Lieberman may try to singlehandedly kill health care reform.

If Just Say No Joe Lieberman, whom I regard as the single worst example of a bought and paid for politician in the entire Senate, gets his way and manages to single-handedly kill health care reform, I will write to Reid and other Senators continually until they strip him of all committee responsibilities and declare him not a member of the Democratic caucus. See this.

Or, to put it a bit more bluntly, what a complete asshole.

Progressive Pressure

"Undoubtedly progressives will see today's development as a validation of their intense activism--pressure that wasn't always appreciated by Democratic party elders."  --Brian Beutler, TPM 

Damn right we do. Better get used to it, 'cause we have no intention of letting up. If you resent pressure from your constituency, then get the hell out of the way and let somebody do your job who actually will do your job... which is to deliver what your constituents want.

Sen. Alexander: no opt out because option too popular..... wha' the...?

How can people say shit like this with a straight face?

Sen. Lamar Alexander, a Republican leader from Tennessee, said on the Senate floor Monday, in advance of Reid's announcement, that the opt-out provision isn't to be taken seriously. Medicaid, he noted, has an opt-out provision, but not one state has opted out. Public health insurance, in other words, is too popular for states to opt out. (Read more here).  

Let's get that straight, now. It's a bad idea, because it's too popular. Right. So much for even pretending we have democratic government in this country.

Depressing Report Card

It's kinda depressing that the historic "change we can believe in" seems to be coming down to being tossed the meatless bone of an opt out public option (what a piece of newspeak that is!) and told to stop barking. Meanwhile, Financial Reregulation is being touted, but the actual proposals are virtually worthless. The Wars in Iraq and Afghanistan continue and threaten still more "no end in sight." Climate Change reform looks to be in serious danger of being derailed or so watered down as to accomplish little. The administration doesn't have any kind of plan to restore our economy to a production footing. Guess that was just words. Wall Street types and unreconstructed neocons have the President's ear, and Congress is bought and paid for by special interests in almost everything that matters. Even restoration of civil protections under the constitution is a half-baked affair at best.

In all, a pretty much unsatisfactory situation, across the board, for us progressives.

In truth, Obama never ran as a Progressive. We just hoped, and took some of what he said a little too optimistically. He received lots of Wall Street money, so I suppose it's not that surprising that he really has no intention to force real changes in the economic system... or the military industrial system...or, even the medical racketeering system....that have brought us to this pass.

Fax to Obama to get off the dime and SUPPORT Public Insurance Reform

In response to reports that Sen. Reid has 60 votes lined up for at least the "opt out" version of the Public Insurance Option for a final Senate Bill, and now it's the WHITE HOUSE that's throwing up a roadblock, I wrote the fax below.

I am incredulous that the President and his main advisers on this issue STILL don't get it that this issue is crucial to the majority of the people who got him elected. I am sick and tired of Washington knowitalls deciding what they think is best, when their constituents already made that decision for them. The polling is clear, and for once, we demand that these people do what we tell them. I've absolutely had it. No one who votes against this or fails to support it will ever receive one penny of support from me again, directly or indirectly. I will support only progressive candidates until this cabal of special interests is defeated once and for all. The hell with the Republicans, we have to fight for the most basic progressive policy WITHIN our party.

President Barack Obama
The White House
Via FAX only: 202-456-2461

Dear Mr. President:

I am urgently writing to DEMAND that your administration support a robust Public Option in the Senate Bill. It is time for the administration to stand firm and support what the people who elected you want by large majorities, and what our country unquestionably needs (as you yourself has said on several occasions).

To paraphrase Representative Alan Grayson: America does not care about Olympia Snowe’s vote. Olympia Snowe was not elected president last year.

No, you were, and it’s time you stood up for the interests of the constituency that put you in the White House. It is clear that at least an “opt out” public insurance option is now a viable reality, apart from incomprehensible lack of leadership and support for it from your administration.

This is totally unacceptable. The people demand this reform NOW.

Thank you.


Sincerely,



David Studhalter

Rethink Afghanistan

Please see www.rethinkafghanistan.com, Filmmaker Robert Greenwald's site making the case for opposition to the Afghanistan war. Portions of the film may be viewed online. Check out this blog piece on Alan Grayson's comments on Afghan policy.

H1N1

I've been somewhat out of commission for a few days; I'm in Day 4 of what I'm pretty sure is H1N1 flu. The second day was the worst; now I'm just exhausted and coughing a painful and raspy cough. Some people apparently get REALLY sick, but for most, it's brief but fairly nasty, mostly respiratory. Whoever  is reading this, I hope you don't get it, and get the shot if you can!

My e-mail to Sen. Reid today

Dear Sen. Reid,

I implore you, sir, to stop beating around the bush about the public insurance option. It is now beyond doubt that the so-called Health Insurance Industry has declared war on the American people and is determined to kill meaningful reform, which a strong majority demand and this country obviously needs. A robust and meaningful public insurance option, actually available as a choice to working people, is a key component of controlling costs and affording coverage to the vast bulk of the currently uninsured.

Sen. Baucus claims to be for it. You have said you're for it. Sen. Dodd is obviously for it. A majority of the Senate and House is for it. The American people, by 57% majority, demand it.

What's more, if the unified Senate bill has a public insurance option, THERE CANNOT BE 60 VOTES to REMOVE IT, so the momentum will be there for it to remain in the legislation all the way to the President's desk.

A great deal of responsibility has been place on your shoulders, sir. The President arguably has failed to take a strong leadership position on this issue. ALL THE MORE REASON YOU MUST DO SO.

The American people are counting on you, Sen. Reid. Please do the right thing and make sure a robust public option is in the Final Senate Bill.

Thank you.

David Studhalter

Smash the "Health" Racket cartel!

It's war! The Sickness Profiteering Rackets (aka Health Insurers) have pretty much delcared war on reform, not satisfied with the 90% of what they wanted that they got in the Baucus bill.

So a movement is afoot in Congress now to remove the totally unjustifiable anti-Trust exemption that this Racketeering Cartel has enjoyed since 1946, either as part of pending reform or separately.

High time.

Political Suicide

Democrats need to think this through, because I'm convinced it's true:


An individual insurance mandate that requires currently uninsured working people to buy health insurance from for-profit Health Rackets (aka "Insurers") without a strong public insurance option with the ability to negotiate pricing, will be political suicide for Democrats in 2010. 


If there is one thing that will alienate younger, economically distressed Democratic voters, it's having to pay high prices for for-profit health plans without good cost control mechanisms in place, and without the option to choose a public insurance plan instead. Illogical as it may seem, these voters will walk with their feet, straight to the Republicans, whose faux populist message, deceptive though it is, will have wide appeal.

This is another reason why I strongly urge all Congressional Democrats to unite behind a robust bill, with real regulation and cost control, and a REAL public insurance option. 


I sent essentially the above to Sen. Reid.

An example of Right Wing Propaganda designed to fool progressive sense of fairness

I got this from a progressive correspondent who in turn had received it from another at least moderately progressive person. It's stealth propaganda, designed to appeal to a populist sense of fairness:

    PLEASE READ AND ACT. IT ONLY TAKES 15 SECONDS

    Send it everyone you know.

    Please pass this on!!

    On Tuesday, the Senate health committee voted 12-11 in favor of a two-page amendment courtesy of Republican Tom Coburn that would require all Members and their staffs to enroll in any new government-run health plan. It took me less than a minute to sign up to require our congressmen and senators to drink at the same trough!

    Three cheers for Congressman John Fleming of Louisiana !
    Congressman John Fleming ( Louisiana physician) has proposed an amendment that would require congressmen and senators to take the same healthcare plan they force on us (under proposed legislation they are curiously exempt).

