The Tea Party Management Style

I think the ongoing situation in Wisconsin is a good lesson on where extreme, partisan politics can take us.

As I wrote in an email not long ago (and I promise to stop quoting myself...soon):

"Walker has always been controversial. He was deeply unpopular with Democrats when he was County Exec in Milwaukee. He took a lot of fire. He didn't care.

"He doesn't care now. He's getting national attention, he's a hero to the Right. It really is excellent news for him, as far as I can see. And I don't see him as being in a position of weakness. The Dem Senators are not going to become Illinois residents; they have to come back at some point. And every day they're away, he can say Democrats are shirking their duties. "Not being on the job" is pretty much perfect for the Right's critique of the labor movement anyhow.

"[recent actions] just confirm what the Rs have been saying. They have the votes. They will stick together. They've seen it work in DC, they're going to stick together in Madison. I would love to see some of them peel off, but don't see any signs it will happen."

As it turns out, one R Senator did peel off. But the hardcore partisan actions of Walker and crew did get them what they wanted. Whether that will have consequences down the road is another question.

My take: being governor is different than being county exec. The latter job is low profile, the public pays little attention to it. That has changed dramatically now that Walker has taken his damnthetorpedoes approach to Madison.

In any case, expect more of the same. This guy is no Barack Obama, he's not going to have beer summits or health care roundtables. He's not going to reach out to the other side, unless it's to smack them upside the head. Compromise is not his style. Some people will dig that. Some won't. We'll have to see how the people of Wisconsin take to the Tea Party style of management.

Blast from the past...

"Progressives will mourn the loss of Feingold, but Scott Walker’s win is a real nightmare for the people of Wisconsin. He is a true believer in downsizing government to the point where it basically ceases to function, as he has proven in his role as county executive for Milwaukee County. Expect Wisconsin’s next governor to be extremely partisan in fighting against health care reform, nixing mass transit projects, slashing education, etc. As George Bush so ably did, Walker believes government can do no good and is dead set on proving it."

Mod Lang, Nov. 1, 2010.

Bill talks about education

Jim commented earlier on my brief education post and raised a good point. And tho I'm not into the demonizing of unions, I do think trying to improve and protect our education system is something we should all be working on.

A Man Hears What He Wants to Hear

David Roberts does an admirable job of discussing how the whole "Climategate" mess was handled in the media.

"It's a numbingly familiar pattern in media coverage. The conservative movement that's been attacking climate science for 20 years has a storied history of demonstrable fabrications, distortions, personal attacks, and nothingburger faux-scandals -- not only on climate science, but going back to asbestos, ozone, leaded gasoline, tobacco, you name it. They don't follow the rigorous standards of professional science; they follow no intellectual or ethical standards whatsoever. Yet no matter how long their record of viciousness and farce, every time the skeptic blogosphere coughs up a new "ZOMG!" it's as though we start from zero again, like no one has a memory longer than five minutes.

"Here's the basic question: At this point, given their respective accomplishments and standards, wouldn't it make sense to give scientists the strong benefit of the doubt when they are attacked by ideologues with a history of dishonesty and error? Shouldn't the threshold for what counts as a "scandal" have been nudged a bit higher?"

Gov't Spending Equals American Jobs, pt. 2

A blogger at Moody's Analytics notes that if Congressional Republicans get the cuts they want, out economy will suffer a grevious hit. Their proposal, he writes, "would reduce 2011 real GDP growth by 0.5% and 2012 growth by 0.2 percentage points This would mean some 400,000 fewer jobs created by the end of 2011 and 700,000 fewer jobs by the end of 2012."

Talking Points Memo also notes that an ABC News report last week predicted that the Republican approach would cut economic growth by 2 percent of GDP--an even more dire analysis than Moody's.

I keep hearing from my conservative friends that if we raise taxes, it will hurt job creation. But that's really a hypothetical. Job creation is driven by many things, and maybe taxes play a role, but demand, business climate, workforce conditions, all of those play a role as well. Cutting government spending will destroy jobs that families are depending on Right Now. Real jobs, not possible jobs. With cutting government spending, you are certain to do one of several things: cancel someone's health insurance, reduce someone's services, cut someone's job. These are not good outcomes.

Government Spending Equals American Jobs

The ongoing protests in Madison have me thinking about what government spends money on. And in many cases, it's employing people like teachers, policemen, firemen, social workers, etc.

So what happens when we cut government spending?

The math isn't difficult.

More people on unemployment (and more government spending). Fewer taxes collected. Less money going into the retail sector. Purchasing decisions (new house, new car, new teeth) delayed or canceled.

That's good for our economy how?

I understand the argument that government is spending too much, and I'm sure there are cases where it's true. But too often this argument is framed this way: "We have to cut government spending so we can create jobs!" But that's not what happens at all. You may be saving the taxpayer some dollars. But what you're also doing is cutting jobs, and there's no reason whatsoever to think that the private sector will pick up the slack.

Right now many states are facing big deficits. A good number of these states, like Wisconsin, have Republican governors. So raising taxes is out. Cutting spending is in. And that means job losses, less revenue, and so on. It does not sound like a formula for economic recovery to me.

What If…?

I’d like to conduct a mental exercise. Let’s pretend the United States had a democratically-elected president back in 2000.

If that had happened, I think today’s headlines would not just be about Egypt and Libya and Bahrain. I think today, or maybe tomorrow or next week, we would be hearing about the overthrow of Saddam Hussein, as Iraq joins the irresistible lurch toward democracy in the Middle East.

Those who sought to justify the war in Iraq trotted out one reason after another. The terrorists who attacked us on 9/11 didn’t come from Iraq, so we heard about weapons of mass destruction. The weapons of mass destruction turned out not to exist, so we heard about democracy and the need to rid the world of this evil dictator.

But as it turns out, time might have done the trick, much more neatly and legitimately. It doesn’t take much imagination to think about a unified Iraq, whose citizens suddenly find themselves with fewer reasons to fight, now that they have worked together to rid themselves of a tyrant.

And think what could have been saved. Thousands of American lives. Hundreds of thousands of Iraqi lives—to say nothing of the refugee problem that afflicts Iraq's neighbors. Trillions of dollars that we still haven’t figured out a way to replace. The reputation of this country as a champion of democracy.

Maybe, right? Maybe it would’ve worked out that way. All we know now, as we stand on the sidelines, is that our slipshod, democracy-at-the-barrel-of-gun solution in Iraq now looks shaky, out-of-touch, and overly expensive. Maybe it will work out. Maybe.

Compare and Contrast

Two neighboring states have elected starkly different governors with starkly different ideas of how to solve their financial crises.

In Wisconsin, Scott Walker is charging ahead with tax cuts, evisceration of public unions, and a government-is-the-problem vision that is as pure, and as radical, as any state executive has articulated in modern times.

Facing a deficit twice as large, Minnesota governor Mark Dayton is similarly taking a blowtorch to government spending, but he is almost unique among governors in asking that the rich also pay a hefty price tag to address financial problems that have been ignored for too long.

Walker’s agenda will almost certainly pass in some form. It’s hard to see how Dayton’s tax increases will get by the new Republican majorities in the Minnesota Legislature.

It’s too bad. We might’ve had a chance to see how two opposite approaches would play out. Would wealthy business owners have stampeded out of Minnesota for the greener pastures of Wisconsin, taking their jobs with them? Would Walker’s gutting of schools and presumably health care programs (if you want to address spending you gotta go there eventually) have made Wisconsin an undesirable destination for employers?

It’s too early to tell how it will all play out. But the two men could hardly be further apart in their ideas about what their states should look like.

A random thought

(That I’ve shared elsewhere…)

As a parent, there is one thing I’m quite sure of.

Public school teachers deserve more compensation, not less.

Meet the New Congress

Heard a really remarkable interview on MPR today. It was with a Congressman from Florida who chairs a transportation committee, John Mica. In the short interview, Mica, who came across as a reasonable and likable guy, really did a remarkable job of downplaying the entire tea party movement.

First, he backpedaled on earmarks, saying that earmarks were necessary to keep the President from just doing whatever he wanted. Fair enough, but pretty different from what the R's were saying the last couple of months.

