Category Archives: Barack Obama

Pre-existing Conditions and Health Care Reform

Originally published at Politicsunlocked.com on July 1, 2009

Neccessary reforms or free-market intrusions?

There are three different classes of people in the health care marketplace in the United States: those receiving employer provided-health insurance, those who individually acquire health plans and those who remain uninsured.

Each group has a different stake in the outcome of health care reform. While costs impact all three, some crucial issues only affect one segment of the health care population, and “exclusions” and “rescissions” are important issues for those who purchase health care individually.

So-called “exclusions” typically relate to pre-existing conditions. Thus, in buying a health care policy, the insured is typically unable to obtain coverage that will pay for medical care as it relates to a pre-existing condition. This is less frequently an issue for the younger segment of the individual insurance market, such as college graduates, who are young and, statistically speaking, not yet burdened with many illnesses. Although if you are 22 and have a medical condition, you will face the reality of not having insurance for that condition unless you are employed by a company that provides insurance. Employer-provided plans generally do not have any pre-existing illness exclusions, but such employment may not be available in all fields or areas of the country, and especially in the current economic climate, many young people are graduating from college without full-time employment prospects in the near term.

Older Americans, not yet eligible for Medicare, are in a very difficult situation when in comes to purchasing individual insurance. They seek insurance in order to protect them from high costs in case of catastrophic illness, but also to aid in the payment for care related to typical illnesses and conditions that afflict people as they age.

Insurance companies are private, for profit, businesses. They compete to obtain clients who are healthy and who will pay the most premiums while requiring the least care, doing this through marketing campaigns, but also through exclusion of pre-existing conditions. Customers do not have good options, and deciding to not purchase insurance and relying on public health facilities and emergency room care can be risky and inconvenient.

One of the goals of President Barack Obama’s reform proposals is to eliminate exclusions for pre-existing conditions in individual insurance plans. This will interfere in the free-market private decision making of insurance companies, but it will be a risk born by all equally. In fact, insurance company executives have at times spoken out in favor of elimination of exclusions so long as it was done in a way that affected all insurers equally.

“Rescission” relates to “exclusion” because it refers to the cancellation of insurance when the insurer determines that the insured was not accurate in the insurance application. This is typically done when the insurer discovers that the insured person seeks payments for conditions that were pre-existing but were not revealed in the application. However, insurers also cancel contracts when they find technicalities in the applications that do not relate to pre-existing illnesses. For example, if someone failed to mention that he/she had a knee condition in his/her application, but then submitted an insurance claim related to heart surgery that was otherwise covered, the insurance company might research the insured’s medical history in search of any inconsistencies which would allow them to cancel insurance and avoid payment on the costly heart surgery.

During testimony by insurance company executives last week, outraged congressmen demanded that insurance companies stop rescissions based on technicalities. However, all three executives at the hearing refused to make that commitment. This is another issue likely to be worked over by legislators as they craft reform packages.

Ghana Hosts U.S. President

Originally published at politicsunlocked.com on July 15, 2009

Obama highlights democratic gains in West African nation

President Barack Obama recently visited Ghana and delivered a speech to its parliament. The U.S. President focused on the achievements of Ghanaian democracy and called on all Africans to work for democratic institutions and accountable government. As with his speech to the Muslim world from Cairo, the President called upon the next generation to take responsibility and assert its authority to end decades of corruption, tyranny and war on the continent.

Not long after the President’s address in Cairo, the Iranian population burst into demonstrations for democratic rights and accountable governance. It is speculation to guess at how much, if any impact, the U.S. President had on the Iranian movement, and Obama himself has bent over backwards in efforts not to appear to interfere in Iranian political affairs. But as with the Cairo address, the administration made efforts to reach a wide audience, broadcasting the Ghana speech in coordination with African embassies.

