Thursday, December 31, 2009

Good Health Care, For Rush

First, the obligatory: like most people, I am glad that it appears that Rush Limbaugh, who entered Queen's Medical Center in Honolulu on Wednesday suffering from pain in his upper left chest "like I've never experienced before," appears to be fine (physically). (If bad health forced him from the air, where else would I get half my ideas for this blog?) No more or less than the a man in Topeka or Albuquerque or a woman in Minneapolis or Little Rock admitted to a hospital emergency room over the past few days.

Rush was his usual snarky, combative self in a press conference, remarking "The treatment I received here was the best that the world has to offer. I don't think there's one thing wrong with the American health care system. It is working just fine." He doesn't believe that, of course, but Limbaugh will say all manner of things which only the completely ignorant would believe. It is just, well, ideologically and politically advantageous for him to pretend that he really, truly believes such things.

More to the point, though: Limbaugh, according to CNN, also

urged anyone who experiences heart or chest pain to seek medical help immediately.

"Don't mess with it," he said.


Yea, no kidding. Presumably, he will be applauded for lending his prestige to the (sensible) idea that if you think you're getting a heart attack, you should not roll over and go back to sleep. But what about when an American experiences less frightening symptoms or is ill short of suffering a heart attack or stroke? How does one respond when there is not "one thing wrong with the American health care system (which) is working just fine?"

A study in 2005 by the Commonwealth Fund found

51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.

It's just a guess but my hunch is no one in the media, once Rush Limbaugh is able to return to work, will ask him if his advice for people experiencing chest or heart pain extends to Americans unable to get health care because they cannot afford it. After all, if a reporter or interviewer did ask such a question, his/her organization would be branded part of the "liberal media" and wouldn't be fulfilling its need to pander to the interests of the private, for-profit health care bureaucracy.

Wednesday, December 30, 2009

Mouthpiece

The shilling goes on and on.

Chris Cillizza went on Hardball on December 28 and claimed (video below, relevant portion beginning at approximately 1:30)

Well, what you always have to remember, Chris, is members of Cogresss have been there a long time; they value the institution. They think they have as much to do with the bill as the President does and of course always important to remember, the political connection- this is ultimately about them surviving the next election.

Now he tells us. We have had months of hearing, ad nauseum, from the mainstream media that a) President Obama is much more popular than Congress (specifically, Democratic members of Congress and b) the fate of Democratic members of Congress is tied to that of the President and thus Democrats must vote for the health care bill before them. And now we have a pundit "explaining" that, well, Democratic congresmen/women really are free agents- and selfish at that- because, after all, the President is almost a lame duck ("this is ultimately about them surviving the next election"). And on top of that, they're almost delusional: they "think" they have as much to do with the bill as the President does.

But that's nothing compared to Eleanor Holmes Norton. The District of Columbia Delegate appeared on the same broadcast, with her fellow member of the House Homeland Security Committee, Republican Dan Lundgren of California, to talk about the federal government's response to the recent failed terrorist plot aboard an airplane headed for Detroit. After Norton asserted (at approximately 4:20 of the video way below), accurately, "now, the President did the right thing," she ignorantly maintained "when you get some body on televison saying everything went well." Matthews then cut her off to play a grossly edited version ("that dreadful comment," he remarked) of Homeland Security Secretary Janet Napolitano on CNN's State of the Union, where on Sunday the latter actually explained

And one thing I’d like to point out is that the system worked. Everybody played an important role here. The passengers and crew of the flight took appropriate action. Within literally an hour to 90 minutes of the incident occurring, all 128 flights in the air had been notified to take some special measures in light of what had occurred on the Northwest Airlines flight. We instituted new measures on the ground and at screening areas, both here in the United States and in Europe, where this flight originated.

So the whole process of making sure that we respond properly, correctly and effectively went very smoothly.


Referring to the reaction of the American people (as she obviously would have it), Norton then contended

When you look like you're spinning the truth, they really turn away from you. She really did the President a disservice when she said that.

Or, Napolitano really would have done the President a disservice if she actually had said that- rather than the bland, benign remark she did make.

Not only did the guest from D.C. (and Matthews) twist obscenly what Norton's "good friend" (beltway for "that jackass") said, it apparently wasn't even appreciated by President Obama, who in his statement Monday, saw fit, graciously and appropriately, not to imply any criticism of the Homeland Security Secretary. Further, his actions belie whatever worry that Norton ascribes to him over the thwarted attack. Politico helpfully reports

President Barack Obama promised a “thorough review” of the government’s terrorist watch list system after a Nigerian man reported to U.S. government officials by his father to have radicalized and gone missing last month was allowed to board a Northwest Airlines flight to Detroit that he later allegedly tried to blow up without any additional security screening.

Yet the individual Obama has chosen to lead the review, White House counterterrorism adviser John Brennan, served for 35 years in the CIA, helped design the current watch list system and served as interim director of the National Counterterrorism Center, whose role is under review.

In the three years before joining the Obama administration, Brennan was president and CEO of The Analysis Corp., an intelligence contracting firm that worked closely with the National Counterterrorism Center and other U.S. government intelligence, law enforcement and homeland security agencies on developing terrorism watch lists.

“Each and every day, TAC makes important contributions in the counterterrorism (CT) and national security realm by supporting national watchlisting activities as well as other CT requirements,” the company’s website states.

According to financial disclosures forms released by the White House, Brennan served as president and CEO of TAC from November 2005 until January 2009, when Obama named him to the White House terrorism and homeland security job. The disclosures show that Brennan reported earning a $783,000 annual salary from The Analysis Corp. in 2008.

The forms also show that Brennan sat on the board of directors for TAC’s parent company, Global Strategic Group, from August 2007 until January 2009. Brennan’s ties to the system he is now charged with reviewing could raise questions about the independence of Obama’s review. One former senior intelligence official told POLITICO it is “unsavory to see Obama put Brennan in charge of a review of this matter, since it is possible that NCTC or TAC could have failed in their responsibilities.”


Brennan will have to labor mightily to divert attention from the agency he once headed, inasmuch as

These concerns landed Abdulmutallab among the about 550,000 names in the Terrorist Identities Datamart Environment database, known as TIDE, which is maintained by the NCTC. Other, smaller lists trigger additional airport screening or other restrictions, but intelligence officials said there wasn't enough information to move Abdulmutallab into those categories.

The NCTC, which has responsibility if any visas are to be pulled over terrorism concerns, then reviewed the information and found it was "insufficient to determine whether his visa should be revoked," Kelly said.


Give the White House some credit: it is smart enought to know a conflict of interest when they see it- just not ethical enough to care. Politico continues:

Senior administration officials said that for the past few days, the White House’s legal and ethics counsel has been reviewing Brennan’s ties and determined that given Brennan’s knowledge of and experience with the intelligence community, any conflict was outweighed by the need for Brennan’s expertise on the issue....

The White House has posted a blog item written by Norm Eisen, special counsel for ethics and government reform, noting the ethics waiver for Brennan and explaining why Obama believes he is the right person to head this review and how its legal counsel determined that it was in the public’s interest.


Defend a guy if you wish; run interference for him at every opportunity. But when that official- in this case, the President of the United States- himself is practically telling you that he is planning to whitewash a terrorist attack, it is foolish to accuse his subordinate of failing to take that incident seriously.





Danger In Immigration Legislation

There are two problems with- wait for the euphemism- "comprehensive immigration reform." One is the substance. The other is the slippery slope it provides.

For today, the slippery slope.

The head of the House of Representatives' Progressive Policy Caucus, Raul Grijalva, has introduced a bill which the californian.com says would

would allow illegal immigrants to stay in the country while they apply to become legal residents or citizens. They would have to pay a $500 fine and show they've made a contribution to the country through work, education, military or community service....