Then he said about the health care reform repeal, and I'm trying to not paraphrase too much: A) I'm going to vote for it, B) it's not going to pass (presumably he meant it would fail in the Senate,) and C) I don't really want to repeal health care reform anyhow.

He then went on to throw up a smokescreen of false and misleading points about the new health care law, for instance saying that it's wrong to mandate health insurance coverage when people can't afford it (the reform law specifically addresses that issue to make it affordable through subsidies), and saying it's too expensive (when in fact repealing the health care reform law will add $100 billion to the deficit).

By this point, I've come to expect R's to peddle in misinformation, tho it was disappointing to hear it from a guy who seemed reasonable otherwise. But it was really incredible to hear the mental gymnastics required to say, "I'm going to vote for something I don't agree with because I know it will eventually fail."

I may disagree with him on the larger points, but on this, I hope he's not wrong.

AaaaOOOOOOOOGA! The horn blows for Childress.

It’s been easy to place blame on Brad Childress for the astonishing collapse of the Minnesota Vikings this season. Blame could also be shared by Brett Favre, an inconsistent-at best receiving corpse (hey, let’s just leave that typo in there, it fits), rapidly aging lines on both sides of the ball, and a secondary that has some very questionable pieces.

But the real culprit for the Vikings mess is owner Zygi Wilf. And he’d better figure out quickly that he needs to change the basic organizational structure of the team, or it’s likely to be in exactly the same place in a year or two. Or sooner.

Wilf did not have a lot of football know-how when he bought the team. And it has showed. With no strong general manager, Wilf pushed most of the power and decision-making to the head coach, and that has been a disaster.

Childress may actually be a pretty good coach on some levels. After all, he had two pretty good seasons with the Vikings and was one-increadibly-boneheaded-I-can’t-believe-Favre-did-that-again-does-he-have-a-death-wish interception away from taking them to the Superbowl.

But then the wheels came off this season. And why? One word: personnel. Childress went for the short-term glory of bringing in big stars like Allen, Favre, and infamously, Moss, rather than cultivating a deep bench of players who could step in if the starters faltered. And falter they have. This team peaked big time last year and clearly Childress had nowhere to go when players like Williams and Rice either got hurt or lost a step.

And just as a side note: what message does it send to the rest of your team when you go for a star player and tacitly tell the world he doesn’t have to play by the same rules as everyone else? Doesn’t have to come to training camp? Gets special treatment. Yeah, Farve’s a legend. But the psychology of this team was dysfunctional from the day Childress played chauffeur to Favre at the beginning of last season. It was festering all along, and the dam burst this year with Moss.

A strong general manager who could avoid the impulsive, go-for-broke decision-making that doomed Childress’ tenure is needed badly by the Vikings. I don’t know if Wilf will be able to figure out how to right this ship. But firing Childress is just the first, and easiest, step.

Waiting for the Great Leap Backwards

In thinking about tomorrow’s election, I was reminded of something someone said after George Bush’s popularity began to plummet early in his second term. “No matter who’s elected, they’re going to have such a mess to clean up they may not want the job,” the statement went.

That seems especially appropriate now. We had two elections that brought Dems to power, and people expected improvements, but the problems that had been building up over eight years—or longer—have turned out to be very tough to fix.

So here we are, poised to punish the Democrats for not fixing the mess Republicans made quickly enough, and putting Republicans back in power to mess things up a little more—or, more likely, to ensure more gridlock on the really tough problems.

Good job, American Democracy.

Hey, it’s not the end of the world. We’ve survived worse than handing power to a bunch of crazy tea-partiers who don’t know what the heck they’re talking about.

I think.

Minnesota, the nice tea party state

I was talking to Al Franken the other day—OK, it was a few months ago and it was the one and only time I have spoken to the man—and he said something like, “you know, we have tea party types here, but they’re nice tea party types.”

And it does seem that the extremes of tea partiers are a little less extreme here. I mean, we do have the tea party queen in Michele Bachmann, but other than her the crazy gets dialed down quite a bit in Minnesota.

Bachmann is cruising against Taryl Clark in the 6^th district. Clark may make the race a bit tighter than former opponents, but I agree with those who say that in the year of the Republican Wave, Bachmann is not going down. Bad timing for Clark.

Tim Walz seems pretty secure down in the 1^st district, probably because he’s so likable and down to earth that the R’s can’t make much traction in arguing he’s part of the problem. The problem is supposed to be out-of-touch Washington insiders who don’t listen to their constituents, and Walz just doesn’t allow himself to get tagged with that. He is dogged in his attempts to stay tuned in with his voters, even if he doesn’t always take the most popular stance.

It is a sign of the times that even Jim Oberstar up in the 8^th district is seeing a challenge, but that seems to be the case with his race against Chip Cravaack. Some internal polls released by the Cravaack camp suggest he was within a point or two of Oberstar. But like Derek Wallbank, I really doubt the underdog can pull this off. I was just up on the North Shore and there can be no doubt that Oberstar brings home the bacon to his district. I have never seen nicer roads than the county highways north of Duluth. I mean, they were amazing. I felt like I was in a car commercial. Of course, some might say that proves that Oberstar is a pork-addled Washington insider, but somehow I doubt he’s going to lose tomorrow. If I’m wrong, it is REALLY going to be a long night for Dems.

Those are the closest congressional races. And except maybe for Walz, I would expect that they end up not being that close.

The governor’s race looks like it will be tight to the end. I have to give credit to Mark Dayton. Despite being far from the smoothest public speaker, despite his rather risky stance on raising taxes on high earners, despite his less-than-stellar track record in office, he has managed to run an efficient and effective campaign. He hasn’t made a major mistake, as Hatch did four years ago.

Tom Emmer also deserves credit. Early in the race, it looked like he would implode and lose his support to the more moderate Independence Party candidate, Tom Horner. But Emmer shored up his base, stopped shooting himself in the foot, and turned on his considerable charm and enthusiasm to make a close race of it. As others have pointed out, when it comes to Minnesota, if the R’s and D’s both turn out the base, the D’s just have the numbers, so they win. That will probably happen tomorrow.

Horner has to be disappointed that he didn’t make more headway with voters. I think a lot of political observers thought that policy-wise, he was the most articulate and made the most sense. You could say he “won” a lot of the 472 debates (a mild exaggeration of the numbers there)

From my viewpoint as someone observing the health care industry, it surprised me that Horner pulled in the endorsement of both the Minnesota Medical Association (MMA) and the Minnesota Hospital Association. When that happened, I thought he might actually have a chance to pull in a lot of more moderate voters. But he’s never come close to cracking 20 percent and making this a real 3-way race.

What that tells us, I think, is that even in Minnesota, where Jesse Ventura once shocked the world, people are comfortable with our two-party system. For all the talk about tea parties and independent voters, we’re still a red and blue electorate.

Wisconsin Swings Back

A state that had been trending blue is going to reverse itself tomorrow, if the polls are correct. Russ Feingold, a great independent/progressive voice and one of the most principled people in the Senate, will lose to ultra-pro-business newcomer Ron Johnson. Anti-government crusader Scott Walker will trounce Milwaukee mayor Tom Barrett.

Progressives will mourn the loss of Feingold, but Scott Walker’s win is a real nightmare for the people of Wisconsin. He is a true believer in downsizing government to the point where it basically ceases to function, as he has proven in his role as county executive for Milwaukee County. Expect Wisconsin’s next governor to be extremely partisan in fighting against health care reform, nixing mass transit projects, slashing education, etc. As George Bush so ably did, Walker believes government can do no good and is dead set on proving it.

Johnson on the other hand will have little power and less know-how, at least to start. He won’t help with much but other than being an R vote, probably can’t do too much harm.

*cough* dusty in here... somebody open a window...

So yeah, I'm firing up the blog now that we're a month away from another big election.

Hopefully it will cut down on me posting an annoying amount of political stuff on FB. I hope so anyhow. If I could keep it to posting, say, 3 or 4 things a day there, that would be good...