The White House press secretary, Robert Gibbs said that Ghana was chosen because it boasts a functioning democracy and civil society. Ghana has a major trade in African arts and tourism and is developing operations in natural resources. While the President has personal ties to Kenya, his father’s homeland, Ghana stands as a model of the government that President Obama would like to see throughout Africa. By contrast, Kenya’s most recent election was disputed and violence ensued. A power-sharing agreement in Kenya has met with limited success.

The President also visited Cape Coast Castle, where black Africans were held before being shipped into slavery in the Americas.

Watch the President’s speech to the Ghanaian Parliament below:

Part One

Part Two

Part Three

Part Four

Obama Power Source — Centrism and Pragmatism

By Marc Seltzer; originally published on July 21, 2009, at care2.com

In a fairly strong critique of the direction of Democratic party leadership, New York Times columnist David Brooks tells us Democrats in Congress and President Obama are going too far in a liberal direction (Liberal Suicide March, July 21).  Comparing their “out of touch-ness” with that of the Republican party’s loose deficit spending in the Bush years, Brooks asserts that the current President risks losing moderate support for his agenda, if liberals hold sway.

Mr. Brooks cites the $878 billion stimulus, the 2009 federal budget and now proposed health care legislation as three examples of where the President has abandoned the moderate center, inhabited by a majority of Americans.

I have to disagree on the stimulus count.  Such stimulus was offered up by moderate economists as one reasonable approach to protecting the economy from a Depression.  Other options, such as Republicans’ suggested payroll tax cut or Professor Roubini’s capital gains tax cut, were likewise logical, but no more certain to work or free of political problems (each could also have raised the short-term deficit and might been saved rather than spent).

The U.S. economy experienced an unprecedented financial freeze in the midst of a cyclical recession.  If we escape this disaster with only a severe recession and some unfair sharing of the burdensome bailout, contributors in the economic rescue will be the heros of the early 21st century.  The fact that people cannot fathom what could have happened or gloss over it for political gain does not change financial reality.

In this light, Brook’s impatience with the speed of stimulus spending is unwarranted.  Only 10% so far?  The spending was intended to be rolled out over two years and there is no question that this is happening.  Wasn’t the clamor in April that it was going out too quickly, without enough record-keeping?

Of course, there are few things as difficult as the loss of a job and financial safety, but that doesn’t mean that the unemployment rate can be kept below 10% or even 15% by force of will.  There is no magic wand — only reasonable policies that support the private economy and time for supply and demand to correct itself.  Republicans calling the stimulus a failure, at this point, or blaming Obama for the rising unemployment rate, play politics at the expense of their integrity.

The federal budget was a closer call.  It contained many earmarks and spending habits that did not fit with the President’s campaign rhetoric.  On the other hand, the bill was prepared during the previous year and Obama only took office weeks before Congress sent it to him for approval.  It might have been a great symbol of “change,” if the President had vetoed the bill and demanded that Congress change its ways from the start of his administration.  On the other hand, in the midst of financial devastation, a budget fight and potential government shutdowns would have caused further economic harm.  This would have been the more irresponsible, if emotionally satisfying, route.

But the health care debate is President Obama’s chance to demonstrate his leadership and vision.  Here, I agree with Mr. Brooks that pragmatic centrist leadership is necessary.  If the President doesn’t tackle the very real problems with health care costs, any solution will be unsustainable.

Mr. Brooks refers to polls showing that Americans are losing confidence in Democratic proposals for health care reform. Americans are savvy enough to know that additional deficit spending is irresponsible.  Thus, while many Americans support the President’s vision of providing insurance to nearly all and forcing change upon a powerful insurance industry, the public still needs to see a coherent financial plan.  Tax increases on upper-income Americans may be part of that plan, but large tax hikes would represent a change in policy beyond what President Obama spoke of in his campaign, and too fast or two great an increase could damage the economy.