The legislation also would repeal the 287(g) program, which enlists local police and sheriff's deputies to enforce federal immigration law. The bill says only the federal government has the authority to enforce those laws.

It also includes a provision that would allow states to offer in-state school tuition to students who aren't citizens and whose parents may be in the country illegally.

The bill acknowledges that strong border security is needed, but it also calls for increased oversight of border control agents to ensure civil liberties are protected.


(Additionally, the Phoenix Business Journal reports "In addition to the $500 fine, the proposed bill would allow some deported illegal immigrants to apply for legal status and would lift immigration rules for those charged only with using fake Social Security numbers." This, however, is sufficiently bizarre that confirmation is required before comment.)

The Obama administration supports a rival, more moderate proposal submitted by Senator Chuck Schumer (D.- N.Y.). A danger lurks, however, in the comment of Representative Flake (R.- AZ.) who, The Californian notes, has worked in the past with Representative Grijalva on immigration reform. Flake says Grijalva's bill

repeats the mistakes of the '86 reform — massive legalization without a temporary-worker program to accommodate future labor demands.

Flake is talking about a guest-worker program or, as he puts it "a temporary-worker program," because (sarcasm alert) what this economy really lacks are unemployed and under employed workers looking for employment.

It's an old Republican or, more fairly, conservative, idea. These advocates generally are hard-core free-market cheerleaders who understand all too well the concept of supply and demand. They know there are too few jobs for Americans looking for work.

The reference to "future labor demands" is a shibboleth- this country increasingly has more individuals in the labor market and too few jobs to allow them a living wage. This will not end any time soon- and possibly never. The intent is clear- get more workers from abroad, have them compete with Americans and legal immigrants (and anyone else here) for a job, and sit back as downward pressure on wages- and benefits- results. And a plus- "temporary," or guest, workers will be here as long as they are employed- giving the employer- responsible or not- huge power over the lives of the immigrant worker. Blackmail, anyone?

There is an additional danger. This nation has an unfortunate tradition of division, obviously, between races and, to a lesser extent, gender. In the past, a gap predicated on religion and ethinicity also was a defining characteristic of society. Now, there is a growing gulf between the affluent and the poor, between the rich and the middle class, the "two Americas" presidential candidate John Edwards emphasized. A guest/temporary worker program would create similar division, as explained in an article (no longer available) entitled "That's Hospitality" from the 4/17/06 edition of The New Republic. Commenting on a proposal of then-President George W. Bush, TNR editors understood

The problem with Bush's plan lies in the term--and the concept of--"guest workers," because there is little that is more antithetical to the American ideal than a guest worker. While there are dangers in romanticizing this country's immigrant heritage, it is an unmistakable part of the national ethos. For generations, immigrants have come to the United States in search of a better life. In the process, they often remake themselves--as Americans. Even those who are here illegally, and whom we call illegal immigrants, can transcend that identity--or at least see their children who are born here transcend it.

But a guest worker and his family have no such opportunity for transcendence. They are slotted into a caste, with no real hope of ever rising above it. Indeed, Bush's guest-worker program would codify a large group of people in the United States as second-class citizens. Although they would enjoy many of the same legal protections as American-born workers, they would never be viewed by Americans as equals. Instead, they would be seen as transient figures here only to make a buck. They would not be immigrants or future Americans. They would merely be janitors, construction workers, and housekeepers.


In the 1950, the editors continued, several European nations adopted guest-worker programs in part to

avoid becoming ethnically plural societies. Of course, those nations became ethnically heterogeneous when the guest workers did not go home. But the workers, while remaining in those European countries, never became of them. Consider Germany, for instance, where more than two million Muslims of Turkish origin--whose families came as guest workers four decades ago--live today. They live in Germany not as Germans, but in a strange sort of nationless limbo-- afforded certain benefits of citizenship (such as health care) but denied the privilege of actually being citizens. Which, of course, denies them any incentive to assimilate to their new country. The prospect of such a thing happening in the United States with Mexican guest workers is only too real.

Creating a (another euphemism) "path to citizenship" (which TNR supported) carries with it advantages and disadvantages for American society. But there is no advantage which could compensate for the risk of adoption of a temporary-worker program, the dream of the corporate conservatives who support legalization of illegal immigrants.

Tuesday, December 29, 2009

Blame With Credit

Ask yourself this: which Congress was it which failed to pass health care reform in the 1990s? Don't remember, do you? Because we remember it as the failure of President Bill Clinton (and of the First Lady).

If a health reform bill passes Congress, it will accrue to the benefit of the President of the United States. President Obama will be sufficiently gracious to praise Congress but the American people and the mainstream media will credit the President with the "W" (not Bush). It will be considered a historic achievement beyond the reach of every Democratic President (and Richard M. Nixon) since Harry S. Truman.

So it's a little disconcerting to read in a post by Jed Lewison at Daily Kos

It is also important to point out that if it were not for corporate special interests and a dysfunctional Senate, this bill could have done even more.

President Obama is positioned to be applauded for passage of a health care bill. But for some progressives/liberals, any blame gets apportioned elsewhere. Despite the progressive, continual growth of power of the Executive Branch at the expense of the legislative branch of the federal government since the administration of President Johnson, the popular target has been Congress. It is always safe to blame the House of Representatives or the Senate, or both, because they are invariably less popular than the President of the United States.

But if credit for this legislation will go to the President, so too must any blame for its inadequacies. In a statement from the press office of Senator Russ Feingold issued on December 20, the Wisconsin Democrat argued

Unfortunately, the lack of support from the administration made keeping the public option in the bill an uphill struggle. Removing the public option from the Senate bill is the wrong move, and eliminates $25 billion in savings. I will be urging members of the House and Senate who draft the final bill to make sure this essential provision is included.

The following day, David Dayen of Firedoglake remarked

Today on MSNBC, Howard Dean was asked if he agreed with Feingold’s statement that the Obama Administration bore responsibility for the public option’s removal. He was unequivocal. “Yes” was his one-word answer.

Rahm Emanuel acting, presumably, on behalf of President Obama, has stage-managed the health care legislative process. In an excellent piece on The Huffington Post exploring the failure of liberal/progressive Democratic members of Congress to exert any leverage on health care reform, Jeffrey Feldman notes

As frustrated as the base of the Democratic Party may be in this late stage of the health care reform battle, few have reflected on the force behind every legislative battle this year: Rahm Emanuel.

If a bill finally is passed, Barack Obama will get the credit for doing what's never been done. At the very least, he should get most of whatever blame is assessed for the its failure as policy and politics, and for promise unfulfilled.
The Republican Media- No. 24

If one is to believe E.J. Dionne- and one usually should- it was inevitable. In his recent column "Two Cheers for Harry Reid," the Washington Post syndicated columnist noted

Such assaults are rarely about ideology, though I have found that liberals or Democrats are often the object of these sustained attacks, perhaps because journalists are overly sensitive to charges of liberal bias. There's nothing like hitting a Democrat hard to "prove" impartiality.

As if to confirm Dionne's suspicion, the Post's syndicated columnist Eugene Robinson snarked

Homeland Security chief Janet Napolitano's initial assessment of the Christmas Day airliner attack -- that "the system worked" -- doesn't quite match the absurdity of "Brownie, you're doing a heck of a job." But only because she quickly took it back.

On the December 28 edition of MSNBC's Hardball, host Chris Matthews took this attack to absurd lengths (video below)

Earlier in the show we brought you Homeland Security Janet Napolitano's initial reaction to the thwarted terrorist attack of Christmas Day. She said, quote, "the system worked." Well, that's like "you're doing a helluva job, Brownie." Well, how many Americans disagree with that assesment? According to an online, unscientific poll by Politioco.com, ninety-six per cent. Just three per cent agree with the Homeland Security Secretary, who said everything's working great. I wonder who the three per cent are. Well, anyway, 96% say the attempt showed the security in place didn't work.