My first shockingly radical political thought has to do with health care reform, of course. I'm on this mailing list of a bunch of cranky doctors, most of whom are strongly opposed to the health care reform law. Oh, there are a few hippies who think it's a good thing to address the issue of millions of uninsured, but many of these docs are just aghast that the government is going to take some steps that might affect their income--ooops, sorry, interfere with the doctor/patient relationship.

What really strikes me is not that a bunch of older physicians who are set in their ways and are quite comfortable with the system as it is are opposing change. What strikes me is that after spending 30-plus years complaining about health insurers and how they are the source of all evil in the world, many of these docs now have turned around and are defending health insurance companies against the ravages of government-controlled health reforms. It really is a head-spinning turn of events.

Mothballs

Yeah, it's become pretty obvious that I can't keep up with the ole' blog. My last post was in March??? Ouch.

Facebook is just a much more immediate and inclusive medium. Even though in theory anyone in the whole wide web can come here to ML, that's not the way it works out. With FB, you know you've got an audience, though you give up some things, such as privacy to some extent.

On the other hand, lots of folks are not interested in political debate on FB, and I probably am quite annoying to them. But some are. It's just not practical to try to drag them to this blog and expect them to make it a destination, especially when I can't even do that myself on a regular basis.

And the truth is, Ezra Klein and Josh Marshall say everything I would say, and more, much better than I could say it. So linking to them is simply more efficient.

I'm not closing the account. There's an election this fall (and unless Obama triggers the Rapture, more to come) and it will probably make sense to fire this site up then, when I have more to write about.

Until then, see you on FB!

PS: I'm also still blogging on MySpace, but that's pretty much just about music stuff.

Good night, everybody, everywhere. Goodnight...

“This is what change looks like”

A few months into the Obama presidency, a liberal friend tried to pin me down on my position on health care reform. Now, I’m not really hard to pin down—I support reform. I’ve been a pretty loud advocate for it. But he wanted to know my opinion on the public option, a measure he saw as essential. I was reluctant to take a militant position on the public option, not because I didn’t see it as a good idea (I do) but because I didn’t see it as the silver bullet of health care reform.

About the same time, I was arguing with conservative friend who thought that the Democrats were just trying to create a huge entitlement program for all the unemployed people, in effect (he argued) “buying” their vote with the currency of health care. I replied that health care reform isn’t about free goodies: it’s about making all of us more economically secure, regardless of whether we’re employed or not.

With such a contentious, divisive issue, I found myself again and again drawing on my experience with people who are actually in the health care industry. I’ve been watching and listening for more than ten years as industry people talked about reform. What I hear over and over again is that our health care system is broken, unsustainable, heading for disaster. I hear words like “catastrophe” and “crisis.”

Year after year, I’ve heard people talk about the failures of our system. And it was more than talk. The doctors and health system people—as well as many the insurance side, knew all too well how real lives were being damaged by the lack of access to health care. They saw the price people paid for being uninsured. We heard those stories over and over again. But when the speech or the conference was over, everyone would go their way, until the next conference or speech.

There just wasn’t enough consensus on how to fix the problem. And I frankly questioned how we ever would find consensus, given the entrenched positions of people, not only politicially, but from their different places as stakeholders in the industry.

One of the really remarkable things about this health reform campaign of the last year was how Obama was able to get industry players on board. The American Medical Association. The drug companies. AARP (representing the Medicare constituency). Even the health plans, though generally opposed, were muted in their criticism because they simply could not make the argument change was not needed.

You can certainly turn that around and say that Obama has sold out to the special interests. But the bottom line is that it would be impossible to bring about reform without the industry being part of the pro-reform team. Unless, of course, it was done with as a kind of top-heavy, big government takeover of health care—outlawing private insurance and replacing it with a government system, for example. In this political climate, who thinks that would have worked?

There were many times during this process I thought health care reform was dead. But time proved me wrong. Just as it has proven Obama right. This is what change looks like. It’s a long, hard, contentious process, and even when you get to the “end” there’s much more to do.

People voted for change in 2008. They voted for health care reform—it was a major campaign issue. They voted for a new approach to our economy and our politics. It’s been a long, hard, contentious battle for those things so far. But we have a president who is delivering on his promises.

And we have passed health care reform in the United States.

“Help Me, ObiWan-AG, You’re My Only Hope”

I’d say the chances of a court challenge overturning health care reform is just slightly less likely than Leia and friends blowing up the Death Star. And remember, folks, that was Hollywood.

There’s been a lot of talk about how the individual mandate (originally a Republican idea) is unconstitutional. Blah blah, Commerce Clause, 10th Amendment, woof woof. If people don’t choose to buy insurance, they’re not part of commerce, therefore, they can’t be forced to be part of the system. This ignores the fact that a) everybody gets sick sometime and 2) they will then access the system, which has real costs, presto, commerce!

This Pioneer Press article is one of many to throw cold water on that idea. Sure, the Supreme Court has been very activist lately, often throwing out decades of precedent to pursue their conservative vision of America, but it seems unlikely they would legislate this openly from the bench. And if they did find the individual mandate unconstitutional, there’s a quick fix: change it so it’s not a mandate—
just make it really hard to refuse.

Here’s part of the PriPress article:

“[The Supreme Court ruled] that staying out of the marijuana market rather than participating in it does affect commerce (even if the market is illegal). Conservative Justice Clarence Thomas and then-Chief Justice William Rehnquist sided with Raich, but the court's liberal wing prevailed, even winning over conservative Justice Antonin Scalia.

‘Raich seemed to stem the Rehnquist court's rollback of Congress' Commerce Clause power. And Justice Scalia went along with that, using reasoning that arguably expands Congress' reach,’ said Mehmet Konar-Steenberg, an associate professor at William Mitchell College of the Law. ‘So I don't know how much stomach there is at the Supreme Court right now to try to revive this line of cases.’

Furthermore, the links between health care and commerce are clearer, Konar-Steenberg said, pointing out — as others have — that many already purchase insurance and that those who don't have their emergency room bills picked up by everyone else. ‘These don't strike me as attenuated links to interstate commerce,’ Konar-Steenberg said.”

Yes, politicians, have been known to make deals before. You didn’t know that? Really?

I recently heard from a friend who was shocked, shocked to find that Democrats were making deals and twisting arms to pass health care reform. She insisted that this was far worse than anything that had ever gone on before. Well, I don’t know, but I suspect it wasn’t worse than this:

“A 15-minute vote was scheduled, and at the end of 15 minutes, the Democrats had won. The Republican leadership froze the clock for three hours while they desperately whipped defectors. This had never been done before. The closest was a 15-minute extension in 1987 that then-congressman Dick Cheney called “the most arrogant, heavy-handed abuse of power I’ve ever seen in the 10 years that I’ve been here.”

Tom DeLay bribed Rep. Nick Smith to vote for the legislation, using the political future of Smith's son for leverage. DeLay was later reprimanded by the House Ethics Committee.

The leadership told Rep. Jim DeMint that they would cut off funding for his Senate race in South Carolina if he didn't vote for the bill.

The chief actuary of Medicare, Rick Foster, had scored the legislation as costing more than $500 billion. The Bush administration suppressed his report, in a move the Government Accounting Office later judged ‘illegal.’”

(Read the whole thing, it’s pretty amazing.)

RIP Alex Chilton

On a non-political note... I named this blog Mod Lang after the Big Star song, thinking that it would be a place to talk about culture more than politics. Well, it hasn't turned out that way, but just the same, I feel I should note the passing of Alex Chilton, who along with Chris Bell founded Big Star.

I was introduced to the music of Alex Chilton and Big Star by Bob Richert, a record store owner and small-label enterpreneur in Bloomington, IN, in the spring of 1981. It was only fitting, then, that I met Alex Chilton in that same small college town a few years later.

I was in town, almost on a whim, to visit a girl. (Of course) I found out that Chilton was playing that weekend and decided to go see him. Since I had been doing some writing for a small music publication in Milwaukee, I decided to push my luck and see if I could get an interview.

Chilton said sure. A couple hours before his show, I met him in the dressing room and we talked about his career and music. I have the article, buried somewhere in my files, but I was a young an clumsy interviewer then, and I'm sure it doesn't say anything that Chilton fans haven't already heard.