The other option is to cut costs.  After efficiency, cutting costs equals cutting back on covered medical care.  Rationing already goes on, across the system as public and private insurers choose what procedures to cover.  After that, only those with enough money are able to purchase additional care. Those without insurance or funds have only what is offered in emergency rooms and subsidized or charitable clinics.

Somehow, many Americans have come to view raising taxes and cutting costs as bad options.  That’s why we find ourselves (Congress) legislating programs and services that we can’t pay for.

Brooks credits Obama for having ideas that go in the right direction, citing his proposed cost-cutting, limits on tax hikes, and an independent commission on Medicare spending.  But Brooks laments that Obama is not feared by the Congressional leadership, and he believes they have the power in the current battle, unless “Blue Dog” conservative Democrats can force a moderate compromise.

One such idea would be to lower the subsidy for employer-provided insurance.  The current system encourages overspending, exactly what we need to remove from the system.  Another would be to provide clearer limits on coverage for end of life treatment, which is very costly and often of debatable value.

I have hope that the President is up for a fight on health care.  He can speak to the nation like few others at this time, and his forceful leadership could shape a responsible compromise.  The President may be afraid that asking too much of Congress risks failing to achieve any reform.  But there is no reason for this to be a repeat of President Clinton’s experience.

President Obama should go to the mat for a bill that restrains costs, targets fiscal balance, aids the underserved, and corrects inefficiencies in the system.  If he fails to get the bill, he should start over after the recess, asking less.  Legislators will not want to go home empty handed a second time with a popular President telling the American people that they deserve more. The President has tremendous national goodwill and strong majorities in the Congress.  Americans will accept compromise, but not without fighting for what is right.  This is the time for the President to spend his political capital.

Drafting New Health Care Legislation

Legislation will be needed for most of the health care plans currently being talked about in the United States. Insurers, doctors groups, and medical organizations have come together to propose voluntary cost-savings measures. However, this has not stopped President Barack Obama or legislators from moving forward on proposals that would substantially change the health care marketplace.

Primarily, it is Democrats that have taken the lead in drafting legislation. Senator Ted Kennedy has long been a proponent of major health care reform. His recent illness has removed him from day-to-day leadership, but his office is continuing to advance legislation for comprehensive reform including a public insurance entity to compete with private insurers. The other substantial Senate proposal will come from fellow Democrat Max Bacaus. Republican Senator Olympia Snowe is working on a proposal that would introduce public insurance only as a punishment to the private insurers if they fail to meet legislated goals for cost savings and good care.

President Obama campaigned aggressively for change in the health care system. He argued for continuation of employer-provided insurance and assistance to individuals who could not acquire health insurance because of pre-existing conditions or the high cost of premiums. Mr. Obama also recognized that rising costs across the U.S. health care system were doomed to bankrupt public financing of Medicare, damage American employers’ competitiveness in the global marketplace and increase the number of people unable to afford private insurance.

The president has continued to weigh in during his first months in office, although he has deferred tolegislative process for the development of detailed proposals. As a result of Mr. Obama’s direction, legislators have overlooked the option of nationalized health care, despite a vocal minority in the public who support adopting the Canadian or European-styled public model.

In the House, the Ways and Means, Energy and Commerce, and Education and Labor committees have come together to present their proposal as the Tri-committee Health Reform Draft. It contains a public insurance entity, requirements for continuation of employer-provided health insurance and aid to individuals seeking to purchase insurance.

Common themes in all proposals are to require at least major employers to provide health care insurance options. This will prevent the new reforms from encouraging employers to abandon heath insurance for their employees. This still may be a problem for employers below, a yet undetermined size. Individuals will be able to buy insurance without exclusions for pre-existing illnesses, although costs may differ based on some criteria, such as age. Public funds will be used to assist local income individuals in the purchase of insurance.

The President has also stated that health care reform must be paid for by cuts in other parts of the budget or efficiency within the health care system. This may be the harder part of the legislative accomplishment. It is not clear how the different proposals will deal with this issue.