Perhaps the 3% are the few who actually heard everything the Homeland Security Chief said when she explained on ABC's This Week (from which the video of Napolitano was taken for this segment)

Number two, I think the important thing to recognize here is that once this incident occurred, everything happened that should have. The passengers reacted correctly, the crew reacted correctly, within an hour to 90 minutes, all 128 flights in the air had been notified. And those flights already had taken mitigation measures on the off-chance that there was somebody else also flying with some sort of destructive intent....

Now once this incident occurred, everything went according to clockwork. Not only sharing throughout the air industry, but also sharing with state and local law enforcement, products were going out on Christmas Day, they went out yesterday, and also to the industry to make sure that the traveling public remains safe.


Once this incident occurred. Once this incident occurred. (She repeated herself; I thought I would.) Napolitano's reference to "the system working" clearly was to what transpired once the suspect/terrorist was subdued. Is that really so hard for Robinson and Matthews to understand?

The answer: no, it's not; and no, they did not misunderstand.

To give Matthews his due: the "earlier in the show" video to which he referred came from Napolitano's appearance on CNN's State of the Union Sunday. There, the Secretary stated

And one thing I’d like to point out is that the system worked. Everybody played an important role here. The passengers and crew of the flight took appropriate action. Within literally an hour to 90 minutes of the incident occurring, all 128 flights in the air had been notified to take some special measures in light of what had occurred on the Northwest Airlines flight. We instituted new measures on the ground and at screening areas, both here in the United States and in Europe, where this flight originated.

But even there she was referring to what transpired after the thwarted attack, given references to: the passengers and crew took appropriate action; within literally an hour to 90 minutes of the incident occurring; we instituted new measures.... where this flight originated.

Again: is that really so hard for Matthews and Robinson to understand? And again, they did not misunderstand.

What is going on here? A hypothesis, supported by this and other remarks by these two gentlemen: as Stepford Wives to Barack Obama, Matthews and Robinson are anxious to distance themselves from Democrats whenever afforded an opportunity. If they fail to do so, they may appear to their colleagues, "overly sensitive to charges of liberal bias," in Dionne's words, to be slightly biased. To viewers whose worldview is already perverted by listening to the likes of Limbaugh, Beck, and Hannity, they may appear part of the "liberal media." Suitably intimidated, they rush to ridicule any Democrat without the initials B.O. in order "to 'prove' their impartiality,"

Conveniently, such journalists can continue to idolize and/or excuse President Obama, while the right can continue to imagine a leftist bias in the mainstream media. A win-win, of a sort.


"

Monday, December 28, 2009

Words And Goals, Words And Goals

ABC News' Jake Tapper with one of the most irrelevant (least relevant?) "gets" of the year:

In the Senate version, the language on abortion funding would allow women who receive government subsidies to purchase insurance policies that cover abortion, but they would have to write separate checks.

But the House language is tougher. It prohibits women who receive government subsidies from taking out plans that provide abortion coverage.

I asked President Obama about that last month.

"There needs to be some more work before we get to the point where we're not changing the status quo. And that's the goal," Obama told me in November.

So, does the Senate language come closer to what the president wants than the House language?

Gibbs told me this morning: "Yes."


Perhaps "not changing the status quo" is the goal of the President of the United States. You know- like the goal of Mr. Obama was to help the nation achieve single payer health care (video below) achievable, he assured us, once Democrats "take over" the House, the Senate, and the White House.

Or of overturning the prohibition in the Medicare prescription drug program prohibiting the federal government from negotiating drug prices directly with the pharmaceutical companies, an aim of an Illinois Senator who in 2007 said

Congress exempted Medicare from being able to negotiate for the cheapest available price. And that was a profound mistake.

Or of the presidential nominee who promised (video way below)

The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what the chairman of the committee, who pushed the law through went to work for the pharmaceutical industry making 2 million dollars a year.

Imagine that.

That's an example of the same old game playing in Washington. You know I don't want to learn how to play the game better, I want to put an end to the game playing.


Whose campaign website suggested the federal government:

Allow Medicare to negotiate for cheaper drug prices. The 2003 Medicare Prescription Drug Improvement and Modernization Act bans the government from negotiating down the prices of prescription drugs, even though the Department of Veterans Affairs' negotiation of prescription drug prices with drug companies has garnered significant savings for taxpayers. Barack Obama and Joe Biden will repeal the ban on direct negotiation with drug companies and use the resulting savings, which could be as high as $310 billion, to further invest in improving health care coverage and quality.

We know what happened to that "goal" (at an eventual cost to the taxpayers of hundreds of billions of dollars):

A memo obtained by the Huffington Post confirms that the White House and the pharmaceutical lobby secretly agreed to precisely the sort of wide-ranging deal that both parties have been denying over the past week....

It says the White House agreed to oppose any congressional efforts to use the government's leverage to bargain for lower drug prices or import drugs from Canada -- and also agreed not to pursue Medicare rebates or shift some drugs from Medicare Part B to Medicare Part D, which would cost Big Pharma billions in reduced reimbursements.

In exchange, the Pharmaceutical Researchers and Manufacturers Association (PhRMA) agreed to cut $80 billion in projected costs to taxpayers and senior citizens over ten years. Or, as the memo says: "Commitment of up to $80 billion, but not more than $80 billion."


And let's not forget this "yes, we can" goal:

We’ll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies.

And this golden oldie from the campaign:

Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options.

Aside from the rhetoric "of new, affordable health insurance options," which probably will not include any public option, in relatively few cases will one's health insurance go down anywhere near $2500 per year- and in most cases probably will go up. And as for the prediction "under the plan.... nothing changes," the Center for Medicare and Medicaid Services, anticipating the possibility of enactment of the Senate's excise tax, explains

In reaction to the tax, many employers would reduce the scope of their health benefits. The resulting reductions in covered services and/or increases in employee cost-sharing requirements would induce workers to use fewer services. Because plan benefit values would generally increase faster than the threshold amounts for defining high-cost plans (which are indexed by the CPI plus 1 percent), over time additional plans would become subject to the excise tax, prompting those employers to scale back coverage.

Jon Walker of Firedoglake has evaluated proposed health care reform in light of Barack Obama's campaign promises, an exercise which begs the question: should we take at face value everything said by Barack Obama?





Friday, December 25, 2009

Warped Arguments

Yellow Dog at theygaveusarepublic.com on 12/24 pretty clear summed up the conflict some of us face in viewing health care reform as it has become (_ _ _ not in original):

This is why I'm glad the Democrats have won - so far - on health care DEform, even though I still think the bill is a piece of s_ _ _ that will cost Democrats dearly in extra work, extra money, extra time and lots of lost votes.

This bill is making repugs rip out their own eyeballs in rage and despair, and for the moment that's a good enough outcome for me.

It's hard to argue with logic like that, especially when one of those Republicans, Oklahoma's Senator Tom Coburn, argued on December 24

If this bill becomes law, future generations will rue this day and I will do everything in my power to work toward its repeal. This bill will ration care, cut Medicare, increase premiums, fund abortion and bury our children in debt.

This process was not compromise. This process was corruption. This bill passed because votes were bought and sold using the issue of abortion as a bargaining chip. The abortion provision alone makes this bill the most arrogant piece of legislation I have seen in Congress. Only the most condescending politician can believe it is appropriate to force Americans to pay for other people's abortions and to coerce medical professional to take the lives of unborn children.

Senator Coburn, understandably did not- could not- say how the measure would "ration care" or "bury our children in debt." Given that the bill would not ration care and was fashioned to be at worst deficit-neutral, Coburn was wisely discreet. And of course he has been an advocate of extending the GWB tax cuts for the wealthy, which did its part in exploding the deficit.