He was cynical about the music business. He was proud of his recent work, which at that time consisted of minimalist solo albums (Feudalist Tarts was probably his latest or about to come out at that time.) --almost to the point of being dismissive of his Big Star work. Probably at that time he was sick of being asked about Big Star, which for all its critical acclaim, had left him nearly penniless.

For all his sour feelings for the music business, he was generous with his time and even asked if I wanted a joint. I'm not sure it helped my standing with him that I declined, but I'm sure it was a good idea I stayed clear-headed for the interview.

After the interview, Chilton played to maybe two dozen people in a no-frills club called Second Story. He played solo and included many choices that I found curious at the time, including old R and B standards and the Italian pop classic Volare (which was a staple for him for many years). Big Star songs were few and far between. But Chilton was following his muse, which he had doggedly done since leaving the Box Tops, and he clearly wasn't interested in reliving his pop-rock legacy.

At the end of the interview, I asked something along the lines of, since he was a hero to many budding songwriters, did he have any advice for them? He looked me in the eye. "Yeah, " he said. "Go to law school."

He was funny, he was cynical, he was dark, and he was light. He was, as he once wrote, "a true heart." He stayed true to his music and himself, even when that wasn't the smartest or easiest call. But he didn't let go of that vision. He held on, and so many times, his music has helped me to do the same.

Thanks for the interview, Alex. And everything.

From now on, let's say we call those "Jim DeMint boots"

Called it.

A couple of days ago, I thought of posting a Facebook status line saying, "COUNTDOWN TO SOCIALISM!!!"

Just as a snarky jab at my conservative friends who have been hyperventilating about this health care reform thing.

Then I thought, nah, let's be a little more gracious than that.

But lo and behold, someone's doing it for reals. "GOVERNMENT HEALTH CARE TAKEOVER IN: 12:23:43" reads prominent banner ads on the Washington Post website. "You Can Stop Obamacare: Act Now!" the ad continues. And "Paid for by the Republican Congressional Committee."

Keeping up the bullshit 'til the bitter end.

A brief history of health care reform in the US

Democrats: "We need health care reform. Let's do Plan A."
Republicans: "We don't like Plan A. We want Plan B."
(TEN YEAR PAUSE)
Democrats: "OK, we'll do Plan B."
Republicans: "No, we want Plan C."
(TEN YEAR PAUSE)
Democrats: "OK, Plan C, then."
Republicans: "Plan C is socialism. We want Plan D."
Democrats: "We're starting to think you're not serious about this."

livecaresummitbloghealth10 : hey, let's not let those uninsured people dominate this discussion...

Dropped back in on the summit and found another Democratic nonwhite guy. Rep. Xavier Becerra squabbled a bit with Paul Ryan, and makes the point that if you throw out CBO numbers, we can’t discuss this.
(CBO tells us the Dems health care reform bills reduce the deficit by 100 billion in the first ten years. Ryan may disagree with those numbers, but they’re the best we have, and the best we’re going to have.)

Boehner is up:
Thank you for having us. A useful conversation. Don’t disagree with premise of meeting.
Our job is to listen. I’ve heard an awful lot. What I’ve heard more than anything ist hat the American people want us to scrap this bill.
Let’s talk about why
Fiscal condition. We’re going broke. This new entitlement program will bankrupt our country. I think this is a dangerous experiment. We may have problems, but we have the best health care system in the world. A government takeover of health care, and I believe that’s what that is, is risky.
The last thing we need to do is raise taxes. $500 billion in cuts to Medicare. It’s going to drive up unemployment. Employers will dump employees into the exchange. Federal government is going to design every single health care plan in America within five years. For thirty years we've had a federal law that says we’re not going to have federal taxpayer funding for abortions. This bill allows for taxpayer funding for abortions
So let’s scrap the bill. Let’s start with a clean sheet of paper we can agree on.
I’ve been patient, I’ve listened. Why can’t we come to an agreement on selling across state lines, malpractice, etc.

(A thoroughly dishonest and distasteful performance.)

Obama: every so often we go back to the standard talking points. And that doesn’t drive us to agreement. There’s so many things you said, that people here disagree with and based on my analysis, just aren’t true. We were trying to focus on the deficit. The CBO says this will reduce the deficit. Paul may disagree. I’ll get back to you on some of these.


Rep. Jim Cooper. Medical expenses driving us off the cliff. Tough talk is not good enough, we need to take tough votes.


Dick Durbin
Orin Hatch asked CBO about tort reform. It saves $54 billion over ten years.
5.4 billion a year is a lot of money except when compared to the 2 trillion we spend each year on health care.
And if we do have tort reform, more people will die. Thousands more.
There are other ways to reduce medical errors and lawsuits that should not be filed.
The number of paid malpractice claims have been cut in half in the last ten years.
Money paid has been going down, cut in half in last ten years.
This is an important issue but to make it the overriding issue is [wrong]
The best health care system in the world for the wealthy. We should give everyone the same plan congress has. If you think it’s a socialist plot for goodness sake drop out of the federal health benefit plan.

(One of the more powerful, and shortest, speeches today.)

Obama: looking at access now. Republican plan would cover an additional 3 million, Dem plan would cover an additional 30 million.
This may be most contentious part: it does cost money. But let’s not pretend that we’re going to cover another $30 million for free. If we think its important as a society to not leave people out then we’re going to have to figure out a way to pay for it.

John Barrasso
This is about all Americans, not just those who don’t have insurance (???).
He says *everyone* believes that passing the bill will increase costs. Will make care worse. Will hurt seniors.
They all believe that because you keep lying to them.
Gotta take another break.

sumbloghealthliveit9care

Ok, gotta take a break for awhile. Hopefully will come back late in the day with some kind of summary.

For the record, a nonmale Republican has been sighted.

livehealtblogcaresummit8

McCain

Wants to talk about process. Taking a pretty critical tone; talking about lack of transparency, “unsavory deal making,” asking rhetorical questions, just being his usual grumpy old man self.

Boy, he’s really making us regret electing Obama.

Obama tries to cut in, McCain steamrolls on, says Americans want us to go back to the beginning. He really reminds me of the debates. I don’t know who this is good for. He’s certainly throwing mud at Obama. Will it stick?

Obama: let’s get back to the issues.

Is Saturday Night Live on this weekend? ‘Cause if it’s a new episode the opening skit should be awesome.

Nancy Sibelius is talking to a roomful of people who probably are counting the minutes to lunch. OK, just an observation. So far this has been going on all morning. Lots of people have been talking. A total of two, I believe, were female. A total of one was not white. The nonmale nonwhite contingent were all Democrats. Just making an observation about how inclusive and diverse our government is these days.

Eric Cantor has a huge stack of paper in front of him, comes about up to his collar. Obama asks about it. I guess Eric wants to be able to look stuff up if he needs to.

“There is a reason why we all voted no.” (Yep, it’s called November).

He says it’s ‘cause the sec. of HHS will define benefits. What these guys are arguing is again, that government can’t work. I guess that’s an argument. Sure isn’t a constructive one, though.

Taking on oversight of insurance premium increases. Government regulation will force premiums to go up, says EC.

Obama ripping apart his talking points. Making the point that regulations are necessary to protect consumers. Explaining the concept of risk pools. Man, it’s sad that we’re at this point.

“We just can’t afford this.” Cantor.

We could afford two wars, massive tax cuts, and the Medicare drug benefit you voted for. Right.

Cantor is dogged, I’ll give him that.

Oh, hey another nonmale. Hello, Rep. Slaughter. Hey, she's pretty good. But she used the phrase "eating my lunch" and I could hear people shifting in their seats.

Livehealthcaresummitblog7

Best new catchphrase (and movie pitch) from summit:

Undercover Patient.


Schumer notes that we can’t health care costs without cutting waste in Medicare, hits R’s for saying you can’t cut Medicare.

Sen John Kyl
We do not agree with the question on who should be in charge.
Do you trust your doc or do you trust Washington.

Oh, he’s going back to the premiums. Quotes a letter from CBO; premiums will go up because it’s a richer benefit, because the government would mandate it. Getting into acturarial tables. Govt will mandate that insurance will cover more things, so premiums will go up. Taxes.

Kyl has a big pile of papers in front of him, and danged if I don’t take him more seriously. Best use of props.