    Congressman Fleming is encouraging people to go on his Website and sign his petition (very simple - just first, last and email). I have immediately done just that at: . Please urge as many people as you can to do the same!

    If Congress forces this on the American people, the Congressmen should have to accept the same level of health care for themselves and their families. 

It bugs me that clever propagandists can twist everything so effectively, and fool people who are a little too busy to really think things through. I'm sure the original author of this e-mail was some kind of Sickness Profiteering Company or Republican Party operative (I refuse to call them "health insurers"). It's not overt; it's insinuative, but if you read this carefully you'll realize that what it's really saying is, if you wanna "force" health care reform on us, you Congresscritters should have to take the same public option as you're proposing for the uninsured (not the options available to the 4/5 of Americans who are insured, including most likely me, never mind about that)....so, [implicitly], don't pass health care reform!

(Fleming and Coburn are particularly nasty Right-Wing Republicans, so that should be a clue). 

I'm quite sure that a tallyer at the Congressional office would tick off "another anti-reform e-mail". But it's cleverly worded and appeals to a sense of injustice, so it can easily fool people who are actually pro-reform. This kind of duplicity is typical Rovian tactics nowadays, and I just deplore it.

I've heard Democrats with a populist streak harping on this point (that Congress has good insurance, so they should have to take the worst option that health care reform will be making available to the currently uninsured (even though that's not what most employed people will get). There's no logic to this at all, and the reality is that it's hardly surprising that Congresspeople have good insurance. So do corporate executives. Of course it isn't totally fair (what is), but the insurance that 535 people, who are undeniably well off and privileged have is really pretty irrelevant to what we as a nation should be doing about health care reimbursement and regulation. After all, they are so privileged, in part, by reason of their having been elected by the people to hold important office. 

Public Option up to Reid?

In reaction to reports that Rahm Emmanuel is meeting with Baucus, Dodd, and Reid (why not Schumer, Rockefeller, and Harkin?), and that Schumer is saying whether a public insurance option emerges in a final Senate bill depends mostly on Reid, I wrote the following to Reid's contact site today:

Dear Senator Reid:

It is being reported today that you, Sen. Baucus, and Sen. Dodd will meet today with Rahm Emmanuel to work on what a combined health care bill will contain.

I am writing to you to STRONGLY URGE the inclusion of a real, cost-saving public insurance option as an essential element. The American people by large majorities demand a public insurance option.

Other factors ARE IMPORTANT, and will need further work, including cost controls both at the provider and insurer level that are not adequately addressed in any of the bills. But please note that ALL the house bills and the HELP bill ALL call for the public insurance option that the majority in almost all states have demanded. The final Senate bill MUST contain this provision.

Thank you.

AHIP doublespeak talking points: why should we care about preserving their rapacious profits? Are they nuts?

TPM has posted anti-reform talking points from AHIP ("America's Health Insurance Sickness Profiteering Plans" [ASPP]). Just an example of their incredible doublespeak: 

• Dismantling Employer-based Coverage: More than 165 million Americans rely on employer-provided health care coverage. The Lewin Group projects that up to 120 million people would move from private health insurance into a government run plan that pays medicare rates and as many as 97 million would shift to a government run plan if it paid Medicare rates plus ten percent. This violates the shared commitment to ensure that those who like their coverage can keep it. [Emphasis added].

Huh? How the hell can they say that giving people additional options, including an option to purchase cheaper and better insurance from a public plan, "violates" a commitment to allow people to keep their current insurance if they like it? 


Essentially, they are admitting that their product adds no value, and they don't want to have to compete with a non-profit plan. So, exactly why should the public care about preserving their profits, again? I missed that part.

My E-mail to "Backward Joe" Lieberman on Health Reform

Dear Senator Lieberman:

I read with alarm reports that you are not supporting even the watered-down Finance Committee Bill on health care reform. I hope this is not true, because I seem to recall that you were once a Democrat and still "caucus" with the Democrats. Please, sir, as Rep. Grayson so aptly put it, the American people know which party supports health care reform and which stands in the way; and the American people by large majorities want real reform, including real regulation of insurers, and a public insurance option. RESPONSIBLE analysis shows that a real public option and real regulation of the insurers would reduce costs, not increase them. The AHIP report and other industry sponsored disinformation is not a valid basis to conclude otherwise.

If you "caucus" with the Democrats, then, please, sir, VOTE like a Democrat. As Rep. Grayson also said, you can lead, you can follow, or you can get out of the way. History is on the side of genuine and meaningful health reform, and if you fail to support it you will be clearly siding with the retrograde faction, finally and completely.

I urge your support.

In exactly what sense Joe Lieberman is or ever has been a Democrat, I am at a loss to think.

Let's see. Supports the Democratic nominee for President. Nope. Supports Democratic foreign policy agenda. Nope. Supports Democratic social reform agenda. Nope. Supports Republican nominee for President. Check. Supports Republican foreign policy ideas. Check. Stands in the way of reform, with the Republicans. Check. Conclusion: Republican pretending to caucus with Democrats. I say, this time enough's enough. If he fails to vote for the final health reform bill, he should be tossed out of all committee leadership posts, and the party should start working on ensuring a viable primary challenger who can win the State next time around.

Health Care Reform Points, beyond Public Option • What's Not Being Included in Current Bills

Although I am and continue to be a strong supporter of a viable and robust public insurance option as a key component of health care reform, I think it's important to bear in mind that other components are equally if not more important, and many of them are unfortunately not included or not adequate in most of the versions of health care reform legislation pending before Congress right now.

To really work, a public/private reform must:

• Prevent discrimination by age or state of health;
  
• Really regulate what insurance companies can charge, (e.g., by setting a floor for so-called medical loss-ratio for adequate standard health insurance, of approximately 90% minimum);
• Even better, All insurers could be mandated to be non-profit, at least for the "adequate standard health care" component of health coverage (ideally, health providers should be non-profit too, but that's less critical);
  
• Require health carriers to cover standardized adequate health care; they can compete for add-ons (this is the system in Germany, France, Holland, Switzerland, etc.). There need to be standard reimbursements and no open-ended patient liabilities; within this system, insurers will have no right to deny claims, and costs are controlled because the costs of all routine medical procedures are regulated;
  
• Provide for continuation of coverage in the event of unemployment and retirement;
• Public Insurance Option with the ability to negotiate discounts on prescription drugs;
  
• Prohibit pre-existing condition exclusion and all rescission;
• Truly universal affordable coverage; subsidies for the poor, including the working poor, paid for by taxes, (or "fees," it doesn't matter what they're called).

I think one way to achieve a good deal of savings in the critical 50-64 age group (to which in full disclosure, I belong), is to set up a Medicare Buy-In option for this age group. Medicare, with the cost-per-patient as calculated by the Congressional Budget Office amortized to a monthly premium. (In other words, the patient, not the government, pays the premium). Again, subject to partial-to-complete subsidy for the poor and working poor. This could replace Medicaid for people in this cohort; and eventually I would like to see this option available to everyone. (One necessary reform would be to allow Medicare to negotiate Pharma prices across the board).

UPDATE:  Now we have the AHIP report, which was dumped late last night with no warning to the White House, despite the fact that the White House was having good faith discussions with their representative over the weekend. It's high time Democrats in Congress not only stop trying to negotiate with Republicans, they must stop trying to placate the "Insurance Industry" as well. These voracious predators have said that even though the Finance Committee Bill, and the other bills for the most part as well, leave their precious profits and price-fixing abilities pretty well alone, they will spike rates if reform passes. So, I say, the hell with 'em. Regulate them to the hilt, set their prices and force them to provide standard coverage on a non-profit basis, and if they don't like it, they can go try to write health insurance in Bolivia.