Certainly Coburn is aware that abortion was used "as a bargaining chip" by the anti-choice Nebraska senator Ben Nelson, not by pro-choice proponents; and that the Senate bill (as does the House bill) further restricts, rather than expands, a woman's right to choose. Sure, gloating would be rude; but whining after a victory is so childish.

It's (sarcasm alert) heartwarming that Senator Coburn worries that the legislation will "cut Medicare." It would be a little more convincing, however, if he hadn't one sentence earlier claimed

Congress ignored the coming economic storm and impending bankruptcy of our entitlement programs....

Now what could one of the Senate's most conservative members have meant when he referred to the "impending bankruptcy of our entitlement programs?" Probably the same thing Rush Limbaugh, Concord Coalition founder Pete Peterson, and what Digby refers to as "the Village" (roughly, the Washington media-corporate-political establishment) mean.

The Social Security system, notwithstanding being robbed by successive congresses and presidents to fund the general debt, is sound. Medicare is endangered- but by increasing health care costs, which must be addressed by effective health care reform. The interests wringing their hands over "the impending bankruptcy of our entitlement programs," as Digby noted in late May, is trying

to break the generational bond between the young and old and are always looking for a good moment of impending crisis (or "opportunity" like a rising stock market) to put an end to the program. Whatever works.

As for Medicare --- there's no fixing it without health care. But they know that too --- which is one of the reasons they will block reform
.

But the more intriguing portion of Coburn's speech contained the seemingly innocuous reference to Christmas, when he contended of Senate Democrats

Their hide the ball strategy led them to rush this process and ram the bill through on the eve of the most important Christian holiday when they hoped the American people wouldn't be watching.

In the long run, the GOP's original intent, to delay the vote until 7:00 p.m. Christmas Eve, is irrelevant. But what about "the most important Christian holiday?"

Perhaps the calendars are all wrong, it is March or April, and we've just celebrated Easter. Christmas may be "the most wonderful time of the year"- to many Christians and non-Christians- and the most important holiday to individual Protestants, Roman Catholics, and Orthodox Church members. But it simply is not the "most important" holiday in Christendom. The Spirit of the Reformation Study Bible explains the importance in Christendom of Jesus Christ's death and resurrection, the former the basis of Good Friday and the latter of Easter, both days obviously inextricably linked:

First, it (the resurrection) has been treated as the validation of Christian claims about the effectiveness of his atoning death. Jesus' resurrection demonstrated his victory over death (Ac 2:24, 1Co 15:54-57), vindicated him as righteous (Jn 16:10) and confirmed his divinity (Ro 1:4). This event therefore led to his ascension, enthronement (Ac 1:9-11; 2:33-34, Php 2:9-11; cf. Isa 53:10-12) and present heavenly reign. The reality of the resurrection guarantees believers; present forgiveness and justification (Ro 4:25; 1 Co 15:17; Heb 7:24-25), as well as their future hope of resurrection life when Christ returns (Jn 11:25-26; Ro 6; Eph 1:16-2:10; Col 2:9-15; 3:1-4).

Moreover, the apostle John (in 6:58) reportedly quoted Jesus as declaring to skeptics "I tell you the truth, before Abraham was born, I am!" (after which stones rained down on him). The birth of the human Jesus (notwithstanding to a virgin) approximately 30 years prior is very important to Christian belief but not as much so. The resurrection of Jesus Christ three days after his death by crucifixion is simply the central event of Christianity.

Feel free not to believe any of this. Most people around the world- including an awful lot of nominal Christians- do not. But they are the fundamental beliefs around which Christianity resolves, contrary to Senator Coburn's implication.

One could argue that Coburn is not even a Christian, but rather a member of a Christian cult- the Family, which combines an elitist allegiance to capitalist domination with its own brand of Christian theology. But that would be a violation of the Law of Parsimony. It is, after all, Christmas season; a time of good cheer, Santa Claus, and egg nog. And if Tom Coburn can combine the positive emotions of the season with the enduring Repub tactic of portraying Democrats as the godless, anti-Christian party, exploitation of the Christian faith is mere "gravy," an added bonus.

Thursday, December 24, 2009

Bad Choice

“You were instrumental in facilitating, putting together, organizing and funding this cruel and inhumane sporting activity,” Hudson told Vick in a courtroom packed with animal-rights activists and Vick’s family and fans. “While you have acknowledged guilt and apologized, I’m convinced it was not a momentary lapse of judgment on your part. You were a full partner.”

Vick, 27, pleaded guilty in August to bankrolling a dogfighting operation, Bad Newz Kennels, and to helping kill six to eight dogs. He voluntarily entered prison three weeks ago, in Warsaw, Va...

Vick denied a direct role in killing the dogs that did not perform to expectations, but his co-defendants — Quanis Phillips and Purnell Peace — said Vick played a major role in some of those killings, which included drownings and hangings.


And so Michael Vick, once a starting quarterback for the Atlanta Falcons, was sentenced on December 10, 2007 to 23 months in prison by Judge Henry E. Hudson in United States District Court.

This past September, Vick would be reinstated to the National Football League by Commissioner Roger Goodell, soon after being signed by the Philadelphia Eagles, for whom he is a backup quarterback.

But if Vick's performance on the field has been unremarkable, his impact on his teammates has been somewhat surprising. They have unanimously voted him the team's recipient of the Ed Block Courage Award, which, ESPN explains, "honors players who exemplify commitment to the principles of sportsmanship and courage. Each of the 32 NFL teams selects a recipient."

There are at at least two ways of viewing this selection: appalling and obscene. Mr. Vick, however, does not see it that way, remarking

I've had to overcome a lot, more than probably one single individual can bear. Take a look at what I've been through. You ask certain people to walk in my shoes, they probably couldn't do it. Probably 95 percent of the people in this world - because nobody had to endure what I've been through, situations I've been put in, situations I've placed myself in, decisions that I've made - whether they were good or bad.

Credit Michael Vick with avoiding false humility. Credit him also with crass insensitivity to the millions of Americans who have served more than 18 months in prison for less heinous crimes- or for committing offenses while being consumed by a drug habit or alcoholism or a severe emotional problem. Many of these have been justly sentenced, but few had the advantage of a multi-million dollar professional football contract and all the trappings that go with it. Or, as Philadelphia Inquirer sports columnist Phil Sheridan put it

And, hey, Vick has been through a lot. He was identified early as a remarkably gifted athlete and treated special throughout his high school years. He was handed a full scholarship to Virginia Tech. After playing just two years there, he was taken with the very first pick in the 2000 NFL draft.

The Atlanta Falcons gave him a six-year, $62 million contract before he ever played a down for them. They tore that up four years later and gave him what was the biggest deal in NFL history at the time: $130 million, including $37 million in bonuses, over 10 years.

Vick overcame all of this privilege and good fortune, winding up bankrupt and incarcerated in federal prison after running an ongoing illegal dogfighting operation. He has since demonstrated the courage to accept a million dollars from the Eagles in an effort to rehab his image and resurrect his very lucrative career.


Ultimately, the award says little about Michael Vick. But it does say a lot about the judgment, and perhaps the integrity, of the players who would enthusiastically honor such an individual.

--------------------------------MERRY CHRISTMAS---------------------------
Bipartisan, To A Fault

Talk show host Laura Ingraham says so, Rush Limbaugh says so, Time Magazine's Mark Halperin says so, even David 'The Legend' Broder says so. Therefore, must it not be true?

According to Media Matters, on 10/27/09 Ingraham claimed on GOP TV's Fox & Friends:

This crowd is the most partisan crowd I have ever seen in Washington. They said Bush was partisan?.... You're about to have your entire health care system changed by one party that's wildly unpopular right now. Unbelievable.

The same day, Halperin contended on MSNBC's Morning Joe:

I agree with what you have been saying for months, which is they made a mistake not making this bipartisan, once they made the decision to do it with Democratic votes.