Taxes, fees, will increase the cost to the consumer. That’s why R’s would rather start by not having to raise a lot of money to pay for bill, instead take it piece by piece.

(my question: how many years til we get reform that addresses the real problems that way? 5? 10? 25?)

Obama responds:
Premium argument. If I’m self-employed, can’t get coverage. High deductible plan: it’s not health insurance, it’s house insurance. (good phrase) What CBO is saying: if I have an opportunity to buy good insurance, costs more but is real insurance. So yes I’m paying more because instead of buying an apple I’m getting an orange.

The federal benefit has a minimum benefit that all in congress enjoy. We’re saying we’re going to do the same thing for others that we do for ourselves. Saying there’s a baseline of coverage is not some radical idea. A lot of states do it.

I just want to point out the issue of gvot regulation is very different than the way this has been framed. This is not a government takeover of insurance. (He’s hammering home that point, I guess it needs to be said)

James Clyborn is talking up community health centers as a way to address cost and access issues. No matter what we do, there should be sig. expansion of those centers.

HCSummitLiveBlog6

Coburn called for undercover patients. I love that song.
“Undercover patient, midnight fantasy…”

After Coburn, Obama points out again, that many of the cost containment ideas and prevention ideas are already in the bill. This is going to be common theme of today: you guys say you want xyz reforms, hey, they’re already in the bill.

Here’s Steny Hoyer, telling Coburn the bill does exactly what he suggests in working on Fraud in Medicare & Medicaid (hereafter known as M&M)

Steny seems more focused and articulate than Reid/Pelosi. Not necessarily more exciting, but I don’t find myself saying, wait, what? …as much.

Obama: what are your objections to health insurance exchanges? I know some of you have agreed to this concept in the past. (ooo, nice passive aggressive move.)

JOHN KLINE, from MINNESOTA!!

Kline: we’re looking at thousands of pages of legisatlion, better to go step by step. We have proposed that small biz be able to band together.

I love that tie. I mean it, it’s outstanding.

Let small biz band together to get the same advantages that bigger co’s have. Obama, nodding. Kline: we think that’s a better idea than exchanges.

Obama asked Max Baucaus to respond.

Baucus: this is what strikes me. We all know what the problems are. We are actually quite close. The gaps are not that great.
Going back to Lamar. We’ve got most of what R’s want. Across state lines. Tort reform (HHS working on) . Baucus seems nervous and a little tongue tied.
HSAs work pretty well for middle and high income people.
Small business: we’re not that far apart. Association health plans (Kline’s thing) That’s fine, what we provide is the SHIP Act. Bipartisan, allows small business participation in exchanges. Major provisions on fraud and waste in the bill. We basically agree. Looks like he's ready to start hugging people.

(I sense a real advantage here for the Dems. They keep hammering home that they have made reasonable attempts to address the R concerns. They show how the bill incorporates R ideas. They get a chance to explain how the bill works and what it does. The R’s can’t come back with the outright falsehoods, because Obama has made it clear he won’t let them pull that stuff. Obviously, I’m pro-reform so my take on this may reflect that. But this seems effective to me.)

McConnell yields to Boehner, Boehner yields to … who is that? Camp? Rep. Dave Camp. He says if you care about costs, why are you spending a trillion dollars? (because it reduces the deficit?) He says someone (medicare?) says the plan does not bend the cost curve the right way. He wants malpractice reform. Quotes CBO that says med malpractice reform would reduce deficit.

Remember he quotes CBO.

Lots of details with this guy, he’s definitely a policy guy, seems more prepared than some of these guys. Talks about an unelected board to make Medicare cuts (death panels!)

Obama cuts him off: doesn’t want to get off on tangents, then lets him finish.

Obama and Camp getting into premium increases. When all this is structured around a government centered exchange: that kind of approach raises cost. Mandates.

Rob somebody. Robert Andrews.
He says difference between association and exchanges is semantic mostly, one substantive difference. Different consumer protections in diff. states. Shouldn’t be 51 different sets of rules, one reasonable federal standard.

Republican guy just said he doesn’t hear people complaining about their health insurance companies. “We do” says Andrews.
“We don’t agree with the idea that the insurance company gets to make (medical decisions.)

McConnell has been keeping a stopwatch. Sheesh.

Paul Ryan from Wisconsin. Washington shouldn’t mandate things. Let the industries set up their associations for their members. We want to decentralize the system, give more power to small businesses.

Andrews: asks Ryan about setting consumer protections.

Should people in Washington decide for everyone?

Obama says its an important point.

Obama: Focus in on this philosophical debate. Legitimate points. When I was young I had to buy auto insurance. It was a joke. Health insurance is different. We should set up minimum standards in the exchange. It is true you can always get cheaper insurance if it has high deductibles or doesn’t cover things. The principle of pooling is at the center of the bills. A lot of talk about government takeover. That’s not the issue. The issue is how much should govt set a baseline?

When we start talking about how much government involvement – it’s not that it’s a takeover, it is that govt is setting up regulation, baseline requirements.

MST3K5

Obama doesn’t respond much to R criticism, but notes that some areas of agreement,
Says let’s not dwell on process and stick to substance

Everyboy agrees on cost

Talking about costs, costs to businesses,
Talks about exchanges –not a Democratic idea but a Republican one! (dig it!)

CBO cost estimates: plan would lower costs for individual markets, calling Lamar out on this, Lamar cuts in--CBO says premiums will rise Obama-no no no
We have to get our facts straight, what you said, Lamar, was not factually accurate
Costs for families would go down 14 to 20 percent
Because they now have a better deal, they may chose to buy better coverage, which might be more expenseive

(So we have our first tussle. Decision, Obama.)

Obama still going over cost containment in the proposals.
Additional ideas that R’s have suggested, that we have included
Buying across state lines: that’s in the proposal
What we’ve tried to do is take every single cost containment idea and put it in bill

What ideas you have that you don’t think are in the bill to contain costs?

10:00

Not letting LA cut back in.

We’ve adopted a lot of your ideas

LA: I punt on this other stuff.

I think your wrong on increasing premiums, I’ll put my facts down and send them to you.

Obama: I’d like to get this issue on premiums increases settled before the day’s out.
(Yes!)

McConnell: Can I get a Pepsi?
(he did not say that)

McConnell: The American people hate this bill. Hate reconciliation.
Calling Dr. Tom Coburn. Stat!

Coburn (whoa, lookat that hair!)

We’re performing bad medicine.
Govt health care doesn’t work

Cost is the problem.
We could solve this problem if we just address costs! There are lots of ways to fix this!
Tort reform! Change the school lunch program!
(I smell a Nobel prize)

LVHCS4

9:35

Alexander:

this has to be bipartisan. (I think this is a good argument, if we have a bipartisan, goodwill effort on both sides. We clearly don't. But let's see where this argument goes and how Obama's team responds)

Re-earn the trust of the American people.

Obama:
kicking it to Nancy and Harry. I loved that movie.

Nancy opens with some lovely hand gestures. Bipartisan passage of House bill to lift anti trust exemption for health insurance cos.

Talking about Sen. Kennedy. (Now you are just bumming me out.)

Character of country, kitchen table,
People don't have time for us to start over

I've seen grown men cry
(I bet she has! I bet she has! Know wot I mean?)

(very sorry)

What it means for economy. People locked to jobs.
some discussion of early legislation health technology, children's insurance
innovation, prevention, wellness

Most people haven't heard about that
they don't want to hear about process they want to hear about results
lower cost, accessibility,

NP kind of rambles at times. Teleprompters aren't always bad, you know.

But making OK points.

Here comes the REIDINATOR!

Babies with prexisting conditions,


Lamar A is entitled to opinions but not facts (that is getting so old)

Make sure we talk about facts

Kaiser Foundation poll found poeple would be angry if we did not do hcr this year

(we are going to hear a lot of dueling polls today)

What is Reid's point on opinion and facts?

No one has talked about reconciliation (what?)

Now he's talking about how Reconciliation has been used for major things, often by R's. Finally a good point but not delivered well.

Bill reported out of committe has more than 150 Repub. amendments

Ok, taking abreak...