Obama Nobel Prize and the Hypocritical Right

Right-wingers are so dumbfoundingly hypocritical. Can't they hear the slightest echo of what they would have said had any left-of-center commentators or politicians said one less-than-enthusiastic word had their favorite president received the Nobel Peace Prize or comparable award?  (However ridiculous that might seem, given the fact that he spent his presidency promoting conflict).

Doesn't it send just a hint of shame through their stony little hearts to be griping about a major international award to the President of their country, which they claim to love so exclusively? These people, like Limbaugh, John Bolton, and Michael Steele, to name just three, are awful, nasty, small-minded and stupid. To which we now have to add unpatriotic. There, that's not mincing words.

UPDATE:  The ever despicable Rush Limbaugh kind of said it all, echoing Ahmadinejad and Taliban spokespersons condemning the award: "We all agree with the Taliban and Iran."  There's a voice of patriotism, for sure.

I'd say "what a pig," but pig is too good a term for Rush. 

Optional Public Option ?? And a Comment on the possibility that Progressives could flee the Democratic Party

Part of me is very suspicious of the Schumer/Carper "Optional Public Option" proposal, but Howard Dean is supporting it. It seems to me that if we get a real public option that states can opt out of, and it is seen after a few years to work (by providing genuine cost savings over the 20% administrative/profits waste of for-profit private insurers), then eventually no states will opt out anyway. But, as always, the devil's in the details.

UPDATE:  (10/9) I am now even more suspicious of this move, which I'm now thinking is intended as a distraction, to derail a real public option and ensure that only a watered-down version is actually enacted.

Apropos, Democrats who fail to act like real Democrats are driving this party to schism. Increasingly, people who consider themselves progressive feel alienated in the Democratic party and are casting their gaze afield wondering if somewhere, somehow, there might be a really progressive political movement in this country that actually stood a chance of electing people who would vote for what a majority of the people demonstrably favor. Populism isn't an ideology, and it is not impossible that much of the ignorant populist rage on the Right, which right now looks like it will materialize as votes for Republicans, could be harnessed by a Populist Party on the left. It hasn't happened in a long, long time, but if the predictions of a double dip recession and institutionalized unemployment lasting decades turn out to be correct, I wouldn't rule it out.

Please E-mail Senators to Support Cloture and Meaningful Public Option

I sent the message below to several Senators whose support to end debate and vote for a bill including public option may be critical. PLEASE JOIN ME in this effort. It's VERY EASY to e-mail Senators. Just go here, select the state or Senator by name, and click on the link directly to their contact site.

I sent the message to Ben Nelson (Neb), Kent Conrad (ND), Sens. Pryor and Lincoln (Ark), Sen. Reid (NV), Sen. Landrieu (LA), Sen Snowe (Maine-Rep.) and Sen. Hagan. (NC)

Ideally, a message something like this should go out from every concerned citizen to every Democratic Senator, so if you have the time, please make the effort.

And please support Keith Olbermann's free clinic project. (In process; I will post a link later).

Thank you for your support.

Dear Senator  *:


As your constituent (Senators represent all the American people as well as residents of their own state), I am writing to strongly urge you to vote to allow a floor vote on health care bill(s), and to support a meaningful public option. Regardless of special interests which may have your ear, you must know the public insurance option has majority public support in your home state. All polling has shown this. For once, it is a moral imperative on this issue for all members of the Senate to act in the interest of the people, not special interests.


Moreover, if this bill ultimately must be passed through reconciliation, please keep in mind BOTH of Pres. Bush's tax cut bills, which the Republicans passed through this process, the second time breaking a tie with Vice-Pres. Cheney's vote. Please support what the people want, MEANINGFUL HEALTH CARE REFORM WITH PUBLIC OPTION.


Thank you.

Baucus Bill to reduce deficit

So the Congressional Budget Office says that the Baucus (pron. "bogus") Finance Committee Bill would save $81B over some or other period of time. I guess is marginally good news, but one has to wonder, how much more would/will a robust public option that requires real cost savings reduce the deficit? And if we really got real about opening up a plausible scheme for developing revenues to pay for the public sector part of health care (including medicare and VA), we could easily arrange things so that Medicare is stabilized and health care does not add anything to the deficit. Easily, that is, except politically. The idea of actually paying for public services is virtually anathema in this crazy country of ours, even though every other advanced nation in the world just accepts this as a fact of life, like gravity.

Moribund Body Politic, an Encouragement (?)

I agree with Robert Borosage, writing in the Huffington Post today:

    The president has called on the Congress to act on fundamental reforms that cannot be avoided. Our broken health care system is unaffordable and must be fixed. Moving to new energy policy is a national security, economic and environmental imperative, not a choice. Fundamental financial reform is necessary if we are to avoid a worse crisis in the near future.


    Glenn Beck and Rush Limbaugh and the Republicans in Congress oppose these reforms. They want, as Limbaugh proclaimed, the president to fail. But they aren't the major roadblocks to the change we need. What stands in the way is the organized power of the entrenched lobbies that have a direct stake in limiting change, and are willing to spend hundreds of millions to obstruct it. Their legions are less angry citizens, than sophisticated lobbyists, increasingly Democrats, many of them retired legislators. They deliver campaign contributions, not votes. They threaten negative campaign ads, not authentic citizen uprisings. 

    Read more here.


As I see it, this fundamental problem, the lack of responsiveness to the public, but only to organized corporate money, is one of the two main reasons it has become virtually impossible to pass reform legislation without debilitating amendments in this country. The other is the unsupportable anachronism of the way the Senate works. Senators from (disproportionately Republican) smaller states have disproportionate power, and, not surprisingly, since these Senators have a harder time raising money from constituents, they tend to be even more beholden to moneyed interests than Senators from larger Northeastern and West Coast states. Then, there are the totally unworkable cloture/filibuster rules, which give way too much power to the minority, especially when the minority opposes change, as the Republicans generally do. Thus, there is an institutional bias in favor of the Republicans, who in recent decades favor pretty much only two things: lowering taxes and starting wars, both of which enough Democrats fear to vote against that they sometimes get them passed. Since other than these things they seldom try to do much of anything, the rules and structure of the Senate give them disproportionate power.

What to do? Oh, that's simple enough. Campaign finance reform to take the money out of politics (except the Right Wing Supreme Court has already virtually guaranteed with its ridiculous rulings equating money with speech that that can't happen).

And, a constitutional amendment to make the Senate elected by proportional representation and mandate fairer procedural rules. (Ha, ha. That has a real good chance of passing through the convoluted process of getting a constitutional amendment approved, in which process the smaller states tending to be Republican have even more disproportionate power, since it takes three quarters of them to approve an amendment).

So, we're in the soup, my friends. Our government is dysfunctional to the point of being moribund, and there is no cure in sight. I suppose we can take encouragement that no political system, no matter how good or bad, lasts forever.

Shepard Smith of Fox News on Public Option

And, wunderra wonders! Shepard Smith, Fox News Commentator (!) said the following about Public Option today:

Over the last ten years health care costs in America have skyrocketed. Regular folks cannot afford it. So, they tax the system by not getting preventative medicine. They go to the emergency room in the last case and we all wind up paying for it. As the costs have gone up, the insurance industry's profits, on average, have gone up more than 350%. And it is the insurance companies which have paid, and who have contributed to Senators and Congressmen on both sides of the aisle to the point where now we cannot get what all concerned on Capitol Hill seem to believe and more 60% of Americans say they would support, which is a public option. This has been an enormous win for the health-care industry, that is an unquestioned fact. But I wonder, what happens to the American people when we come out with legislation now which requires everyone to have health care insurance -- or many more people -- but does not give a public option? Therefore millions more people will have to buy insurance from the very corporations that are overcharging us, and whose profits have gone up 350 percent in the last ten years. It seems like we the people are the ones getting the shaft here.