On December 16 Limbaugh blustered:

It is not simple-minded. It is not simplistic to say, "I oppose that, it's liberal. I oppose that candidate," or, "I oppose that president, because it's liberal." In fact, it is highly wise. It's very smart to cite liberalism as the primary reason you oppose any liberal or any Democrat. It's the smartest thing you can do is to stop liberalism at every chance you've got. Not work with it, not compromise with them, not try to prove to them that you're a nice guy. Just beat 'em. Just stop 'em. Especially now. We have never faced a more radically left leadership in this country than now, and there's no compromising with them.

And now, on Christmas Eve, Broder imagines

But even those Republicans who were initially inclined to do that (i.e., "offer a sustained working partnership)-- and there were at least a handful of them -- were turned away by the White House and the Senate Democratic leaders, who never lifted their sights much beyond the Democratic ranks....

It would help a lot if he (President Obama)reached out personally to those few Republicans who might still want to improve the bill rather than sink it. And it would help even more if he shamed the Democrats into rescinding some of the crasser bargains they made to buy votes along the way.

The country would welcome even a few signs that this legislation has bipartisan support.


On October 13, in the opening statement (html) he gave to the "markup" of the bill passed by the Senate Finance Committee he chairs, Senator Max Baucus explained:

Over the last two years, we held 20 hearings on health care. Last June, we held a health care summit at the Library of Congress. We held three roundtable discussions with experts on each of the three major areas of reform:

health care delivery, coverage, and how to pay for it. In connection with each roundtable, we put out detailed option papers. And then we held three walk‐throughs to hash out those options. Six Members of the Committee — three Republicans and three Democrats — held 31 meetings to try to come to a consensus. We held exhaustive meetings. We met for more than 61 hours. We went the extra mile.


Who are these "bipartisan" Republicans?

Arizona Senator Jon Kyl on an August 18 conference call with reporters, referring to GOP senators, stated

I think it’s safe to say that there are a huge number of big issues that people have. There is no way that Republicans are going to support a trillion-dollar-plus bill.

South Carolina Senator Jim DeMint on a conference call on July 17 boasted

If we’re able to stop Obama on this it will be his Waterloo. It will break him.

Iowa's Senator Grassley, himself a member of the Gang Of Six which crafted the bill in the Finance Committee, on August 17 that he wouldn't vote for any bill which would not get the support of most Republicans.

In his remarks, Senator Baucus explained "Senators offered and the Committee considered 135 amendments. We conducted 79 roll‐call votes. And we adopted 41 amendments." On December 20, the Salt Lake City Tribune reported on one of these amendments:

A number of studies have cast some serious doubt about the effectiveness of abstinence-only sex education and as a result, congressional Democrats -- who have bristled at the program for years -- cut off all federal funding.

But then Hatch stepped in. During a committee health reform debate, he cited his own supportive studies and proposed an amendment restoring $50 million for the controversial program for the next five years. It passed with the help of two Democrats -- Sens. Blanche Lincoln, from Arkansas, and Kent Conrad, from North Dakota -- much to the chagrin of Senate liberals.

"I sure do not want the abstinence education to be short-changed," Hatch said during the hearing.

The committee passed a second amendment supported by the Democratic chairman that created a separate $50 million program for comprehensive sex-ed, which combines information about abstinence, sexually transmitted diseases and contraceptives.


Aside from whether abstinence-only education generally works (it doesn't) or whether the Utah Senator (or Lincoln, Conrad, and the others) will continue to pose as a "fiscal conservative" (he shouldn't, but will), this was an amendment proposed by a Republican, approved by a Democratic-dominated committee and Senate, and which probably will appear in the combined House/Senate bill- even though most congressional Democrats don't agree with it.

In the mainstream media and, to a lesser extent, among the public, where "bipartisanship" is next to godliness, it's political gold for the GOP to pretend that the Democratic Party shut it out in advancing health care reform. But as at least Repub partisans like Ingraham and Limbaugh understand (but never would admit), it is bogus.

President Emanuel Obama and congressional leaders have strenuously attempted to get any Republican on board with health care reform. Any Republican. At almost any cost. But they have faced a party bound and determined to oppose all initiatives the Democratic Party has to offer on this issue. And they have held firm- with only one Republican vote (cast only after the necessary majority for approval had been attained)in favor of reform in the House and none in the Senate. And they have gotten their way- even if they have chosen, for strategic reasons, to claim otherwise- in persuading Democrats to promote legislation far more pleasing to health insurers and drug companies than to consumers.



-------------------Merry Christmas---------------------------------

Tuesday, December 22, 2009

A Limited Grasp Of Reality

During the presidential campaign, the Democratic nominee's website, barackobama.com, included this:

The Obama-Biden plan will create a National Health Insurance Exchange to help individuals purchase new affordable health care options if they are uninsured or want new health insurance. Through the Exchange, any American will have the opportunity to enroll in the new public plan or an approved private plan, and income based sliding scale tax credits will be AFFORDABLE, ACCESSIBLE COVERAGE OPTIONS FOR ALL provided for people and families who need it.

Pretty simple, right?

When he responded during that campaign to questions posed to him by The Washington Post, Obama wrote

My plan builds on and improves our current insurance system, which most Americans continue to rely upon, and creates a new public health plan for those currently without coverage. Under my plan, Americans will be able to choose to maintain their current coverage if they choose to. For those without health insurance I will establish a new public insurance program....

Pretty simple, right?

Senator Obama became President Obama, and his (rhetorical) support for the public option did not flag, asserting (video, from DailyKosTV, below) on June 23, 2009

The notion that all these insurance companies who say they’re giving consumers the best possible deal, if they can’t compete against a public plan as one option, with consumers making the decision what’s the best deal, that defies logic, which is why I think you’ve seen in the polling data overwhelming support for a public plan.

And on July 18, he again declared his unambiguous support for the public option, warning (video, from DailyKosTV, way below)

Any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans – including a public option to increase competition and keep insurance companies honest – and choose what’s best for your family.

But that was then and this is now. The Washington Post reports in "Obama rejects criticism on halth-care reform legislation":

Nowhere has there been a bigger gap between the perceptions of compromise and the realities of compromise than in the health-care bill," Obama said in an Oval Office interview with The Washington Post about his legislative record this year. "Every single criteria for reform I put forward is in this bill...."

He said the Senate legislation accomplishes "95 percent" of what he called for during his 2008 presidential campaign and in his September speech to a joint session of Congress on the need for health-care reform....

Obama said the public option "has become a source of ideological contention between the left and right." But, he added, "I didn't campaign on the public option."


How does one square "perception with reality," as Mr. Obama would put it? In a piece for The Huffington Post, Drew Westin noted "what they're (the American people) are "seeing is weakness, waffling, and wandering through the wilderness without an ideological compass." Although posted two days before the interview with the President took place, Westin's comments neatly apply to Obama's disingenuous remarks about his support for a public option:

I can't stand them (the President's speeches) because I realize he doesn't mean what he says -- or if he does, he just doesn't have the fire in his belly to follow through. He can't seem to muster the passion to fight for any of what he believes in, whatever that is. He'd make a great queen -- his ceremonial addresses are magnificent -- but he prefers to fly Air Force One at 60,000 feet and "stay above the fray...."

To be honest, I don't know what the president believes on anything, and I'm not alone among American voters.


It no longer is an issue of Barack Obama's sincerity, but rather whether the President, as Westin suggests, evinces "a failure to articulate and defend any coherent ideological position on virtually anything" or simply finds truth distasteful.