LBHCS3

McConnell kicks it to Alexandar! Alexander has the ball and is pulling the Governor end run. OH, the tea party gambit! Not even three sentences into it! Town Halls proved we should start over!

Good they're not going to talking points.

We want you to succeed, but would like you to change direction.

Detroit auto show (what the-- trying to tie this to the unpopular auto bailout??? Yeah, they've done that before)

Should start with a clean sheet of paper. ( --I am very interested in hearing Obama's response to this talking point--)

New taxes, premiums will go up, unfunded mandates, just maybe a few scare tactics here, dumps millions of americans into a Medicaid program (yeah, they're going to HATE having health insurance--ok, legit concerns about reimbursments but come on)

This is car that can't be recalled and fixed

Is he going to throw in a Toyota reference? Come on Lamarr, go for it!

We don't do comprehensive well. Our country is too big and complicated (to govern, I guess)(why are these guys senators. I mean, really why are you in government if you think it's a waste of time?)

going over points of R plan. Cost control, selling across state lines, medical malpractice, Health savings accounts, Hey, we have SIX ideas! Oh, and maybe we need to rein in insurance companies. But maybe not.

Renounce your plan! Give up on reconciliation! Surrender Dorothy!!!

All yr bases R Mine!

LIve Blogging the Health Care Summit 2

Outlining the problem: families suffering, drain on economy, things are getting worse, hurting businesses, effect on the federal budget (bad), exploding cost of medicare and medicaid...

Personal stories--his kids going to the hospital when they were young, what would've happened if he didn't have reliable health care, his mom's cancer. I think this personal, low key approach is good for setting the tone as not intimidating or confrontational. I guess since his real audience is the country it also is a way to connect with normal folks.

"This became a very partisan battle" um hmmm.

That plant by his head is distracting

Overlap of ideas, areas of agreement

9:20

Hope as we discuss each section today, hope to bridge some gaps, don't know if we *can* bridge gaps, but I'd like to make sure this discussion is actually a discussion and not just us trading talking points.

Well, good luck with that

...(it could happen)...

Live blog the health care summit? Sure, why not?

I'm keeping one eye on the health care summit in washington today. So I figure it might be fun to drop a few comments here. Or not. We'll see how it turns out.

9:05, POTUS in the HOUSE!

Sorry, just trying to spice it up. Mostly the diff. lawmakers were sitting around looking nervous,now Obama is making the rounds shaking hands. Some of these guys are introducing themselves to the Prez,so I'm guessing they're aides or -- wait, Paul Ryan just introduced himself. What? Those two have never met?

Obama has a nice tie... oh, had to wait a sec for Biden to sit down. Get it together, Joe!!

Post-State of the Union Preview!

Republicans: He sux!
Dems: Home Run!
Everyone else: I want an iPad!!!

Ok, seriously, if you are one of the literally ones of Mod Lang readers, I'd like to hear your two cents on the State of the Union.

"Throwing Molasses in the Road"

TPM's on a roll today, as their new article on filibusters really shows how obstructionism has become the GOP's most defining feature.

This fits the narrative that we've been hearing from the left, namely that our system is too dysfunctional to allow for effective governance. Now, some might say that's just making excuses. But there's no doubt that we're not getting much accomplished on the most pressing issues of the day. And from my point of view, we didn't get much accomplished when the Rs were in charge, either. I mean, besides wars. Surely we can be good at more than one thing?

The point is, and I hear this from all sides, is that our system does not work well. Is the answer as simple as getting rid of the filibuster?

(Hint: I don't know.)

"Either we fix this problem going forward, or the game really is over."

An interview on the economy that is funny and sobering at the same time.

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Elizabeth Warren
www.thedailyshow.com
Daily Show Full Episodes Political Humor Health Care Crisis

You Win Some, You Lose Some

OK, I’ve had about enough with the hyperventilating and weeping and wailing from the left the last couple of days.

They lost an election. It happens. The Democrats still have strong majorities in both houses. They can still get things done, although the filibuster is going to make it very tough to pass meaningful health care reform. But tough is not the same as impossible, no matter what the blogs tell you.

It’s clear that Democrats have a reason to be worried. But enough with the finger-pointing. Simply saying that Dems have to be more ideologically pure, as tempting as that is, is not going to cut it. We can wish that Obama would’ve been more partisan and made this a big fight about good (Democrats) versus evil (Republicans). But he’s never been that kind of guy. The left-leaning blogs see life that way. He doesn’t.

And really, that may be a good thing. After all, isn’t he supposed to be President of the entire country, both D and R? Didn’t we hate George W. Bush because he never listened to the other side? Should we be more like him?

I know it’s not “fair” that Obama got stuck with cleaning up the mess, and the people who made the mess are now saying it’s his fault. But it is reality. It’s his job, and his supporters’ job, to find a way to communicate a better vision. Yes, it’s not “fair” that professional assholes and liars like Hannity/Beck/Limbaugh push and poison the political debate as much as they do. But that’s reality. Obama, and the rest of us, need to find a way to overcome that. And we won’t get there by screaming louder.

So what do the American people want? If we go by the Massachusetts election, we can conclude a few things:

1. “No more back room deals, we want transparency in government.”
2. “We demand deficit reduction.”
3. “Work to help Main Street, not Wall Street.”
4. “Health care reform has to be something that we can understand.”

I think that’s a list that all my Republican friends could agree on. Of course, when Bush was in office, they all said:

1. “We don’t care about that.”
2. “We don’t care about that.”
3. “We don’t care about that.”
4. “We don’t care about that.”

But hey, bygones. The mood of the country has changed, and if voters have unreasonable double-standards, well, welcome to democracy.

The point is, Obama and the Dems need to respond to the mood of the country. They don’t need to become Republicans to do it. After all, transparency, anti-big banks, deficit reduction—those are all things Dems can support, right? Take the message, reframe the debate, move forward and prove your side has the better ideas.

It’s time to get back to work.

The Republican Plan for Health Care Reform Is to Not Pass Health Care Reform

Minnesota Public Radio gives us a timely reminder that no matter what they say, the Republican strategy since Obama’s election has always been to stop health care reform efforts.

In this story, former Republican Senator Dave Durenberger, who’s no longer in office so he doesn’t have to toe the party line, spells it out.

“Durenberger contends most Republicans never intended to commit to changing health care policy, even with ideas brought forward by other Republican senators -- for example, tax changes that John McCain recommended or Medicare changes that Olympia Snow recommended.

“‘There were plenty of good Republicans in the past that have worked together with Democrats -- [Charles] Grassley, Orrin Hatch and others,’ said Durenberger. ‘Those people made a choice, along with the Republican leadership, to be negative this time, not to play ball. And of course that was a factor that perhaps should've been anticipated by the Democrats, but clearly wasn't.’”

It didn’t matter how much the Dems tried to work with the R’s, it didn’t matter how many Republican ideas were incorporated into reform legislation, the Republicans were not going to support it. And they still won’t.

Somehow, that message has to be part of this story: that one party wants to address a critical problem, and the other would rather see Americans go bankrupt, get sick, and die because they’re playing politics.

I have no problem with Republicans who have different ideas of what we should do. I have a problem with them refusing to do anything, and refusing to allow the process to go forward because they don’t get exactly what they want. And that’s where we have been for some time.

In the meantime, health care providers here in Minnesota can take comfort in the fact that because of the Brown victory in Massachusetts, well, we’re screwed.

MLK Day

On this Martin Luther King Day, I am thinking about Massachusetts, and the election there. It appears that many voters in Mass. are thinking that we can solve today's problems by going back to the failed policies of yesterday.

I've had too many arguments lately with people who simply don't make sense to me. And I'm hearing too much hate and anger. So this quote seems fitting today:

“Like an unchecked cancer, hate corrodes the personality and eats away its vital unity. Hate destroys a man's sense of values and his objectivity. It causes him to describe the beautiful as ugly and the ugly as beautiful, and to confuse the true with the false and the false with the true.”
Martin Luther King Jr.