Read more at: http://www.huffingtonpost.com/2009/10/06/fox-newss-shepard-smith-g_n_311627.html

"Governator" supports health care legislation

Although exactly what is being supported is not clear, and if it's the Finance Committee Bill in its present form, I can't get too excited about it, it is notable that Gov. Schwarzenegger today announced his call for "bipartisan support" for health care reform.

SNL skit pretty pointed, but too true

Fred Armisen's devastating spoof of Obama's lack of accomplishments on last Saturday's Saturday Night Live was really pointed, even brutal, but, in point of fact, there was too much truth in it to dismiss. This president needs to really, really ramp up the effort to get major portions of his agenda passed, or he risks being seen as essentially ineffectual. Which is a real shame, because our country has more problems needing major legislative action right now than it has for a long, long time.

Keith Olbermann Wednesday, entire program on Health Care Reform

Keith Olbermann's style isn't to everyone's taste, but you really can't fault him for being a serious moderate-Progressive television commentator; on cable/network (i.e., other than Bill Moyers and Amy Goodman), you'd be hard pressed to name others, excepting his colleague Rachel Maddow, who are serious and smart enough to really carry this water.

So, I hope everyone who can tunes in on Wednesday when he devotes his entire program to a special commentary on health care reform.

Republican Gomorrah

I recommend Max Blumenthal's Republican Gomorrah. An excellent insight into what makes the fanatic religious right work.

McChrystal should go

Here. This is simple. General McChrystal should be ordered to resign. (Cf. Truman vis-a-vis Douglas MacArthur). This isn't an issue of whether you agree with McChrystal (I don't), or whether Obama will eventually order more troops in Afghanistan (I hope he doesn't; there's no plausible U.S. interest there any longer). It's that a general doesn't make policy, and doesn't go around making speeches contradicting the president or vice-president. He's not a private citizen. He's the president's general officer. Any general who does this should fully expect to be fired.

A Minor Health Care Travesty, a Personal Story with a Larger Meaning

I'm in the midst of a dispute with my health care insurer, which, although it is over a fairly minor amount for a blood test, is indicative of a much larger problem, and is one of the very many reasons why sweeping health care reimbursement reform is absolutely necessary in this country.

I have a family history of prostate cancer and am over 50. Thus, by almost all reasonable medical standards, the PSA test (Prostate Specific Antigen, info here), is indicated annually, to test for signs of the disease. My doctor has told me of patients of his whose potentially life threatening cancer was detected by this test. I have had this test every year since I was 50, and have had the same health insurance all that time. The insurance has always paid for it.

Now, all of a sudden, I get a confusing "Explanation of Benefits" with a code that when you look up the fine print means "Denied due to lack of medical necessity." That's all. The same day, a bill from the lab arrives for the full, "Cadillac", uninsured-patient price of $115, just for this one test. If the insurer had paid it, they would have paid $30 or so, and the lab would have taken that, because that's their negotiated price, but if the insurer denies payment, they expect you to pay the "gouge" price, which is actually about 130% of the market price for the test if you walk into an independent lab and pay for it out of pocket (I checked).

I truly believe this practice is racketeering, pure and simple. I would so love it if a State AG or the US AG would prosecute (or sue) some of these people under RICO, but I guess that's a vain hope.

I won't go into all the hoops you have to jump through just to get the insurer to deign to reconsider (no guarantee they'll pay even then). They lie to you and say they told the doctor they need more documentation and a letter of why it's necessary, but it isn't true, they just deny it and it's up to the patient to initiate and follow through with all the convoluted steps in the process to try to get the bill paid.

Meanwhile, the option of negotiating with the lab gets you nowhere. They stonewall: "We don't negotiate." Bullshit. They negotiate all the time, with those who have leverage. But as a mere patient, you have none, and they threaten you, on the very first call, with sending their bill to collections to ruin your credit.

You have to be extremely proactive to get affordable health care in America, and not get cheated, even if you have (supposedly) decent employer-based health insurance.

Check out T. R. Reid's The Healing of America, the Quest for Better, Fairer and Cheaper Health Care. I'd send my copy to everyone I know if I could afford it. It's already spoken for by about five people.

Reid happens to mention the very test that I'm disputing, PSA. The truth is, the National Health Service in Britain, as an example of an alternative system, doesn't pay for this test. They pay for a lot of preventive care but they've concluded this one isn't reliable enough. (Most countries' health systems do pay for it). But the difference is, when you go to the doctor in Britain and say, "I seem to remember there's a blood test for prostate cancer," the doctor will tell you, "sure, mate, but the NHS won't pay. You can pay for it yourself, for £10." (Because the doctors depend on this kind of uninsured service to make extra income, and they compete fairly for it).

Here, you and your doctor think it's covered, till you find out it isn't, then you find out you've agreed in the fine print of the lab form, sight unseen, to an outrageous gouging amount (undisclosed in advance, of course), which if you don't pay in full you're officially a deadbeat, even though the amount may in some cases be as much as ten times what the insurer would have paid for the same item. And these kinds of discrepancies in what insurance will pay and what health vendors expect uninsured and underinsured patients to pay out of pocket don't just apply to labs. These problems exist across the board in American health care. No wonder Americans more and more hate health insurance and everything about it!

As I said, this particular personal instance is a minor matter. The $115, if I just paid it, wouldn't kill me. They count on that. Most people just pay, to avoid the hassle. But what if it were a $100,000 surgery? Because don't think it doesn't happen. And the scenario unfolds in much the same way. Employer Health Care Advocates (now there's a job that shouldn't be necessary. I'd rather see people employed as elevator operators to push the buttons for you). Countless letters, phone calls, and faxes back and forth, all a tremendous waste of time and mental energy. And then, like as not, they deny it anyway. And if you can't afford it, it ruins your credit. Some file bankruptcy. Some lose their homes.

This stinks. It really, really stinks, and it's time to put an end to it. 45,000 people die every year in this country because they can't afford medical care or insurance. That's the worst. But another 700,000 file bankruptcy, which doesn't happen in any other advanced country. Can't. In countries with private health insurers, the cost of everything, and what's covered and what's not, is public record. No one has to just pray their insurance carrier will pay for something and that the medical bills they get stuck with won't .... literally.... bankrupt them. It's illegal not to pay claims in every other country that has private insurance. Health cost related bankruptcies are unheard of. (Because, of course, no one is uninsured, even in advanced countries with purely private systems, like Switzerland and Germany). But not here. In America, our health care delivery is very good, overall, if you have insurance (not so good on preventive care), but our system of paying for health care just plain sucks and must, must be changed.

Please join with me in making our politicians make that happen, for real, and soon.

Brouhaha over Rep. Grayson saying Repub Health Plan is "Die Quickly"

Reliable statistics now show that 45,000 Americans die each year from treatable illness or injury because they can't afford health care or health insurance. It's a simple fact that by far the majority of Republicans in Congress are either living up to their moniker of the "Party of No" by supporting nothing in the way of health care reform other than trying to delay and ultimately kill any efforts from the other side of the aisle to accomplish anything. There are NO serious Republican health care reform initiatives on the agenda. Ergo, Rep. Alan Grayson's using hyperbole to make a point by saying the Republican health care plan is "1. Don't get sick, 2. And if you do get sick... 3. Die Quickly"... was maybe a bit rude, but actually pretty much true.