Judicial Nominee Sparks Debate on Racism, Discrimination

By Marc Seltzer; originally published on July 13, 2009 at politicsunlocked.com

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As the hearing on Judge Sonia Sotomayor’s nomination to the Supreme Court commences, there is a great focus on whether Judge Sotomayor is biased. This reflects more the nations’ prejudices than it does any real question about the judge. She has been on the bench for sixteen years, and there is little informed concern about the impartiality of her decisions.

The Ricci decision, in which she rejected claims by Hispanic and white firefighters in favor of the city of New Haven’s effort to aid African American firefighters, clearly does not show a bias towards her Hispanic cultural identity. Her decision followed federal law, which allowed cities such as New Haven to take remedial efforts where discrimination was argued or perceived. In concert with other federal judges, she deferred to Congress in its lawmaking and the city in its application of the law. While a five-member majority of the U.S. Supreme Court reversed her decision last week and provided a new authority for lower courts, this hardly paints her as either biased or activist.

Her comment, “I would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion than a white male who hasn’t lived that life,” has also inspired a strong reaction and many questions regarding her perspectives on race and gender.

News reports about her judicial temperament showed her to be no-nonsense, tough, smart, detail-oriented, and fair. Even those on the losing side held her in high regard. Some critics have harped on her toughness on lawyers appearing before her as a negative aspect, which reminds me of a very tough senior federal judge I have often appeared before. He sometimes berated lawyers and their arguments and had no tolerance for the unprepared. In my experience, I went out of my way to make sure I was ready for every hearing, and I was nervous in my uncertainty about how each hearing would go. But I did not question his capacity for the job because he was particularly demanding.

Judge Sotomayor’s comments off the bench do raise questions about the role of personal characteristics such as gender, race, religion and culture in judging, but do not create real issues about her capability or about the nature of her judicial philosophy. Justice Sanual Alito said essentially the same things that Judge Sotomayor has said – noting the impact of his Italian heritage and experience as an Italian American on his judicial outlook – without raising an eyebrow. When this kind of sentiment is expressed by a white male, it sounds “cultural,” like a tribute to our shared melting-pot cultural identity. But when the same ideas are expressed by a minority voice, it raises the concern in some of reverse discrimination as if minorities given a voice must necessarily use it in a power grab.

After a period of being attacked, without the opportunity to respond, the hearings will be Judge Sotomayor’s forum to speak. Republicans have noted that while they cannot seriously expect to thwart Sotomayor’s confirmation, they can use the hearings as a platform to argue judicial philosophy. As their criticism so far has been off the mark, it is likely that it is they who will receive a schooling in the Senate.

President Obama Reaches Out to the Muslim world

Originally published at care2.com/causes/politics/blog

President Barack Obama’s recent speech, delivered in Cairo, Egypt and broadcast worldwide was historic, visionary and ingenious.
From its rhetorical highlight “America is not – and never will be – at war with Islam” to refashioning American policy on democracies abroad:  “we will welcome all elected, peaceful governments – provided they govern with respect for all their people,”  the speech was ambitious to the point of reasserting American international leadership.

President Barack Obama’s recent speech, delivered in Cairo, Egypt and broadcast worldwide was historic, visionary and ingenious.

From its rhetorical highlight “America is not – and never will be – at war with Islam” to refashioning American policy on democracies abroad:  “we will welcome all elected, peaceful governments – provided they govern with respect for all their people,”  the speech was ambitious to the point of reasserting American international leadership.  Full Story

What We Wont Learn from the Sotomayor Confirmation Hearings

By Marc Seltzer; originally published on July 11, 2009, at politicsunlocked.com

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If there is one legal question that is profound and topical, the discussion of which would be deeply thought provoking and educational in the Supreme Court nomination hearings of Judge Sonia Sotomayor, it is the constitutional division of power between the different branches of government.

