Bike Love over the last few days, it's clear that both cyclists and drivers don't know the law. Even a bike shop owner — whose site was my source for checking the statutes — had it backwards in a comment. [Correction: My recollection of where I found the link to state statutes was wrong.]

Such confusion isn't helpful to cyclists or drivers, but neither is poor roadway design that adds bikes into the traffic flow as an afterthought.

If auto lanes were as inconsistent and in such poor shape as the places cyclists are expected to ride, even anti-tax drivers would be ready to pay for improvements.

Meanwhile, we're on our own.

Memorial Weekend Mashup: Pig Farm Fawning and Other Hogwash.

Yesterday's news had three remarkably detailed descriptions of sex crime suspects. Here's one:

The suspect is described as a man in his 30s with light brown skin, who is possibly Hispanic or American Indian.

He is 5 feet 1 to 5 feet 2 with a muscular, stocky build and a thick neck. He has straight short black hair that is combed back on the sides and sticks up on top. He has medium sideburns with a thin beard along his jaw line and a slight mustache. He has a scar running under his left ear, a burn mark on the top of his left hand, a missing right upper tooth and a gold upper left tooth.

He had a metal cross post earring in his left ear and walks with a slight limp. He was wearing a white T-shirt with curved lettering on the chest and a picture of a black male. He had a red and white bandana around his neck and black or blue pants.

An earlier report also mentioned an "unusual body odor," which could indicate he's living on the street. Somehow, I think they'll find this guy.

*****

Speaking of unusual odors, all week a scandal has been unfolding involving British Parliament member misuse of expense accounts — which have a purpose similar to the per diems paid to Minnesota legislators who incur living expenses away from home during a session. Another purpose, of course, is to pad their salaries.

Among the most notorious, Conservative MP Douglas Hogg charged £2,200 in expenses for cleaning his moat. In the old days, you would never clean the moat because that would reduce its value as a castle defense. Today, it's the opposite. One must keep up one's property values, mustn't one?

Of course, Americans do not have moats because we are less attached to our historic home sewer systems — or if we did build a moat, we'd call it a lake and pretend the property was on an island.  Plus, we have guns for home defense, which are much easier to clean. And if a legislator did have a moat that needed cleaning, it would be done by friendly private contractors who would forget to submit a bill.

*****

Speaking of hogs, a letter writer in today's Strib called out a particularly fawning 600-word editorial that supports the state's pork producers and urges American consumers to keep pork in "its time-honored spot at the family dinner table."

All the arguments would be familiar to anyone who has been following the pork industry's PR campaign to counter unfounded consumer fears about contracting "swine flu" from pork products.

Bill Lehto disputed the editorial's position that "pork continues to be a smart, safe food choice," making counterpoints about health, environment, employment, jobs, economic impact and humane treatment of animals. It would've been a perfect letter [not yet online] had it also mentioned the number of full-page ads that have run this month in the Strib as part of the pork PR campaign.

*****

Speaking of non-transparent agendas and highly identifiable suspects, Steve Perry writes about the Minnesota false claims act passed this year, sponsored by DFL Rep. Steve Simon, signed by GOP Gov. Tim Pawlenty and opposed by former Attorney General Mike Hatch, "who first brought the idea to the Legislature and urged its passage, back in 2004." 

The about-face this year was almost universally viewed as a vendetta against Simon, a former staffer in the attorney general's office who incurred the wrath of Hatch and his successor, Lori Swanson, by getting the Office of Legislative Auditor to look into whistleblower claims by AG staffers. 

Ah, yes. Maybe, if Peter Hutchinson hadn't split the vote in the last governor's race, we'd have a different budget and intact health and human services funding. But we'd also have Gov. Pigsticker instead of Gov.  Hogwash.

It's All About Cuts, Stupid.

Governor Pawlenty wants your ideas about how to cut state spending.

No, really, he does. He's asked legislators to forward their ideas for general fund spending cuts, just in case any new ideas occur to them after working on the budget for the past four months. And he's even set up a special email address for you: budgetideas@state.mn.us.