Should he have apologized? I have to say I can't really see what he should have apologized for. What he said was not nice, but it wasn't inaccurate. Whereas Sen. Grassley saying the Obama plan would allow the government to "pull the plug on Grandma" was inaccurate. Ex-Gov. (and unemployed blogger) Sarah Palin saying the health plans advocated by Democrats would force her to justify treatment for her Downs' syndrome child was inaccurate. In fact, both statements are entirely baseless and ridiculous. I'm frankly quite sure both these lovely people knew perfectly well that what they were saying was not factual. Most of the pending health reform proposals allow for funding of end-of-life counseling, just as almost all private health insurance does. So it's a total non-issue, except as despicable propaganda.

Video here.

The fact is, this number of preventable deaths (45,000) is by far the worst of any developed country. Moreover, when T. R. Reid (The Healing of America) asked health ministers in England, France, Germany, Denmark, and Japan how many health-care related bankruptcies occurred in their countries each year, as he put it, they all looked at him liked he'd just asked them how many alien spacecraft had landed on top of their building in the past week, because the answer (the same for every single advanced nation other than USA, without exception)... is zero. In the US, it's 700,000. No other advanced country allows its citizens to lose everything because they can't afford to go to the doctor but can't go without health care. If that doesn't bother you just a bit, I really don't know what to say to you. I love my country and want the best for it, but that is not something we can be proud of; quite the contrary.

UPDATE:  (10/12) In retrospect, I don't even think what Grayson said about Republicans was even rude. As he later said, the American people don't care about their feelings. And, in any case, what he said was essentially true, so how is that rude? If you can't stand plain talk, get the hell out of the way. When you try to compare what he said with the duplicity and conniving of Republicans to deny the up to 20% of Americans who are without health insurance their right to health care, there is no comparison. 

E-mailing Finance Committee Members in Favor of Robust Public Option

I have e-mailed every single one of the members of the Senate Finance Committee <link here> with this message. (Click on name, and find contact form on Senator's website, they all have them). I left out the sentence about "ALL democrats" in my e-mails to the Republican members, and added thanks to Sens. Schumer, Kerry, and Rockefeller for their already stated strong support for the Public Insurance Option.

I am writing to strongly urge passage of a robust public insurance option amendment to the Finance Committee’s health care reform bill. Consistent polling shows that over 60% of Americans favor a public insurance option. It is time for the Senate of the United States to vote for what the people want for once.

It is particularly important for ALL Democrats on the Committee to support this crucial policy.

Thank you.

David Studhalter
North Hollywood, California
•••••••••••••••••••••••••••••••••••


Update: CBS/NYT poll today shows even Republicans favor public option by a plurality 47-42. Among the General public, its 65-26 and among Democrats 81-12. Independents come in at 61-30. With numbers like these there's just no excuse for not passing a public option.

How the President Could Re-energize his Agenda

I have some suggestions for how the President could begin to change the way politics is played. I think it’s pretty obvious that the closely divided government, especially in the Senate, (as a result of Senate rules giving great power to a unified minority, which is what we have), have made it very difficult for the President to get action on much of his agenda. I think it’s clear that some pretty radical new strategies are needed to move forward on real health care reform, financial re-regulation, workers’ rights, revenue reform, environmental action, rethinking of national security issues, and other elements of the president’s agenda going forward.

The president needs to abandon traditional constraints and enter into a regular dialog directly with the American people. I suggest reaching out to the major networks and offering them this deal. The president gets ten minutes on Sunday morning, or, better, the news hour time slot on a weekday, to speak to the American people, then he will take questions from the news suits for ten minutes. EVERY WEEK. They can give a Republican spokesman the same time on the same or another day for rebuttal… it won’t matter. No Republican is the draw or has the gravitas that the president is and has.

The president will then use his time, like a fireside chat, to address a particular issue. He should follow these precepts:

1. Speak directly to the people, and ask them for help, using phraseology from the Bible and JudaeoChristian tradition, in much the way that John F. Kennedy sometimes did. Study George Lakoff and reframe everything in positive ways that influence people to want to help the president get things done. (References to “our better angels,” and “the fundamental decency and integrity of the American people,” that kind of thing). 

2. Talk about making changes in economy, environment, health, etc. for the benefit of your children and grandchildren.

3. Talk openly and honestly about the need to break the logjam of the way Congress works. Ask people to communicate directly to their congressman and senators regularly, using a system outlined below. Ask them to ask their congressperson directly, politely, repeatedly, to support the president’s policies, not just generally but the particular action he’s talking about that week.

4. Teach, but don't talk down. The president is masterful at this when he’s got the right framing going.

Next, the administration needs to be much more proactive in providing outlines, with specifics, of exactly what legislation is needed, to the key members of Congress, both House and Senate. Call them in for conferences all the time. Engage them, and never let up. The White House needs to ramp up its activity to a legendary level. We need to be speaking of the incredible energy and activity of the Obama White House for a generation to come. 

As part of the help the president asks of the people, a means of putting pressure on Congress needs to be created. The whitehouse.gov website could be a springboard. Ask people to go to a website where they will be able to link directly, by entering their zip code, to a form that goes directly to each Congressperson and Senator, giving the citizens an opportunity to say in their own words that they want the reform or action the president is talking about to happen, and they want their Congressperson to support it. This could go a long way to blunting the power of lobbies and money, by giving the people direct feedback, and a direct connection to their government at the highest level. And people will do it, because the president, speaking directly to them, has ASKED them to do it.

I have been one of the President’s progressive critics heretofore, but I have decided since the president’s masterful health care speech that we need to rally around our President, and help him, because it’s now or never, and he’s the only chance we have.

Thank you.

Dianne Feinstein Must Go

It is a source of continual frustration and embarrassment to California Democrats that one of our two Democratic Senators, Dianne Feinstein, votes consistently like a Republican on key issues. I've said it before and I will say it again; I will never, ever vote for this woman again for anything.

Pawlenty Now Card Carrying Lunatic Fringer

Here we go. Governor Pawlenty has just declared himself to be a card-carrying member of the lunatic fringe.

If it were not so clearly true, what Mencken said, that no one ever went broke underestimating the intelligence of the American populace, you'd have to expect that the GOP was well on its way to marginalizing itself completely, but the ability of sharp practicers to use Goebbellian propaganda techniques to get millions of people to strongly believe all kinds of nonsense that's totally inimical to their own interests is demonstrably real.

Reaction to Obama Speech

Having had a day to digest what he said, I am cautiously optimistic that President Obama's speech, which was very good in many ways, will have the effect of uniting the party and lending some backbone to wavering Democrats. I think some kind of health care bill, hopefully one worth having, will pass the Congress this year, and that the president and Democratic members of Congress will receive more credit than opprobrium for it.

I appreciated that the president laid out a pretty clear and convincing case for why a public insurance option is necessary (although most people seem to have missed the point that it is necessary in large part because it is the only realistic plan on the table which will have the ability to cut costs). I was not too thrilled that he didn't insist on it more forcefully, but I am not giving up, despite Lawrence O'Donnell's refrain that legislation always only moves in one direction (in this case, as in almost all cases, rightward). I think it may be possible to convince enough Democrats that only a public insurance option will really work to control costs.