The power struggle between the branches is most notably implicated in the national debate over the Bush administration’s conduct of foreign policy and war.  President Bush and Vice-President Cheney asserted generally exclusive executive branch authority in the conduct of intelligence, detention of prisoners and avoidance of oversight in national security operations after 9/11.

Now that Bush and Cheney are out of power and more information is coming out about their conduct, opponents of such policies are on the attack, calling for investigation.  Only the most recent issue is whether Vice-President Cheney directed that the CIA withhold information from Congress that Congress has by law, demanded that the executive branch provide.  Other red-hot manifestations are whether the use of torture by the administration can be subject to explicit laws banning such activity, and whether the President was in fact required to brief congress regularly on its conduct of foreign policy and military action, as Congress has demanded.

Underlying this and other such conflicts is the question of constitutional authority in the different branches of government.  The President is the Commander-in-Chief.  Does this grant the President sole authority for decisions relating to national security, or is it an authority shared by the peoples’ representatives in Congress?

In the same vein, what are the limits of such Presidential authority?  Can the President authorize torture if he believes it is necessary for national defense?  If Congress requests that the President provide information on on-going military operations, can the President ignore the request if he believes that to follow it will harm the operations?

The ultimate answers to these questions cannot be known until the U.S. Supreme Court decides each issue in the context of specific facts presented in a lawsuit.  But a Supreme Court nominee could give us her reflections and a certain education.  This would be far more meaningful then the competing assertions of power by the administration and congress.  Of no more use are the pundits and professors who weigh in.  Almost universally, commentators take political positions based on desired outcomes, but give no real insight into what the Supreme Court would be likely to do.  The Supreme Court is deeply aware of its profound power and cautious about its legitimacy in asserting its authority over other branches of government – being the unelected branch.   Pundits have none of this real world caution.

Consequently, the Supreme Court tends to go to great lengths to avoid constitutional questions, instead deciding cases on smaller technical matters whenever possible.   There is nothing wrong with this judicial approach, except that it leaves many of us wondering where the bounds of legislative or executive power really are.

I, for one, have no doubt that they are not where the President and Congress say they are.

Supreme Court Reverses Sotomayor Panel in Ricci Case

By Marc Seltzer; originally published on July 8, 2009 at politicsunlocked.com

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The Supreme Court recently overturned an opinion issued from a three-judge appellate panel including Supreme Court nominee Judge Sonia Sotomayor. The core of the case turned on how a government agency, in this case the city of New Haven, Connecticut, should deal with potential discrimination against minority employees.

The city took a number of steps to address concerns about discrimination in promotions for fire department officer positions, such as making great efforts to create a race-neutral test and ensuring that minority officers from other departments participated in the candidate evaluation process. The lawsuit arose when the city decided to throw out the results of the firefighter promotion exams because no African-American applicants achieved top scores, meriting promotion.

The Supreme Court decision sheds some light on how government entities are expected to handle discrimination concerns. However, it does not fit as nicely into the affirmative action debate as commentators claim. It also fails to provide any significant evidence against Judge Sotomayor’s promotion to the U.S. Supreme Court.

It was white and Hispanic firefighters who sued the government in Ricci v. DeStefano when their success on the exams was disregarded. They lost their case in the lower courts and petitioned the Supreme Court for a final review. The Supreme Court found that once the promotion exams were completed, the city needed evidence that the exam was discriminatory, beyond just the results themselves, to justify disregarding those results. This, the city did not have. It had a history of discrimination, where only one of 21 fire captains was African-American, and it had a fear of lawsuits from unsuccessful black candidates, a legitimate concern recognized in the law guiding cities’ decision making on employment matters, but it did not have evidence that this test was unfairly discriminatory.

The Supreme Court decision was 5-4, with Justice Anthony Kennedy writing an opinion joined by Justices Scalia, Thomas, Alito and Chief Justice Roberts. The decision does not seem to overturn much law on affirmative action or to allow discrimination against minorities to go unchecked. It does say that once a hiring process is completed and candidates are ranked for promotion, it should not be upended without evidence that it was faulty.