The Conservative Vision of Health Care Reform Wins the Day

It is a measure of the political environment of the United States that a proposition as basic as trying to improve health care coverage for the millions of uninsured has unleashed a firestorm of controversy, with unusually strong opposition from people who stand to directly benefit from the reform. In this county, some on the Christian Right are praying that their fellow Americans be denied an opportunity to have better health care.

It is a testimony to the toxic power of media ideologues like Rush Limbaugh and Glenn Beck that they can so poison the atmosphere of political dialogue that people have spent months arguing over myths and distortions, with very little understanding of what the reform bills actually are trying to do and what the consequences of action—or inaction—will be.

What strikes me, as we see the Senate bill do exactly what many political insiders long predicted it would do—lose the public option—is how conservative health care reform is turning out to be. If the Senate bill passes and the final legislation mirrors its current proposals—which is not certain, but still likely—we will have what should be a conservative’s dream health care reform law.

It is still a private system. It has no large government plan. It reduces the deficit. It provides subsidies to health insurance plans to cover the uninsured (which is the only realistic way to solve this problem, if you refuse to consider a government option). It gives the drug manufacturers what they want. It doesn’t force physicians to deal with a new government bureaucracy.

Certainly it doesn’t please everyone. All those groups and many more have found reasons to criticize the bill. But it would be wrong to be willfully blind to how much this reform tries to meet all the various stakeholders half way.

In today’s political realities, of course, that’s not good enough. Willful blindness is all the rage. The bill is too conservative for Howard Dean, so he wants to tear it up and start over. It’s too restrictive for the health plans, so they oppose it. And of course, if it comes from the Democrats and Obama, the Fox News world must reflexively hate it.

What the Fox News world doesn’t realize is, they’ve won. If they really believe what they say: that they in fact DO want to reform health care, but they want to do it without the government taking over the health care system, then they have won.

But what they say and what they really want are obviously two different things. Their real opposition is to letting the Democrats get credit for fixing the county’s most pressing domestic problem. It is, to use a cliché, politics as usual.

I’ve heard, over and over again, the talking points: conservatives want to reform health care, but it should include tort reform. It should allow health plans to sell insurance over state borders. It shouldn’t explode the deficit. It should empower doctors and patients to make decisions, not the government.

Well, that last one—as nonsensical as it is, since the government was never going to intrude on medical decisions in the way that reform opponents suggested—should be satisfied by the death of the public option. The sell-insurance-over-state-borders idea is part of the Senate bill. The CBO has scored both the Senate and House bill as reducing, not increasing, the deficit. Tort reform is another idea that has merit; however, the state that has done the most in the area of tort reform is Texas: a state with one of the highest rates of uninsurance as well as the most out-of-control health care cost increases. So much for that silver bullet.

The point is, conservative ideas have been co-opted by the reform bills much more than conservatives are willing to admit. The exception is tort reform, and that, by the examples we’ve seen, is not going to make that much of a difference.

But overall, a conservative approach to reforming health care is exactly what we’re looking at. The fact is, conservatives have won this round. And really, if they would realize it and support health care reform, we’d all be better off. But they won’t realize it, and they will keep trying to go down a path that will damage the country and its future, to the bitter end.

Let me be clear in what I’m trying to say. I don’t care if some on the left see this as a sell-out or defeat of some principled ideal (single payer). I support addressing the problems we have with health care delivery in the country. If that means a conservative approach, so be it. It’s a step in the right direction. The Senate bill is very much a step in the right direction. But in its basic approach and philosophical framework, this is not a liberal reform bill.

It is a conservative one.

Gold's Fool

News from the health care reform front is pretty grim today, so let's go back a week or so to Jon Stewart taking on Sold Gold Glenn.

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Beck - Not So Mellow Gold
www.thedailyshow.com
Daily Show Full Episodes Political Humor Health Care Crisis

Just a money changer in the Temple.

More Medicare stuff

Ezra Klein, who else, had some more comments on Medicare that I think are worth noting.

First, in a chat, he relays that according to MedPac--the agency that advises Congress on Medicare-related issues--96.8 percent of physicians say they will take new Medicare patients. So the argument that Medicare's lower reimbursements are driving doctors to stop taking Medicare patients seems, well, questionable.

Second, this very insightful post
argues that it's a mistake to simply paint insurers as the villians and physicians as the victims. Insurers seem like villians because they're doling out health--they're distributing life and death-- on a free-market basis. Of COURSE the people trying to make such a system profitable are going to seem evil. But it's the entire system that needs reform, and that includes providers.

Here's how Klein puts it:

"Most importantly, they [physicians] should be forced to work in a way that doesn't hurt society. That, after all, is the guiding principle behind the insurance reforms: Insurers will have to live with a market that society can live with. Similarly, providers will have to live within a market that society can afford. That will mean a strict budget, at least within the federal programs (and over time, as the private programs become unaffordable, they will probably come on budget as well).

"Providers won't like this, of course. It means adjusting to a lot less revenue than they currently expect to have, and no one quite knows how to do that. People run businesses atop the assumption of growth, not contraction. And the complaints are understandable: They haven't been doing anything wrong, and don't feel like they should be punished.

"But this isn't punishment. This is, well, medicine. It's that or national bankruptcy. And the problem, if left untreated, will only get worse, and the eventual correction, when it comes, will only be more severe. That, however, is exactly what they're asking Snowe, and the rest of Congress, to permit. The fear with Medicare buy-in is that Medicare pays somewhat lower rates than private insurers because it tries to live within a budget, even if it fails. But like it or not, that's the future, or one variant of it. And as most providers know, putting a scary diagnosis off is generally not a good idea"

The Public Option is Dead. Long live the Public Option.

Very big developments in the health care reform bill being considered by the Senate. The latest is that a bunch of Senators have negotiated away the Public Option in favor of: expanding the age of Medicare eligiblity down from 65 to 55; doing some regulatory ju-jitsu to allow nonprofit health plans to compete in the insurance exchanges; and requiring health plans to spend 90 percent of every health premium dollar on actual health care.

I think that last one might be the most interesting. By some estimates, plans now use 70 percent of every premium dollar on actual health services. That would be a big change, and in theory could make health care less expensive and more efficient. Health plans in MN are required to be nonprofit and are currently spending 91 percent of ever premium dollar on health services. So it can be done. But it will be a big change for some of these for-profit plans. IF this actually happens, it could be that health plans nationwide are going to rue the day they celebrated the death of the public option.

The change in Medicare is going to be bitterly fought by hospitals and providers, who insist that they can't get by on current Medicare reimbursements. If you expand the number of people using Medicare, then the dollars coming in will be even less.

I understand their concerns, but really, doesn't everybody agree we have to bring health care costs down? So how will we do it without someone taking a hit? If the medical community had united in insisting on stronger reforms for the insurance side (ie public option or something like it) then the dollars would've come from health plan profits. Now... well, they didn't want a big govt plan for everybody, so they won't get one. But they will get a larger chunk of the population on Medicare, and less reimbursement. Tell me, do you think physicians will throw their hands up, say "I quit" and take on a different job, like, say, public school teacher, or sanitation worker?

Sorry to be snarky, but I don't think so either. There is no fixing this system without someone experiencing a little less income. The Medicare change means that someone is probably going to be (some) doctors. I would rather it had been insurance company CEOs. Maybe with the new 90 percent rule, we'll see some changes there too.

The bottom line is; everybody to right of Evan Bayh (not the most liberal of senators by a long shot) was screaming about socialized medicine and the horrors of a public option.

Maybe they should've been careful what they wished for.

I continue to think that the public option, or something like it, will eventually be tried. But what we're looking at with this bill is: regulation of plans to force them to be more inclusive and more efficient, controlling payments to providers, subsidizing citizens to help them afford premiums, and some combination of taxes/subsidies for businesses--depending largely on the size of the business. There's a lot more, obviously. But all of that falls squarely in the "significant reform" camp in my opinion. And it is very much still a private/public mix with the emphasis on private insurance.

Still, a big improvement over the current death spiral; again, in my opinion.