The conventional wisdom is that the insurance lobbies will do anything to kill it, and that may be true, because it really does attack them at their point of vulnerability. Both sides agree, with opposite policy conclusions: public option, if structured rationally, will outcompete private insurance, for the simple reason that private insurance spends more than 30% on overhead and administration, not to mention profit, which is zero added value. The public insurance system would be able to function on 3 or 4% overhead, like Medicare, and would deliver a much better value for premium spent. Eventually, if allowed to function rationally, we would have a system like that in many other countries, where most people receive insurance through a public system, and very wealthy people choose to have private coverage for convenience.

One way around the obvious impasse this might create would be to have private companies function as TPAs (third-party administrators) of the public insurance system. Lower overhead, lower profit, but at least they would survive. Medicare actually functions in this way to a great extent.

But on the area of paying for all of this, I think the administration is kicking the can. It's just not realistic to expect to pay for covering 1/5 of the population now not covered through cost savings. Not gonna happen. And the tax on "cadillac" policies won't be enough.

What is needed, maybe not this year, but soon, is a paradigm shift. We need to recognize that health care is valuable and we need it, and we have to pay for it. There will have to be modest tax increases on the middle class, and large tax increases on the very rich, to pay for it (and to pay for some other much needed programs that have been sorely neglected under what amounts to 30 years of rightist government).

Overall, I think Obama did a pretty good save of what threatened to be a total debacle, so I'm reserving my criticisms and offering the administration my support to get this done, while reserving strong advocacy of a robust public insurance option as an essential ingredient of a workable plan. If we fail to get that in the final bill, we will be back trying to figure out how the total mess that the legislation will create can be fixed pretty soon after it takes effect (which isn't even for years, anyway).

It has been clear to me for years that the insurance paradigm is really unworkable when it comes to paying for health care. Insurance works for unlikely casualties, like shipwrecks, burglaries, fires, car accidents, etc. It spreads risk and provides security for an affordable cost. It tends to break down (and require subsidies) covering broad risks, like earthquakes and floods. And it fails completely covering costs that everyone is guaranteed to experience, like health care costs. Insurance does function (barely) to cover the risk of catastrophic costs, but the system is so bogged down paying (badly and with totally unsustainable inefficiencies) for ordinary care that it is fundamentally dysfunctional. What is needed is a reimbursement system that not only spreads the risk of catastrophe, but recognizes the role of public subsidy to transfer the cost of health care for the poorest third or so of the population to everyone else: this is simply the reality of the situation. And, what most people just won't acknowledge, is that the system needs to rationalize rationing. We have rationing now, it's just that it's grossly inequitable. The ability to make medical care choices based on what's best overall for patients and families, without profit considerations, needs to be returned to doctors, with realistic controls to protect against abuse, through stringent regulation and a system that covers everyone for rationalized health care costs and protects consumer interests.

Throw Snowe under the bus

So Olympia Snowe says a public option bill will never pass the Senate, after President Obama's speech last night? Fine, time to throw her and any fantasy of bipartisanship entirely under the bus. The hell with 60 votes, the hell with trying to get her ... or any Republican.... to vote for the plan. I know it's hard, but let's all try to spell it: r·e·c·o·n·c·i·l·i·a·t·i·o·n.

And, hell, who says you need 60 votes to end debate, anyway? Why is it that no one will ever even consider anymore calling their damn bluff and forcing them to actually filibuster? This bill is important enough to undergo that tedium for a while, isn't it?

Supreme Court could destroy popular influence on public affairs with Decision on Elections Case

This report in the L. A. Times concerns an issue that hasn't yet garnered much public attention. But if the Supreme Court in Citizens United v. Federal Elections Commsn. ends up building on its earlier rulings that campaign money is "speech" protected by the First Amendment and broadly rules that Corporate candidate donations cannot be limited by law, we will effectively see American politics come to be completely dominated by corporate interests.

I find it hard to imagine five justices choosing to so completely throw over protections of ordinary citizens' ability to influence the political process, but the trend in rulings of the Court in this area has been decidedly negative in recent years. If this horrible result were to come to pass, the only out would likely be a Constitutional Amendment, and that's very, very hard to do, especially in the present divisive political climate.

Obama Gots Some Rethinkin' to Do

Now there's all kinds of reports that Progressives will be "disappointed" by Obama's Health Care Speech. Lemme put it straight: if the plan he lays out doesn't include a robust public option, we won't be "disappointed," we'll be really, really pissed at having been betrayed on this signature issue. Obama would not have won the presidency without the efforts (and money) of Progressive Democrats, and this promise was one of the big motivators.

With 84 members of the House, including Speaker Pelosi, on record that they will not vote for a bill that doesn't include a robust public option, I sure as hell hope the President rethinks this incredibly foolish strategy before next week, or likely as not there will be no health care bill at all.

There's no way around it: President Obama has messed up this whole issue very, very badly already. If he hopes to get back on track and accomplish something worth having, not to mention anything else during his Presidency, he had better do some serious rethinking and quick.

Part of that rethinking needs to be a realization that 84 House Progressives are more important than the illusion of bipartisanship, and that the only way we're going to pass this thing is by dropping any effort to woo Olympia Snowe or any other Republican and proceed by way of Reconciliation. And, frankly, if Obama and his people can't twist arms to get 50 votes in the Senate, then his leadership is seriously in doubt.

Among the things the President should be thinking about is which of his underperforming and tone-deaf advisors on this issue should be fired immediately. Or which dozen. 'Cause he's been getting some really, really bad advice lately.

After that, he can think about cleaning house in some other areas, too, because people who think like Obama talked when he was still a Senator have had serious concerns that this Administration has gone off track on a variety of issues:

1. Real Financial Re-regulation
2. Real Adherence to the Constitution in Detainee issues and 1st Amendment Issues
   
3. Climate Change Agenda
4. Tax Reform to end Tax Advantages for the Very Rich
5. End Don't Ask Don't Tell already
6. Recognize that Afghanistan is a disaster and needs to be completely reevaluated, with a plan for withdrawal

Is the President Failing Us?

My "policy comment" to whitehouse.gov today:

If reports are true that President Obama will not demand the "public option" in a renewed push for a health care bill, the covenant will be broken, as far as I'm concerned: this president will have betrayed the people who elected him and rather definitively failed to establish himself as a major leader for progressive change. "Change we can believe in" will have become a hollow and false promise. Real universal health care was a keystone of his campaign agenda, and if the President fails to fight like hell to achieve it, and if he fails to insist and lead on the most important aspect of this reform agenda, I think it unlikely it will be achieved. Sure, some bill will pass, but genuine comprehensive reform will be doomed.

If the president were to use his bully pulpit to fight like hell for comprehensive reform, and the Congress failed him, I would see things differently, but as this debate has developed, I believe the inescapable conclusion is that it unless these reports turn out not to be true, it will be primarily he who has failed. He has not yet clearly articulated the minimum requirement, which he should understand requires the public option, and he has thusfar never really fought for this reform. The blame for its prospective failure must reside with him, in large measure, if it comes to pass, as seems likely now.

I am sharing these dismal thoughts with the White House in the hope that the President will reconsider. Health Care reform without the Public Option will not achieve cost savings, and will not achieve real universal coverage. It will fail. Its failure will be the President's failure, and will be irreparable. Please, Mr. President, reconsider any decision not to fight like your whole presidency depended on it for real health care reform -- BECAUSE IT DOES. We are counting on you, and we see defeat looming because of your inaction so far.

Pope, Church Leaders not Mourning Edward Kennedy

Without intention to offend any Catholics who may be reading, I can't help but think that reports that conservative Catholic leaders are not mourning Edward Kennedy, with whom they had prickly relations, and that the Pope has remained silent on his passing, do these Catholic leaders no credit whatsoever.