The dissent would have allowed the city to disregard the test results in light of past discrimination and suspicion and potential legal challenges over the results themselves. There was evidence that another type of exam process might have yielded different results and the dissenting opinion considered that sufficient to put the test results into question and justify the city’s action.

Judge Sotomayor, along with two other appellate judges, had agreed with the trial judge that the city was within its rights to redress what it perceived was a problem in the test results. Justice Sotomayor will be asked about the decision in the nomination hearings next week. However, her position was hardly the type that should concern the judiciary committee reviewing her nomination. Sotomayor followed existing law on an issue where there is obviously substantial disagreement.

Why Health Care is So Expensive

Originally published at politicsunlocked.com on June 29, 2009

As the health care debate moves forward, the mess of issues surrounding why health care is so expensive is finally being fleshed out.

Private insurance and costs for health care make up great deal of our national economy. If we were all receiving excellent care and had few complaints about the system, the fact that it costs so much might not be a problem.

However, companies can ill-afford insurance costs when they offer insurance to employees and compete in a global economy. Some of our most successful corporations, those that have “adapted” to international competition such as Walmart, have dropped health care insurance for their employees. Others such as automobile manufacturers and airlines could not compete partly because of the growing costs of health care plans for current and retired workers. Bankruptcies have resulted and health care plans for retired workers have been trimmed or eliminated in the process.

About eighteen percent of the population is uninsured and are likely to avoid some care that would be important for good health and then pay for private care on their own or use expensive public resources without paying for care.

Even the insured have complaints about the system. The public often blames the insurance companies for skimping on coverage and profiting unfairly. While Americans who have employer-provided insurance are most often satisfied with their health care, those who have to obtain insurance privately have great concerns about exclusions of pre-existing illness and recession of contracts for insurance after they become ill.

A recent New Yorker article attempted to discover why the costs in different areas of the country differ dramatically. The article is a must-read for sorting out one aspect of health care: can costs be lowered while still providing excellent care? The writer, an M.D. himself, Atul Gawande, interviewed doctors in two Texas areas, where statistics show widely different costs per person for about the same health care outcomes for their patients. In one section of the article, Dr. Gawande recounts a conversation with doctors from the more expensive health care area:

Some were dubious when I told them that McAllen was the country’s most expensive place for health care. I gave them the spending data from Medicare. In 1992, in the McAllen market, the average cost per Medicare enrollee was $4,891, almost exactly the national average. But since then, year after year, McAllen’s health costs have grown faster than any other market in the country, ultimately soaring by more than ten thousand dollars per person.

“Maybe the service is better here,” the cardiologist suggested. People can be seen faster and get their tests more readily, he said.

Others were skeptical. “I don’t think that explains the costs he’s talking about,” the general surgeon said.

“It’s malpractice,” a family physician who had practiced here for thirty-three years said.

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted.

“Come on,” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here, pure and simple.”  Doctors, he said, “were racking up charges with extra tests, services, and procedures.”

This does not demonstrate that the problems of health care costs are all related to decisions made by doctors. But research shows that the outcomes of care provided in lower-cost areas can be as good as that provided in high cost areas. If this is the case, insurers, the government and the public pay more than what is necessary through premiums, co-pays and taxes. A change in the care prescribed by doctors could save everyone a great deal of money without providing less care. In fact, patients would endure fewer tests, less and medical procedures than they are currently made to face.

Much of the current debate focuses on the politics of health care. People imagine a war between socialism and capitalism fought in the guise of health care reform. Good financial reform will be much more specifically tailored to deal with the problems in the current system and hopefully will give us more for less.

What can Canada teach us about banking regulation?

By Marc Seltzer and Leslie Schreiber; originally published as “Northern Light” on June 19, 2009, in Commonweal Magazine and at Commonwealmagazine.org.