Monday, December 21, 2009

Enthusiasm Unwarranted

Digby writes (1/19/09, "Clarifying Debate"):

But the first thing Democrats need to do is dial down the end-zone dance and start talking about this bill for what it is. Indeed, if I were them, I'd work hard to lower expectations. nor do I think that the political system will allow the quick fixes that will be necessary to keep people on board while they get the reforms in place, regardless of whether the Republicans come back into power during the implementation period, which they very well could. This just isn't a big New Deal style social insurance program and selling it in those terms is setting the stage for a backlash.

As the proprietor of Hullabaloo understands better than most of us, this (Senate health care) bill is not a done deal. A vote on final passage in the upper chamber is now scheduled for Christmas Eve and, if (as expected) approved, the House and Senate bills will go to conference and the merged bill eventually to a vote.

Until passage of "health care reform" by Congress, expectations will be ramped up so as to increase chances of approval. But Barack Obama is not stupid- or even halfway there. Once he signs the a piece of legislation (assuming that occurs), there will be a deliberate effort by the White House, aided and abetted by the mainstream media, to lower expectations. That will be realistic, of course, given that anything now gaining the signature of the President will (as Digby apparently understands) bear as much resemblance to the New Deal as the Cleveland Browns' victory yesterday; that is, nothing. But it will be the only wise political strategy. There will be a backlash- but not because champagne corks will be popping.

Nevertheless, if the legislation will not revolutionize health care, perhaps it represents the beginning of a 'slippery slope.' This seems to be a common theme of the liberals/progressives who are disappointed at the emerging outcome, but nevertheless believe it is a step forward.

Take Jacob Hacker, heralded as the author of the "public option," who writes

The current bills in Congress do too little to help Americans immediately; their main actions are delayed for years. If and when legislation passes, progressives should demand immediate concrete actions to make the promise of a reform a reality more quickly and more effectively.

Paul Starr of The American Prospect believes

Liberals in Congress should also recognize that with either a 2013 or 2014 date for implementation, there will be time enough to revise the program before it goes into effect (indeed, time enough for the opponents to roll it back). Many of the specifics, such as the level of subsidies, almost certainly will be changed in the intervening years. And many of those specifics can be changed through budget reconciliation, which requires only 51 votes to pass the Senate.

This evening, Senator Bernie Sanders (I-Vt.), appearing after the Iowa Democrat on The Ed Show on MSNBC, contended (transcript and video not yet available)

As Tom Harkin said, the day after this vote passes, we can come back and improve it.

The New Republic's Jonathan Cohn argues more concisely:

Pass this bill now. Improve it later. That's the way we do things in America, for better or for worse.

Cohn also has echoed Harkin's comparison of the bill to "a starter home" with a solid foundation, a strong roof, and room for expansion. He concludes "No, this legislation is not everything it could be. But Harkin is right: It’s also not everything it will be."

No, no, no, and no. As Digby explains, "I do not believe this legislation will be exempt from repeal or serious whittling away as time goes on." While the public's attention has been focused on health care for months, there generally has been a narrow majority of the American people supportive of a public option and greater annoyance with the influence of money in politics. If a bill is passed, the special interests then will go to work, unrestrained by the prominence of the debate and media glare which now act as a (limited) brake on their power. No one will be around to promote the interests of the public and corporate interests will dominate the scene to an even greater extent than they have thus far.

It's questionable whether these leading liberal lights really believe that passage of something approaching health care reform will be a stepping stone to actual impovement in the health care system. If they do so, they might actually think Browns' late-season surge of those Cleveland Browns portends an improvement that will drive them to the Super Bowl next season.

Saturday, December 19, 2009

The New Testament, Perry Version

Michelle Bachmann, move over.

Competition may not be coming to private health insurance companies, but it has come to Michelle Bachmann.

The Minnesota congresswoman, famed for her repeated, ludicrous remarks, may have met her match in Texas Governor Rick Perry.

Perry appeared before a builders group in Dallas on December 16 and was asked (video below) of Al Gore's environmental activism: "Did you get religion? Did he get religion? What happened since then?" To approving laughter and applause, he responded

I certainly got religion. I think he's gone to hell.

The remark led MSNBC's Ed Schultz to note (video way below) "Using religion to take down Democrts just doesn't seem very Christ-like to me. In fact, it is in violation of the spirit of Christmas."

Truly, it doesn't sound like the fellow who on the Mount of Olives explained "The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me." But it may in fact be in the spirit of Christmas which, these days, is saturated with commercialism. And such remarks may qualify Perry, if he loses his bid for re-nomination against Kay Bailey Hutchison, to work on the Conservative Bible Project.

Consider the possibilities. Here are a few of the best-known quotes of Jesus Christ (all from English Standard Version), followed by the re-interpretation Governor Perry might give them:



Truly, truly, I say to you, whoever believes has eternal life. (John 6:47)

Truly, truly, I say to you, whoever denies climate change has eternal life.
______________________________________________________
And as Moses lifted up the serpent in the wilderness, so must the Son of Man be lifted up, that whoever believes in him may have eternal life. (John 3:13)

And as Moses lifted up the serpent in the wilderness, so must Rush Limbaugh be lifted up, that whomever believes in tax cuts may have eternal life.
_____________________________________________________


Truly, truly, I say to you, whoever hears my word and believes him who sent me has eternal life. (John 5:24)

Truly, truly, I say to you, whoever hears the NRA’s word and believes it has eternal life.
_____________________________________________________

For God so loved the world that he gave his only Son, that whoever believes in him should not perish but have eternal life. (John 3:16)

For God so loved the GOP that he gave his only Son, that whoever believes in Ronald Reagan should not perish but have eternal life.


And in a less sarcastic vein: why would Rick Perry believe that one who believes in the reality of climate change necessarily go to hell? or that one who works in that field would necessarily go to hell? or who does anything Rick Perry doesn't like necessarily go to hell? or that Rick Perry would supplant his judgement of who is going to hell for that of the God he claims to believe in?






Column Of The Week

Back in September, Washington Post ombudsman Andrew Alexander, referring to the "tardiness" of the media in addressing the Association of Community Organizations for Reform Now (ACORN) scandal (trumped up, but still a scandal), wrote

One explanation may be that traditional news outlets like The Post simply don't pay sufficient attention to conservative media or viewpoints.

It "can't be discounted," said Tom Rosenstiel, director of the Pew Research Center's Project for Excellence in Journalism. "Complaints by conservatives are slower to be picked up by non-ideological media because there are not enough conservatives and too many liberals in most newsrooms."

"They just don't see the resonance of these issues. They don't hear about them as fast [and] they're not naturally watching as much," he added.

Post Executive Editor Marcus Brauchli said he worries "that we are not well-enough informed about conservative issues. It's particularly a problem in a town so dominated by Democrats and the Democratic point of view."


Addressing this recently in his weekly Wall Street Journal column, author Thomas Frank could have slammed this reasoning by noting that in an investigation commissioned by ACORN, former Massachusetts Attorney General Scott Harshbarger concluded that the community organization's management had been lax but "we did not find a pattern of intentional, illegal conduct by ACORN staff involved; in fact, no action, illegal or otherwise, was ever taken by any ACORN employee on behalf of the videographers.'' Or that a U.S. District Court judge on December 11 issued a preliminary injunction against the congressional resolution which cut off federal funds to the group, ruling that it was a "bill of attainder," thus unconstitutional.

Instead, Frank focused on critiquing Alexander's belief that "traditional news outlets" should consider ideological diversity in its hiring practices. But, as Frank indicates, the argument collapses when considering:

* There is no analogy between racial/gender diversity and ideological diversity because "unlike race or gender, people choose their ideologies. Alexander's notion that achieving ideological diversity is akin to achieving racial and gender diversity is faulty because "people choose their ideologies. What's more, they often change them as they go through life, and they sometimes find that it is to their pecuniary advantage to ditch the embarrasing political enthusiasms of their youth";

* It would be futile because "anyone setting out to appease bias-spotters on the right should know that the conservative movement feels that it is plagued by impostors and faker, and it won't be satisfied until these (Republicans in Name Only), too, are chased from the newsrooms of the nation;

* The decade's "far more consequential failures" would probably not be eliminated by hiring more Republicans and fewer Democrats; they would be the "failure to look critically at the Bush administration's rationale for the Iraq War; and then, the business press's failure to understand the depth of the subprime mortage problem and to anticipate its massive consequences."