Sen. Kennedy succession

There's a lot of discussion everywhere in the media of Sen. Kennedy's "dying wish" that Massachusetts change the "Kerry Succession" law (unused, since Kerry failed to win), and allow Gov. Patrick to appoint an interim successor.

Personally, I'm not insensitive to the argument that this sets bad precedent; that it's too highly politicized, etc. I think the original law was probably ill advised. Better to have provided that the governor could appoint whoever he liked, but that the interim Senator would be barred from running for the seat, and a special election would have to be held within 60 days, or something like that. If that were the law, there would be no problem.

Anyway, I think the politics of the moment trump procedural and state constitutional integrity arguments in this particular case. Health Care reform could be the essential legacy of Sen. Kennedy, if it can be made to happen, and the galvanizing effect of not wanting to be seen as destroying that legacy could make the difference. So, in this case, I am hoping the Massachusetts Legislature accedes to the late senator's wishes and gives Gov. Patrick the ability to appoint an interim successor who can provide a YES vote for real health care, for which Sen. Kennedy almost literally fought his entire career.

Byrd calls for Health Bill to be named for Kennedy

TPM reports Robert Byrd is calling for the Health bill to be named after Kennedy. Perhaps there will be a 'galvanizing' effect. Could it be that Kennedy's death will act as a catalyst to shame Blue Dogs into voting for the bill, which can maybe be beefed up a bit in view of that? Obama could give a speech saying that we must honor the memory of Teddy Kennedy by passing a bill that includes meaningful health care choices for all Americans, i.e. public option. Or is that just wishful thinking?

I gotta say, if the White House doesn't get it that the President has to appeal directly to the American people, and explain exactly what effect the bill will and will not have in ordinary terms everyone can understand, and soon, I think the whole thing is doomed.

Mind and Brain

«I used to think the brain was the most wonderful organ in the body. Then I realized who was telling me this.» --Emo Phillips

I confess I still have a bit of this brain bias. This quote is jokey, but it has a certain serious side too.

Traditional IndoTibetan Buddhist teaching (which comes from Ancient Hindu beliefs) has it that the mind is not the brain, or even co-located with it, but is a completely nonphysical continuum. Mind, the teaching goes, is separate from memory and mental abilities, and independent of what most people think of as concsciousness. What we call consciouness is really what Buddhists call self-grasping ignorance, the deluded perception of "I", which is what causes us to experience suffering. Ancient Buddhist teachers would have considered it fundamental and pervasive mental illness: a disturbance, like waves in an ocean, or even mud in water, which does not intrinsically affect the underlying purity of the water, but is merely contamination that can be removed. Pure awareness is mostly unfamiliar to us.

The mind, according to this thinking, has no physical existence, but is nonetheless "located" inside the body, in the region of the heart, according to this tradition. It is the "cognizer," that is, the awareness, which arises from previous moments of awareness and can never cease to exist.

Ancillary to all that: Computers may be smart, in the sense that they can perform calculations quickly, and integrate complex functions to yield an output, maybe even a simulacrum of human behavior. But, according to this thinking, they are merely physical systems, complex toys, completely devoid of awareness. Hence, the hope of some extreme materialists that they will be able do download their minds into a computer memory and achieve virtual immortality is a ridiculous pipe dream.

I still perceive what seems like awareness to me to be located behind my eyes, in my head (it's a cultural thing, I guess), and I have my doubts about some aspects of these abidharma teachings. But on the essential distinction between brain function and mind, I'm pretty sure the old Buddhists had it just about right.

Another e-mail to Obama on health care

Look, folks. Let's get it straight. Bipartisanship is not working. The Republicans have one agenda and one agenda only: to kill health care reform. They are succeeding. The President is being far too conciliatory. Anthony Weiner on Chris Matthews' show had it right yesterday. The President needs to clearly articulate exactly what the health reform plan should be, and DEMAND that Congress enact it, using the Reconciliation process if necessary. And that plan ABSOLUTELY MUST include a public option program, with real teeth and ability to negotiate costs. ALSO, the plan needs to have more ability to introduce regulation later on to move towards eliminating for-profit medical care, which gives us high costs, poor outcomes, and completely wrong-way-around incentives.

The president needs to use his very considerable ability to communicate to articulate a clear agenda, articulate exactly what it needs to contain, and why we need it, and sell, sell, sell. The hell with the Republicans. They will only obstruct.

To which I add, the hell with the most conservative of the Blue Dogs, too, because they really are Republicans. We can pass a decent health care bill in the House, and we should be able to strongarm 50 Senators into voting for it. Biden can break the tie, and the Reconciliation process can make the whole question of a filibuster irrelevant. It is absolutely time to show the Republicans the mettle of Obama's mandate, before it evaporates completely, which given the White House's strange, almost psychotic behavior lately, will happen soon if things don't change.

White House Points on Health Care Reform

The White House has put out the following series of three 8-point summaries of 1) why health care reform provides security and stability for all; 2) myths about health care reform; and (3) reasons we need health care reform now. These are offered specifically to dispel the large amount of deliberate disinformation and propaganda being disseminated by insurance industry and Right Wing lobbies, media outlets, commentators and political organizations, who have organized and/or promoted "shoutdowns" in an attempt to stifle and shut down reasoned debate on this issue. It's one thing to have civil disagreements and policy differences. It's quite another to use scare tactics, deliberate lies, and intimidation to try to shut down debate.

PLEASE READ. This is a crucial issue for the future of our country. Thank you.


8 ways reform provides security and stability to those with or without coverage

1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

Learn more and get details: http://www.WhiteHouse.gov/health-insurance-consumer-protections/

8 common myths about health insurance reform

1. Reform will stop "rationing" - not increase it: It’s a myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
2. We can’t afford reform: It's the status quo we can't afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
3. Reform would encourage "euthanasia": It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
4. Vets' health care is safe and sound: It’s a myth that health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
5. Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
6. Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare "doughnut" hole to make prescription drugs more affordable for seniors.
7. You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
8. No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.

Learn more and get details:
http://www.WhiteHouse.gov/realitycheck
http://www.WhiteHouse.gov/realitycheck/faq

8 Reasons We Need Health Insurance Reform Now

1. Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more: http://www.healthreform.gov/reports/denied_coverage/index.html
2. Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. Learn more: http://www.healthreform.gov/reports/hiddencosts/index.html
3. Roadblocks to Care for Women: Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care. Women are also more likely to report fair or poor health than men (9.5% versus 9.0%). While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches and are more likely to experience joint, back or neck pain. These chronic conditions often require regular and frequent treatment and follow-up care. Learn more: http://www.healthreform.gov/reports/women/index.html
4. Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more: http://www.healthreform.gov/reports/hardtimes
5. Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more: http://www.healthreform.gov/reports/helpbottomline
6. The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more: http://www.healthreform.gov/reports/inaction
7. Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more: http://www.healthreform.gov/reports/inaction/diminishing/index.html
8. The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance - projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more: http://www.WhiteHouse.gov/assets/documents/CEA_Health_Care_Report.pdf

Public Health Care -- an Anecdotal Account

There's a common belief among Americans, which I believe is almost entirely the result of deliberate disinformational propaganda, that in countries which have universal, fair public health care, such as the UK, Taiwan, South Korea, Canada, Japan, France, Germany, the Scandinavian countries, etc.,* people resent the public systems and receive unreasonably rationed, substandard care. (This bad reputation is most often attached to the UK's National Health Service, probably because there is a segment of society (some rich people) in the UK that opts for private medical care). Anecdotal evidence must always be discounted, but this account, published in TPM today, certainly shows that the automatic assumption that "public" health care automatically means "lousy" health care should not be taken for granted:

I am an middle aged, white male American who lives in the UK working for a medium sized US company. The following is a true story about my many years experience of the NHS (National Health Service) in the UK, only the names have been changed to protect the identity of my family.