US Regulatory Reform Follows Canadian Model

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Amid the greatest worldwide financial meltdown since the Great Depression, there have been few examples of sound financial management and regulation. Public authorities have had to provide billions of dollars to support ailing institutions and have acknowledged far-reaching gaps in public oversight. Responding to the disastrous bubble and bust, the Obama administration is calling for comprehensive reform. International leaders have even gone so far as to call for the creation of a world financial regulator.

U.S. Treasury Secretary Timothy Geithner, while not going that far, is asking Congress to grant the Treasury broad oversight authority for virtually all financial institutions, and a mandate to monitor systemic risk. Additional proposals seek to insure that financial instruments, such as credit-default swaps, are subject to federal regulation. While Congress will ultimately be responsible for crafting legislation, Geithner’s proposals provide a road map for a new financial order, in his words-“not modest repairs at the margin, but new rules of the game.”

The economic crisis has tested the stability of financial systems across the international community. The results differ widely, from Iceland’s near-bankruptcy to Canada’s remarkable financial health and insulation from risk. Beyond the private gains and losses, the crisis has revealed strengths and weaknesses of different regulatory environments. Remarkably, not a single major Canadian financial institution has needed a bailout. In March, the International Monetary Fund praised Canada’s banks for their “remarkable stability amid the global turbulence.” Howard Kaplow, an investment executive and director of financial services in Montreal, noted that Canadians “tend to be more conservative, but we also have a more restrictive financial authority with tougher rules to follow.” The IMF agrees, commending Canada’s “strong regulatory and supervisory framework.”

In this light one may ask how Secretary Geithner’s proposals for regulatory reform measure up against the Canadian model. Are the Obama administration’s efforts to monitor systemic risk and regulate all substantial financial entities and instruments in line with the Canadian approach?

In contrast to Canada’s conservatism, the U.S. system has gone through a period of “irrational exuberance.” Over the past twenty years, Congress deregulated financial industries in order to maximize business opportunity. New financial instruments, markets, and conglomerates were unleashed without oversight. In a recent debate over the causes of the crisis, New York University Professor Nouriel Roubini (nicknamed “Dr. Doom” for having predicted the current crisis) argued that, “deregulation occurred too fast and in ways that did not provide prudential regulation for provision of the financial system.”

The dominant political ethos was trust in free markets, competition, and modest regulation-even self-regulation. Where regulators did act, they followed a framework that called for distinct regulators in compartmentalized markets. The FDIC has been highly praised for its success at handling the closing of failed banks, but neither the FDIC nor the Federal Reserve had authority to intervene when an investment bank or insurer acted unwisely or teetered on the brink of bankruptcy.

In the end, the failures were systemic and pervasive. They could not be limited to one sector of the financial system, nor were they detected by any existing regulatory agency. In warning that the problems would not respond to a quick fix, President Barack Obama observed that the crisis “didn’t result from any one action or decision. It took many years and many failures to lead us here.”

New regulations were contemplated long before Secretary Geithner was confirmed. Former Treasury Secretary Henry Paulson and the General Accounting Office oversaw substantial groundwork in 2008, but it now falls to Geithner to finish the job. While Geithner is promoting a more comprehensive regulatory regime, the proposals have been developed by financial and market experts and insiders who believe in free-market capitalism. They do not wish to stifle financial innovation. Instead, the aim is to protect the overall system while allowing risk-taking activity to continue. This approach is in line with the Canadian system, where, despite strong regulatory authority, the financial sector has prospered. Today, five of the country’s banks are among the top fifty banks in the world. Ten years ago none of them was.