Here in Newsrooms Don't Need More Conservatives, Frank does not argue (as he easily could) that reporting of news from the mainstream media is dominated by a rightward and/or Republican tilt. Rather, he observes

....the problem, in each of these masive failures, wasn't really ideological at all. The people who got it right, in both cases, were the ones willing to hold power accountable, to directly challenge the conventional wisdom.

Thomas Frank may be extraordinary, liberal, and populist, but proves he can be extraordinary, populist, and objective.

Friday, December 18, 2009

Not Much Of A Strategy

Another day, another compromise by liberal/progressive Democrats. The Washington Post reports today that

Earlier Thursday, in an interview with a Nebraska radio station, Nelson said even if the abortion issue were resolved, he still could not support the $848 billion package, complaining that the plan to cover more than 30 million additional Americans calls for dramatically expanding Medicaid, which is partially funded by the states. The Medicaid expansion would "create an underfunded federal mandate for the state of Nebraska," Nelson said, arguing that states should be permitted to "opt out" of that idea and find other ways to offer coverage to their poorest residents.

Why concession after concession by Democrats who believed candidate Barack Obama when as a candidate he expressed skepticism about a mandate for private insurance and enthusiasm for a public option? Even Paul Krugman, while realistically unenthusiastic, is on board, arguing today in The New York Times

But let’s all take a deep breath, and consider just how much good this bill would do, if passed — and how much better it would be than anything that seemed possible just a few years ago....

Right now, let’s pass the bill that’s on the table.


Krugman contends the bill

would prohibit discrimination by insurance companies on the basis of medical condition or history: Americans could no longer be denied health insurance because of a pre-existing condition, or have their insurance canceled when they get sick.

Well, sort of; and no. Section 2701, titled "Fair Health Insurance Premiums," addresses pre-existing conditions:

‘(a) Prohibiting Discriminatory Premium Rates-
‘(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--
‘(A) such rate shall vary with respect to the particular plan or coverage involved only by--
‘(i) whether such plan or coverage covers an individual or family;
‘(ii) rating area, as established in accordance with paragraph (2);
‘(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and
‘(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and
‘(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).


You could argue that being a smoker or elderly is not technically a "pre-existing condition," but blogger mcjoan at Daily Kos would not:

So what that means is that if you can be charged more than three times as much, for exactly the same plan, as someone younger than you. So being older is a pre-existing condition. So is being a smoker. Which makes sense from a profit-making point of view--these people could cost insurance companies more. But it also means that you can be charged more for being older or a smoker.

Apparently, legislators also don't consider such conditions as obesity or diabetes a "pre-existing" condition, as revealed in this Washington Post article:

By more than doubling the maximum penalties that companies can apply to employees who flunk medical evaluations, the legislation could put workers under intense financial pressure to lose weight, stop smoking or even lower their cholesterol....

Critics say employers could use the rewards and penalties to drive some workers out of their health plans.

President Obama and members of Congress have said they are trying to create a system in which no one can be denied coverage or charged higher premiums based on their health status. The insurance lobby has said it shares that goal. However, so-called wellness incentives could introduce a colossal loophole. In effect, they would permit insurers and employers to make coverage less affordable for people exhibiting risk factors for problems such as diabetes, heart disease and stroke....

The legislation would make exceptions for people who have medical reasons for not meeting targets.


But if the claim that the bill as currently written would ban rejection based on pre-existing conditions is questionable, the claim that rescission would be prohibited is almost laughable:

Section 2712 addresses "Prohibition of Rescissions:"

A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not rescind such plan or coverage with respect to an enrollee once the enrollee is covered under such plan or coverage involved, except that this section shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage. Such plan or coverage may not be cancelled except with prior notice to the enrollee, and only as permitted under section 2702(c) or 2742(b).

Commenting in another post, mcjoan notes that "fraud" and "intentional misrepresentation of material fact" are typically used by insurance companies to deny or terminate coverage, common when the insured was unaware of a health problem, or for honest mistakes or inadvertent omissions on their applications. Lisa Girion of The Los Angeles Times wrote in June:

Executives of three of the nation's largest health insurers told federal lawmakers in Washington on Tuesday that they would continue canceling medical coverage for some sick policyholders, despite withering criticism from Republican and Democratic members of Congress who decried the practice as unfair and abusive.

The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums, began a day after President Obama outlined his proposals for revamping the nation's healthcare system.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses....

The executives -- Richard A. Collins, chief executive of UnitedHealth's Golden Rule Insurance Co.; Don Hamm, chief executive of Assurant Health and Brian Sassi, president of consumer business for WellPoint Inc., parent of Blue Cross of California -- were courteous and matter-of-fact in their testimony.

But they would not commit to limiting rescissions to only policyholders who intentionally lie or commit fraud to obtain coverage, a refusal that met with dismay from legislators on both sides of the political aisle....

Late in the hearing, Stupak, the committee chairman, put the executives on the spot. Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show "intentional fraud."

The answer from all three executives:

"No."


Nevertheless, as Markos observes,the standard response of liberals/progressives has been to "shrug their shoulders and say, "all right, we'll take whatever we can get." Why? The obvious answer is that liberals/progressives fell in love with the idea of health care reform- and especially the phrase- quickly and completely. And that they believe failure to pass a bill would make them appear incompetent and unworthy of holding power. And that the failure of their President, their party leader, to shepherd a major piece of legislation to passage would erode his credibility and, in so doing, their own.

But what was the strategic error? It is so obvious that it's easily ignored. Markos and Atrios (to whom he links) make parallel remarks almost in passing without recognizing the basic, simplistic truth they hold.

Markos: People are so quick to rush to embrace a bill that's not set in stone, which has been consistently eroded over the past year, at an exponentially accelerated pace....

Atrios (Eschaton): A bit tired of people demanding that progressives support a bill which doesn't exist....

So fundamental no one even noticed (even the comments of those two bloggers were in service of a different point). All along, congressional liberals/progressives have been asked: "Do you support the bill?" And instead of responding "what bill?" they've actually answered the question. Dealing themselves into a position of weakness has been almost as instinctive as it has been self-defeating.

We cannot say what the result will be- if we did, we'd be making the same error congressmen have been making all along by assuming that "health care reform" is not subject to modification, tweaking, and, almost exclusively, weakening.

Wednesday, December 16, 2009

President Obama, (Selectively) Loyal

They say patience is a virtue. So is loyalty.

On July 7, representatives of several pharmaceutical companies met at the White House with representatives of the Administration and carved out a then-secret deal. In return for its support of President Obama's health care efforts, the Pharmaceutical Research and Manufacturers of America received several concessions from the White House. The deal, as outlined in a memorandum obtained the following month by The Huffington Post and reported by Ryan Grim, comprised a

Commitment of up to $80 billion, but not more than $80 billion.
1. Agree to increase of Medicaid rebate from 15.1 - 23.1% ($34 billion)

2. Agree to get FOBs done (but no agreement on details -- express disagreement on data exclusivity which both sides say does not affect the score of the legislation.) ($9 billion)

3. Sell drugs to patients in the donut hole at 50% discount ($25 billion)
This totals $68 billion

4. Companies will be assessed a tax or fee that will score at $12 billion. There was no agreement as to how or on what this tax/fee will be based.