Maybe the governor sees this empty PR gesture as conciliatory. But judging from the suggestions made by the public so far, I doubt he'll get anything new beyond what he already has — and certainly nothing that will change his basic course of cutting expenditures that benefit the poorest and least politically powerful Minnesotans.

Early this year, the Minnesota Senate created a web site dedicated to discussion of the budget. The section on the HHS budget alone received 140 comments, with the first comment out of the box:

Cut, Cut, Cut, Cut, Cut…I am sick of the welfare queens in this state.

[Reagan-era imagery of welfare queens living high on the hog was also popular with pig farmer and GOP Rep. Rod Hamilton, who remarked in the closing days of the session how people on welfare drive nicer cars than most of the rest of us do.]

In February, a coalition of conservative organizations introduced their budget solutions site. It seems to have received only four comments before they were closed out of embarrassment. Minnesota Public Radio created a Budget Shortfall Idea Generator that attracted about 100 comments.

The Star Tribune announced a Streamlining Minnesota series that proposed "new ideas for the public sector." It ran out of steam after only three more op-eds in two weeks, and the promised section for reader comments devoted to the series is indistinguishable from the regular opinion exchange section.

And, of course, DFL legislators conducted budget-focused listening sessions throughout the state.

Through all this, progressives were wasting our time talking about "needs" and "quality of life" and "human suffering" and "fairness." And forget major structural reforms.

It's all about cuts, stupid.

We have a governor, an extremely skilled politician, who appears to be looking through Laffer-colored glasses at a run for the presidency. And people's fears about the economy are enabling his boldness.

His approach is as simple as his message. In times of economic uncertainty, people don't know the right course, so they follow the guy who most looks like he knows what he's doing. To a large extent, that's the Obama formula once you extract the hope stuff.

Gov. Pawlenty knows what he's doing politically. If he doesn't plan to be around to clean up his own mess, it matters to him a bit less whether he knows what he's doing economically. Any negative results will be manifest as a continued decline, not a fall off the cliff, so they might not hurt him while he's still in office here. 

He wants your ideas for cover, not because he can't decide where to cut. I can hear the speech now:

"Ralph, a farmer in New Harmony, suggested I should cut welfare by $300 million. Well, actually Minnesota's public assistance spending is only 1.4% of the state's budget; the national average for all states 1.8%. So I figured he meant cut publicly funded health insurance — and sure enough, I was able to find $381 million to cut. Thanks, Ralph!

"Eloise, who owns a small business in Blackduck and has a son in Iraq, said 'why are we taxpayers paying all this local government aid to places we don't even visit?' And she's right. So I'm cutting Blackduck's LGA by — oh, let's say somewhere between 20 and 40 grand. And I see Minneapolis can spare another $35 million.

"And Bob Smith of Circle Pines said: Cut, cut, cut, cut, cut...."

A Hobby and More.

But the fact is, a bike - like a gun - is nothing more than a tool.
— Mitch Berg posting on the death of cyclist Dennis Dumm

Mitch covers a fair amount of what I had left to say on this topic and has provided the flypaper for many of the commenters who hobby will be disrupted when Anti-Strib folds.

To the armchair experts who insist bicycling is a hobby: A bicycle can be that, but for some it is a primary transportation choice. Because they live in a city where it's a practical way to get around. Because they can't afford a car. Because they've lost their drivers license. Because they enjoy it. Because they want to consume less. Because it packs commuting, fun and fitness into one activity. Because they are not old enough to drive.

For those who think cars own the road, Mitch has part of the answer — about how roads are actually paid for. And the historical reality is that the adoption of the car happened more quickly in America because a populist mode of personal transportation — the bicycle — created broad public support for building good roads.

Books in the Strangest Places.

Larry McMurtry has some competition.

Don't let the TV promo clips at the start put you off this. It's a sweet book story and love story [via News Cut].