I live with my wife and son just outside of London. When our son Leo was due to be born, like virtually every family in the UK (rich or poor), we went to our local NHS hospital for the delivery. An unpredictable chain of events resulted in unforeseeable complications during his birth. Leo was born in very poor health and was immediately transferred to a SCBU (Special Care Birth Unit) in another hospital. Because of the severity of Leo's condition we were transferred to the most advanced SCBU in the region.

Leo spent the next three weeks in the SCBU being cared for 24/7 by highly trained nursing staff using the latest technology and a team was formed with about a dozen specialists from around the country working together to ensure Leo's many complex problems were dealt with using the best medical knowledge available. As parents we stayed with Leo in the parents residence just down the hall from the SCBU. Our room was basic, but it had cable TV and we got clean bedding and towels as well as three meals a day for three weeks. How much did all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service. By the time Leo was three months old it was obvious he was experiencing many very difficult problems. Leo was referred to one of the top specialists in Europe, a professor consultant in neonatal neurology. The professor determined Leo needed a MRI scan, but because of Leo's small size and constant abnormal movement, no existing scanner could safely be used. It was decided the newest and fastest scanner in the country would be modified to accommodate Leo's situation. When we arrived for the scan we were greeted not only by the professor and her team but by a team of technicians and scientists from the manufacturer. The MRI magnets were partially dismantled and recalibrated and a frame for Leo was built on the spot so he could safely undergo the scanning procedure. How much did all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service. The scan showed that Leo had received a profound brain injury before birth. He had many different tests to determine the extent of his disabilities including EEG, X-ray, video fluoroscopy, endoscopy, sight tests, hearing tests, and others. Leo was referred to eight different specialists to deal with his problems and underwent surgery to implant a portal in his stomach so he can be fed directly by tube, without danger of food being "swallowed" into his lungs. Leo's dietary requirements are very special and all food, as well as the daily feeding kits and the pump needed to deliver the feed are provided by the NHS. Leo is on about a dozen different medications and all meds, syringes and other daily disposable equipment are provided by the NHS. Leo has a wheelchair, sitting frame, standing frame, sleep system, leg and hand splints and other equipment, all designed for him and all replaced or adjusted every few months because he is a growing boy. All equipment as well as the technicians who maintain the equipment are provided by the NHS. How much does all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service. Is the NHS perfect? Far from it! Can it be more bureaucratic and slower than I would like at times? Of course! Has there ever been an issue about Leo not receiving care because he is profoundly disabled? Never! Have we ever had to stand before a "Death Panel" and justify the vast ongoing expense of Leo's care, even though he will never be a productive member of society? NO! When surveys ask people what is the single thing they are proudest about the UK, the winner is The National Health Service.

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* There are so many... in the developed world, other than here, health care is generally considered a right.
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Of course, what the NHS is is universal public service health care, which according to the right-wing framing we all blithely accept, is misleadingly called "single payer" in this country. We're so benighted with right wing propaganda in this country that (almost) no one in public life is even proposing such a system. Yet the unsatisfactory compromise with the health care denial and profiteering industry (inaccurately referred to as "insurance") being proposed is being labeled as "socialism," "fascism," etc. etc., and the outrageous antics of the far right are actually being acknowledged as politically effective, as in likely to result in still more watering down of reform.

Sometimes it's just unbelievable to me what our country has come to.

My Letter to President Obama on Health Care today

Dear President Obama,

I am writing to strongly urge you to become much more proactive in the program to achieve serious and meaningful health care reform. This was a keystone of your campaign to become president, and will, if successful, become a major element of your legacy. But there are well-organized and surprisingly effective forces on the right arrayed against this effort, and I fear that they are having much more effect than their relatively small numbers — in terms of public support — would indicate. I refer, of course, to the right-wing interest group funded “Astroturf shoutdowns” which are drawing far more media attention than is justified. I also have serious concerns that your legislative program is not effective enough in making clear to members of Congress that the bill must include a meaningful public program.

Part of the problem is framing the issue and communicating with the public. I understand you have read and been influenced to some extent by George Lakoff, who has discussed the importance of not accepting the right-wing framing. We must avoid terms like “public option” and “single payer” and use words like “fair health care for all” and “meaningful competition.” I urge you to use the bully pulpit, as often as necessary, with your very considerable communication skills at their fullest, to explain to the American people exactly what is at stake. Ask for their support. Ask them to demand support for your bill. And communicate to Congressional leaders exactly what the bill must contain.

Rahm Emmanuel is way off base condemning progressives for resisting attempts by so-called “Blue Dogs” to sell out to the Republicans. We need to make it clear that this is a critical issue, and we will pass this bill without Republican support if necessary— which it will be. Reconciliation should remain an option. But first, you need to stand firm. You need to be willing to say to the American people that the time is now, this opportunity cannot be allowed to slip away, and you will not sign a bill that does not contain meaningful reform, including a robust and effective public plan to ensure affordable health care for all.

Please, Mr. President. This is a crucial issue. It’s the reason many of us contributed more of our hard-earned money and time than we could comfortably afford to elect you. You simply cannot let us down on this.

Jack Vance

The New York Times Magazine has published a lovely piece on Jack Vance, who is publishing a short autobiography this summer, at 92. If you don't know Vance, you ought to give him a try.

Gazpacho Andaluz

Its being summer, here's a modification of a traditional Andalusian recipe found in Foods and Wines of Spain by Penelope Casas. (The original has no pear or olive oil; I find both add something). It's fresh and simple, without unnecessary heavy ingredients found in some other gazpachos like breadcrumbs, mayonnaise or eggs.

Gazpacho Andaluz

1½ lbs very ripe fresh tomatoes (Don't use supermarket tomatoes; if you don't have garden tomatoes, use canned, at least they're ripe)
1 medium green pepper (or equivalent of sweet hungarian peppers, or mix of both)
1 medium sweet onion (e.g. Maui or Vidalia)
1 cucumber
4 tbs red wine vinegar
1 tsp (+) fresh shredded tarragon (or use whatever you have; such as basil or even mint)
1 small can pear halves in juice, with juice (not syrup) (or use fresh, peeled pear, cut in pieces; add a little sugar)
1-2 cloves garlic
1 cup tomato juice, or ice water (use juice if tomatoes less ripe or flavorful; I usually use juice).
2 tbs. extra virgin olive oil
Sea Salt

Diced cucumber, tomatoes, onions, and croutons for garnish (optional)

Cook the bell pepper, garlic and onion (separately) very briefly, whole, in microwave, if desired. (Makes them sweeter). Cool them in cold water. Peel cucumber and chop coarsely. Rinse tomatoes, and chop coarsely. Peel and coarsely chop onions. Seed and coarsely chop the pepper. Place all ingredients (except garnish) in blender, in batches, blending thoroughly. Force mixture through through sieve into large bowl or pitcher. (I use a flat bottomed plastic strainer, and force the mixture through it with a silicon spatula). Add salt to taste, and chill the entire mixture for at least two hours, preferably longer; use a little ice in place of ice water if it needs to chill quickly. Salt to taste. You can also add other seasoning if desired.

Gazpacho improves if left overnight before serving, and keeps several days in the refrigerator.

Serve with garnish, if desired. Serves 6.

I've found this recipe can be doubled, tripled, or even quadrupled with no ill effect.