Update: I've been gently reminded by a certain provider that low Medicare reimbursments are a real financial problem for many primary care physicians and hospitals. And there is an actual trend away from primary care as a career because of such financial pressures. As with all of the health care reform debate, it's complicated, and my "doctors won't take up ditch digging" snark was probably an unfair dig in itself. For the record, Medicare reimbursments are an issue that many health care reformers are trying to address, and there are various parts of the current reform bill that take on this issue. I'm not sure yet how those are faring in the latest negotiations, but I'll try to provide an update at some point. In any case, reform is an ongoing process that is going to need a lot of fine-tuning. Medicare certainly is going to have be tweaked as we go down this road. But it will be easier, not harder, to do that if reform passes.

Health Care Reform

It will cut the deficit by $127 billion and increase the number of the insured to 94 percent of Americans.

It will lower out of pocket costs for most Americans.

It will cover more poor people

It will help seniors by lowering drug costs—see below.

It will also take too long to phase in, not cover as many people as it should, and not do enough, at least at first, to control costs.

But the alternative is doing nothing for the foreseeable future.

What the opponents of health care reform never seem willing to consider is the cost of doing nothing.

“Among the range of options for health-care reform, there's one that is sure to raise your taxes, increase your out-of-pocket medical expenses, swell the federal deficit, leave more Americans without insurance and guarantee that wages will remain stagnant.

“That's the option of doing nothing, letting things continue to drift as they have for the past two decades as we continue to search in vain for the perfect plan that would let everyone have everything they want and preserve everything they already have while getting someone else to pay for it.”

-Steve Pearlstein, Washington Post

http://www.washingtonpost.com/wp-dyn/content/article/2009/07/21/AR2009072102961.html?hpid=topnews

(Link printed out because Blogger won't hide it.)

“Barack Obama is a Muslim.”

Or so I was told in a Facebook discussion recently. This was in a discussion between a group of presumably Christian folks, several of whom agreed that Obama was not a Christian.

What does it say about people that they are willing to call a man a liar about something a personal as his religion? Without any evidence, in fact with all evidence to the contrary? It’s not like Obama has not been a public figure. It’s not like he hasn’t regularly talked to people about his faith.

Of course, from this same discussion, one poster dared me to find one video of Obama saying the Pledge of Allegience. “You can’t do it!” she crowed.

I found a youtube video of Obama leading the Pledge in about five seconds.

It’s very disturbing. My friends on the right are not just losing touch with reality. They’re rejecting it. And I can’t quite puzzle out why. Are their lives really so miserable they have to take up this crusade against the real world?

But the beat goes on. The birthers. The death panels. FEMA concentration camps. Global Warming Denial. There was even a poll that found Republicans think Obama was elected because ACORN rigged the election.

The Anti-Defamation League recently put out a report called “Rage Grows in America: Anti-Government Conspiracies.” It’s not a fun read, but it underscores some of the irrational anger I’ve been seeing out there.

“What characterizes this anti-government hostility is a shared belief that Obama and his administration actually pose a threat to the future of the United States. Some accuse Obama of plotting to bring socialism to the United States, while others claim he will bring about Nazism or fascism. All believe that Obama and his administration will trample on individual freedoms and civil liberties, due to some sinister agenda, and they see his economic and social policies as manifestations of this agenda. In particular anti-government activists used the issue of health care reform as a rallying point, accusing Obama and his administration of dark designs ranging from “socialized medicine” to “death panels,” even when the Obama administration had not come out with a specific health care reform plan. Some even compared the Obama administration’s intentions to Nazi eugenics programs.

“Some of these assertions are motivated by prejudice, but more common is an intense strain of anti-government distrust and anger, colored by a streak of paranoia and belief in conspiracies. These sentiments are present both in mainstream and “grass-roots” movements as well as in extreme anti-government movements such as a resurgent militia movement. Ultimately, this anti-government anger, if it continues to grow in intensity and scope, may result in an increase in anti-government extremists and the potential for a rise of violent anti-government acts.”

You Should Be Reading Ezra Klein Every Day

At least if you care about health care reform.

Day after day, he delivers great stuff on health care and other economic policy. He’s able to play the policy wonk, political insider, and sharp-eyed blogger, providing lots of information in small bundles that are easy to digest. Some great recent quotes:

“If you had tuned in six months ago for 10 minutes, you would have had all the information necessary to predict exactly where we'd be today. Democrats commanded exactly 60 votes, which meant that they had enough potential supporters to overcome a filibuster, but that each individual senator had sufficient leverage to extract enormous concessions in the final days. … Pretty much everything else has been a distraction, at least so far as the bill's ultimate fortune is concerned. The chaos of August didn't change a single vote. The Gang of Six didn't net firm bipartisan support. The president's speech didn't end the controversies. The deficit reduction embedded in the bill didn't assure a large majority.”

Or: “One of the costs of not passing health-care reform, it seems, is that policies in the individual market will cost about 23 percent more than they will under reform. A vote against change is, in effect, a vote for that.”

Or: “We've had wars of necessity, wars of choice, and the escalations of those wars stretching across both good and bad economies, and both Democratic and Republican presidents. And none of them have been paid for. The political system is learning to think of war as an off-budget expense, which is bad both from the perspective of the deficit, but also from the perspective of forcing us to confront the costs and tradeoffs of war.”

Or this interesting insight into media and politics.

Doughnut Hole

Such a fun name for such a horrendous policy. Mmmm doughnut hole.

A friend who opposed HCR recently lambasted Medicare because her parents were caught in the doughnut hole. I told her that the health care reform legislation would fix that. Suddenly we stopped talking about the doughnut hole.

The point is, it IS a big bill. And it takes on a lot of problems. Lots of people will end up benefiting in small ways and large. Some new challenges and problems will be created. And it will cost a lot. But at least this President believes in paying for his big new programs.

Remember, the Doughnut hole was created as part of Medicare Part D, brought to us by a Republican administration and Congress that decided a $700 billion program financed entirely by deficit spending was a good idea. We really need to put those folks back in charge of the government.

Growing Pains

A sunny election day here in Mpls, much like the day one year ago when we made history. Here’s something I wrote the day after the election:

“One thing that struck me about Obama’s speech last night was how somber and restrained it was. I loved the (subtle) references to Martin Luther King, Jr. and Sam Cooke. But overall, this speech was not a celebration. He obviously knows that all the work, all the fighting against stereotype and distrust and tribalism has just been prelude. Now he has to lead a nation.

“I thought he did a masterful job of reaching out last night to all Americans. But there are some who heard it differently. A conservative woman I know told me today she is distraught because she heard Obama has said his first act will be to sign an executive order legalizing partial birth abortions. And that he has said he wants to redistrubute wealth.

“I asked her if she thought his speech last night tried to extend a hand to people like her who didn’t support him. “No,” she said.

“It’s an example of what President Obama will face. Rumors, myths, misinformation campaigns, and a segment of the electorate determined to see the worst in him, determined not to give him a break. No wonder he was somber last night. The hard work hasn’t yet begun.”

The hard work continues.

CBO? What's that?

Early in the health care reform debate, conservatives couldn't stop quoting the Congressional Budget Office figures on how reform would affect the deficit. Now that the bills have been roughly hammered into shape, the CBO is finding that health care reform will bring deficits down.

And what do conservatives have to say about that?

*crickets*

Fox News Reports the Opposite of Truth (In other news, rain still wet)

"This was pretty classic even for Fox. Fox News managed to go almost two days reporting that Dede Scozzafava had dropped out to help Doug Hoffman beat Democrat Bill Owens. And then they went as far as to report that Scozzafava had endorsed Hoffman. This despite the fact there was no evidence for either and ample evidence that Scozzafava was privately supporting Owens."

TPM catches an amazing sequence of coverage by Fox, where they totally start making stuff up to support their political agenda--and this is their "news" coverage, for anyone who still sees that distinction.

(video added)

A (Very) Simple Plan

One of the lessons of health care reform is that fiddling around the edges -- as we have for decades-- has not been effective in addressing the really big problems we face. Dare I suggest that to fix big problems, you need a big bill? Maybe even a thousand pages or more?

"After months of debate within Republican ranks, House Minority Leader John Boehner (R-Ohio) is finally about to release his health care bill, but the outline he gave reporters does little to cover the tens of millions of Americans without health insurance."

Exactly. The Republican "solutions" are like calling the Fire Department when your house is on fire and having them hand you a lawn sprinkler.