The lead financial regulatory authority in Canada is the Office of the Superintendent of Financial Institutions (OSFI), currently headed by Julie Dickson. She chairs the Financial Institutions Supervisory Committee, which has broad authority to monitor systemic risk and, for that purpose, brings together regulators who oversee market stability, risk-management, and business practices from across the financial economy. The OSFI mandate covers “all banks, along with federally regulated property, casualty, and life insurers, and trust and loan companies, plus about 10 percent of private pension plans” according to OSFI spokesman Jean Paul Duval. If any of the institutions “raise a red flag, the OSFI can implement a range of disciplinary measures, affecting everything from bank capitalization to controlling assets, and even getting directly involved in business planning.” Indirectly, this also includes securities firms, which are 70-percent bank-owned in Canada (for example, RBC Dominion Securities is part of the Royal Bank of Canada). The OSFI oversees 450 banks and insurers, and approximately 1,350 private pension plans. Its authority, while not reaching all financial institutions (hedge funds are not regulated by the OSFI), is fairly comprehensive and is foundational for the soundness of the Canadian system.

Secretary Geithner told Congress in March that the oversight he was proposing “would include bank and thrift holding companies and holding companies that control broker-dealers, insurance companies, and futures commission merchants, or any other financial firm posing substantial risk” (emphasis added). Not every financial entity reaches the size and significance to affect systemic risk, but Geithner wants to avoid a system where the legal form of an entity can be used to shield it from regulation. A key component of meaningful oversight is the ability of the regulator to set standards for institutional risk management. Geithner is asking Congress for authority to increase capital requirements, to restrict leverage ratios, and to enact additional prudential rules.

In Canada, the OSFI has substantial experience with such oversight. According to Duval, since its creation in 1987, the OSFI “has always been vigilant in the development of its risk-management practices.” Capital requirements for Canadian banks have been held at 7 percent, while the global average is closer to 4 percent. Similarly, Canada’s bank-leverage ratio has been kept under twenty-to-one, while international bank leverage ratios were thirty-to-one and even forty-to-one. OSFI Superintendent Dickson remarked in November 2008, “We have seen how strong capital cushions in Canada have paid off to the benefit of our institutions and overall financial system.”

Canadian institutions were not free from risk-taking or even from exposure to subprime loans from the United States, but strong capital and leverage standards kept the damage from overwhelming Canada’s banks, let alone destabilizing the economy. In addition, Canadian banks generally still maintain the mortgage portfolios of loans they originate, retaining direct knowledge and responsibility for their management. These conservative practices reinforce sound regulation, and vice versa.

Canadian regulators give special attention to larger, “too big to fail” organizations. Duval explains that “OSFI utilizes a risk-based methodology, where institutions that we believe are operating in a riskier manner are subject to increased supervision. That said, the larger institutions will be operating in larger parts of the market, so [they] would naturally receive greater attention…and can be subject to different supervisory requirements.”

Similarly, the U.S. federal regulator proposed by Geithner will have the power to step in and manage problems when institutions fail to meet prudential standards or find themselves in financial difficulty. Special consideration would be given to entities deemed “too big to fail.” Geithner is asking Congress for the flexibility to intervene where there is risk to the wider economy. He has already intervened with a few of the big banks. Recent “stress tests” resulted in some banks being required to raise capital, although banks could choose whether to seek private or public funds.

Critics have called for regulations that would cap the size or restrict the legal structure of financial institutions. However, noting that other countries have allowed hybrid entities such as Canada’s banking and securities conglomerates, Geithner appears to trust that oversight will protect the system, and that private decision making should be allowed as much leeway as possible. The changes he proposes will require legislation. Under his lead, the Obama administration should be pushing hard for a substantial increase in federal regulatory authority. What might have been politically impossible before the crisis is now high on the legislative agenda. In addition, the chairman of the Federal Reserve, Ben Bernanke, has spoken in concert with the administration. While Congress will take a significant role in designing new regulation and is not likely to rubber-stamp the administration’s proposals, momentum is strong for the creation of comprehensive financial reform. The success of the regulatory system across the border should inspire both humility and hope.