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.