Total: $80 billion

In exchange for these items, the White House agreed to:

1. Oppose importation

2. Oppose rebates in Medicare Part D

3. Oppose repeal of non-interference

4. Oppose opening Medicare Part B


The deal did not bind the United States Congress. But 0n Tuesday, 30.5 (Lieberman included) Democrats joined 17 Republicans and the White House in killing a major effort by Senator Byron Dorgan (D.-ND) to lower drug prices for millions of Americans.

The amendment would have allowed pharmacies and wholesalers to import U.S.-approved medication from Canada, Europe, Australia, New Zealand and Japan and faced major opposition from Senators Thomas Carper (D.- AstraZeneca), Robert Menendez (D.- Merck), and Frank Lautenberg (D.- Sanofi-Aventis).

Sure, as the Democratic nominee for President, Mr. Obama had other ideas, as he made clear when in October 2008 he declared (video below- starts at approximately 23:00)

First, we'll take on the drug and insurance companies and hold them accountable for the prices they charge and the harm they cause... And then we'll tell the pharmaceutical companies, 'Thanks but no thanks for overpriced drugs'. Drugs that cost twice as much here as they do in Europe and Canada and Mexico. We'll let Medicare negotiate for lower prices. We'll stop drug companies from blocking generic drugs that are just as effective and far less expensive. We'll allow the safe reimportation of low-cost drugs from countries like Canada."

The Pharmaceutical Market Access and Drug Safety Act would have saved the federal government $19,4 billion over ten years and American consumers $20 billion over the same period. It had 20 co-sponsors, including four Republicans, demonstrating the bipartisanship so treasured by Barack Obama during the campaign and when it undermines the progressive nature of legislation such as the stimulus and health care reform. And the bill was co-sponsored by Mr. Obama when he was in the Senate.

But a deal is a deal. So when Margaret A. Hamburg, the President's commissioner at the FDA, sent the upper chamber a letter Tuesday morning raising the specter of tainted drugs entering the U.S. from abroad, she was serving the President well. Though it may have been unnecessary, given the wide range of recipients of campaign funds from the pharmaceutical industry, the scare tactic could only help the industry's interests.

It didn't matter, as Roger Hickey, Jeff Cruz, and Dean Baker found in April 2007 "the U.S. consumers pays 52% more than British, 67% more than Canadian, and 92% more than French consumers for a market basket of 30 drugs.[3]"

Nor was it consequential

that many good ol’ American drugs sold at good ol’ American pharmacies are manufactured in China. We live in a largely deregulated global economy today — and this is the case whether you order your medications from U.S. or Canadian pharmacies. In most if not all cases, the drugs you receive from a properly licensed Canadian pharmacy are identical to those you would receive from a U.S. pharmacy.

The deal with Big Pharma- which would have been blown up by adoption of Dorgan's amendment- commits the White House to "oppose repeal of non-interference." As Grim noted, "'Non-interference' is the industry term for the status quo, in which government-driven price negotiations are barred. In other words, the government is "interfering" in the market if it negotiates lower prices." Hickey, Cruz, and Baker had estimated "Repealing this provision (i.e., non-interference) and allowing the government to negotiate for cheaper prices could save U.S. taxpayers and seniors more then $30 billion a year."

Nor does it matter that the drug companies have rewarded President Obama's generosity in an odd fashion, according to a New York Times article of last month:

In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992.

The drug trend is distinctly at odds with the direction of the Consumer Price Index, which has fallen by 1.3 percent in the last year.


But a deal is a deal. It may damage the budget, impoverish millions of Americans, and mark the President as a sucker by the pharmaceutical industry. But ever virtuous, Mr. Obama is loyal, at least to powerful corporate interests.



Universal Coverage

Despite all other criticism, the Patient Protection And Affordable Care Act, fashioned by Rahm Emanuel, Harry Reid, and Joe Lieberman, provides for universal health insurance. Finally, the United States, in mandating coverage for every legal citizen, joins the rest of the industrialized world in ensuring that no one dies because of lack of health care. Salon's Thomas Schaller summarizes the opinions of health reform analysts, finding:

Jonathan Cohn, acknowledged health care expert at The New Republic, says so:

Is health care reform without a public option still worth passing? Unequivocally, unambiguously yes.

The case for is simple and straightforward: 30 million additional people, maybe more, will have health insurance.

Paul Starr, co-founder of The American Prospect, says so:

None of this, however, affects the central provisions of the legislation, which would extend health coverage to an estimated 33 million of the uninsured....

Ezra Klein, who has faithfully and famously been following the health care debate for The Washington Post, says so:

The core of this legislation is as it always was: $900 billion, give or take, so people who can't afford health-care insurance suddenly can....

You can choose your estimate. The Institute of Medicine's methodology says 22,000 people died in 2006 because they didn't have health-care coverage. A recent Harvard study found the number nearer to 45,000. Since we talk about the costs of health-care reform over a 10-year period, may as well talk about the lives saved that way, too. And we're looking, easily, at more than a hundred thousand lives, to say nothing of the people who will be spared bankruptcy, chronic pain, unnecessary impairment, unnecessary caretaking, bereavement, loss of wages, painful surgeries, and so on.


Oops. Just when a child, an adult, most likely an elderly person needs it the most

A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.

The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.

As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.

Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned "No lifetime or annual limits."


Consumer Reports cites the clause and adds a comment:

‘‘(a) IN GENERAL.—A group health plan and a health-insurance issuer offering group or individual health insurance coverage may not establish—(1) lifetime limits on the dollar value of benefits for any participant or beneficiary; or ‘‘(2) unreasonable annual limits (within the meaning of section 223 of the Internal Revenue Code of 1986) on the dollar value of benefits for any participant or beneficiary."

Apparently, according to this clause, insurers can set “reasonable” annual caps on coverage, just not “unreasonable” ones. But what’s a “reasonable” limit? The bill doesn’t say.

And that’s not the only problem with this text. See where it says “dollar value”? This is a loophole that would let insurers limit certain types of care, such as physical rehabilitation sessions or mental-health counseling
.

Still, although this gives insurance companies a great opportunity to cut off (catastrophic) coverage when your needs are greatest and their costs are the hightest, at least no one will lose coverage under any other circumstance.

Oops. Insurance companies will be able to drop you when they object to your claim, as noted, ironically, on the website of the Senate Democrats as an "immediate benefit":

Protection from Rescissions of Existing Coverage
 The Patient Protection and Affordable Care Act will stop insurers from rescinding insurance when claims are filed, except in cases of fraud or intentional misrepresentation of material fact.


It's (almost) unfortunate that General Motors has stopped production on the Hummer- you could have driven that baby right through that loophole. On Daily Kos, math4barack explains

That's not really a ban on rescissions. "Fraud and intentional misrepresentation of material fact" are precisely the excuses that the insurance companies are using when rescinding policies. Does the Senate actually believe that the insurance companies are telling people that their policy is rescinded because they got sick? No way.

They always claim that it's due to fraud or misrepresentations. For example, one of the many horror stories involves a woman's policy being rescinded because she didn't report a prior case of acne. Her insurance company interpreted this as fraud and rescinded the policy. Fraud! The ban on rescissions is supposed to prevent this.


And these are the benefits of the health care legislatin, aside from closing the doughnut hole in Medicare prescription drug coverage and other incremental reforms. This is without even considering the impact on insurance premiums when the industry picks up tens of millions of additional customers with no Medicare expansion, public option, or any innovation that provides competition.

We will learn more about the legislation as it (presumably) passes the Senate, goes to the House, and (presumably) eventually to conference. In the meantime, you will be forgiven if you, too, observe as has the Kos blogger

This bill is an indirect transfer of wealth from Americans and their taxes to the private insurance industry. It is subsidizing their largesse. It is a bailout of the private insurance industry.

Score One for the Former, and Still, Thespian

Not the main question but: if we're fools, what does that make the two moderates of The View? Joe Scarborough and Mika Brzezinski real...