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.

The rise and fall of political posting on Facebook

For a while, it really appeared that Facebook was going to make this blog obsolete. It was so much easier and quicker to just put something up on Facebook. And it got immediate reaction, which was often quite, uh, lively.

But the "lively" discussion was a little too much so at times. There was more than one discussion that crossed a line or three, and after a while I found myself just not wanting to respond to FB friends' political posts; they knew where I stood, I knew where they stood, it was just becoming an exercise in bickering.

And guess what--that feeling seems to have become pretty common. A lot of my very conservative friends have, like me, cut way back on the political posts. In my case, I still do post occasionally on health care or some other topic, but I try not to provoke anyone with snide comments or pointed rhetoric. Facebook is a place for friends, after all.

So here I am, back at the old Mod Lang, wiping the dust off the shelf, cleaning out the old milk cartons from the fridge, uh, extending metaphors far past their usefulness...

And it gives me an excuse to post (again) the latest Auto tune the news; not as good as some of their stuff, but any lowbrow political satire that namedrops Gilgamesh is still worth seeing, in my book.

Wait, um, the pundits were WRONG about something???

It's too early for either side to gloat about the public option. The version that the Senate is considering is pretty weak tea: only a small percentage of Americans will be eligible, and of course states can opt out.

The House version will be a bit stronger; but I expect to see a pretty watered-down version in the end.

Still, it's pretty funny to see how many times the pundits declared the public option dead-dead-dead, and how sure they were it would not be in the final Senate bill. The fact is, it was a popular idea, and even with the barrage of mud thrown at it, still is.

Are NOT fair and balanced! Are SO! Are NOT! Are SO!

The clash between Fox News and the White House has been interesting. Although I am a big critic of Fox, I admit not being real comfortable with a president declaring what is and what is not a news organization. Shouldn't be up to politicians to decide that. However, having said that, I think the Obama Admin. is entirely correct when they say that Fox is the "opposition press" or an arm of the Republican Party.

It's a totally partisan news channel. The attacks against Obama are nonstop, even during news programming (as opposed to their "opinion" shows--which curiously seem to set the agenda for their "news" shows.) When a Fox VP said the White House couldn't tell the difference between Fox' news and opinion programming, all I could say was "Neither can I!"

If Fox admitted to being a partisan media source they'd lose credibility to some degree. That's why they fight the notion so strongly. But I think most people see through the charade. And in the end, I don't think Fox' audience *cares* about that issue. They *want* a news channel that reinforces their politics. Fox is there to serve them. But it's a media form that dare not speak its name.



I also note: regardless of whether it's an "opinion" or "news" show, the "Fox News" symbol is rotating in the lower left corner at all times. Shouldn't they label the opinion programs as such?

The Big Speech

Hey, no pressure, Mr. President. It’s not like your presidency, not to mention the health and welfare of the Republic, hangs in the balance.

OK, seriously. My theory is Obama has taken the best shot that anti-reform forces could muster (and it was quite a shot), and now things are going to start coming together for health care reform. It may not be as comprehensive as some wanted, it may not in the end include a public option, but there’s simply no option for failure for the Democrats. They have to pass health care reform. And they’re going to do whatever it takes to do it.

Something I’d like to hear tonight is a clear, concise attack on the “let’s start over” argument. Something along the lines of:

“Some on the Republican side say we should not rush into this. They say more time is needed, more discussion, more studies. Certainly, we should discuss this thoughtfully. We’ve been trying to.” (slight pause, just to let people remember the town halls) “But we cannot forget that health care has been a drain on our economy and a burden to millions of working Americans for decades. For eight years, Republicans controlled the White House. For six of those years, Republicans controlled Congress. And yet, aside from a well-intended but inefficient Medicare drug benefit, Republican leadership did nothing to address the health care crisis in America. They did nothing to reduce the number of the uninsured. They did nothing to end the insurance industry’s practice of dropping patients for pre-existing conditions. They did nothing to address the high copays and deductibles that make health care prohibitively expensive for millions. They did nothing to control the premium increases that are hamstringing small businesses and forcing them to drop coverage for employees.”

“They had six years. They did nothing. We cannot wait another six years. We cannot wait another 16 years, which is how long it’s been since the last president tried to reform health care. Let’s be clear: we have a plan before us that would address the biggest domestic problem that America faces. On the other hand, the Republican solution is to do nothing. I believe that is not an option.”

Too partisan? I dunno. Certainly is true, as far as I can see.

Health Care Town Hall, the Musical

That White House Janitor? Beck’s Doing a Three-Part Series on the “Mop Czar”

As this article points out, the “czar” controversy has in part been manufactured by people too lazy to look up the officials’ real titles.

“Here’s the problem: Some of the people whom conservatives and mainstream media voices alike have labeled “czars” have been confirmed by the Senate. Some of them, and others, hold jobs that were created by previous presidents.”

Who would Jesus refuse health insurance to?

“Opposition to Health Care Reform Revives the Christian Right”

You know, I spent a lot of time with the Bible in my youth. I just can’t remember the part where Jesus said to refuse to help people who were less fortunate. I can’t remember the part where Jesus said that the sick and the poor were on their own. I guess I read a different Bible.

Part of the absolutely crazy, what-planet-am-I-on, quality of the health care debate is that some on the right say, “Oh, the Left criticized Bush and protested and held rallies, why is it wrong now that Obama’s in office???”

Well, one president was taking us into an unnecessary war that killed thousands of Americans and spent trillions. The other one wants to make sure you have access to health care.

Yeah, I can see how those two things are the same.

You Can’t Handle the Bill!

Politico makes a good point:

“…reading actual legislative text is often the least productive way to learn what’s actually in a bill.”

Will They Be Heard?

Health Reform on the YouTubes

Well, I've been coming across a lot of videos on the tubes lately so I thought I'd share some. Here's a clever-yet-simple one about how (BOO!) Socialism (BOO! SCARY!) is indeed at the root of a public option.

Canada and Coburn: which vision do you prefer?

Again, with the socialists... Hey, we could listen to these guys talk about what the Canadian system is really like, or we could listen to Glenn Beck talk about Obama/Hitler some more.




And for a real slice of America; here's a weeping woman, desperate for her injured husband, pleading with Sen. Coburn to help. He says two things: 1)It's not the government's job to help you, and 2) Sure, my office will help you. Gives me a headache thinking about it and a heartache watching it.

Pray You Don’t Get Sick

Michelle Bachmann, who is on TV once every nine days(!) calls for prayer and fasting to stop Americans from getting a better health care system. Alrighty then.

From MinnPost:

“Bachmann repeated the myth, adopted early by Sarah Palin, that the health-care plans being debated in Congress would set up “death panels” to determine which old folks are entitled to health care. “Thank God that Sarah Palin said that,” she told the callers. ‘These are true.’

“But it was Bachmann’s fervent call to utilize prayer and fasting to beat back health-care reform efforts that was the true highlight of the call.

“That’s really where this battle will be won — on our knees in prayer and fasting,” she told the listeners. “Remember: faith without works is dead. So we’re asking you to do all of it: pray, fast, believe, trust the Lord, but also act.”

An oldie but a goodie:



“We get to choose, we get to choose…”

“Both Parties Are Responsible for Not Dealing With Health Care…”

A recent Tim Walz town hall had the usual circus atmosphere, signs of Obama as Hitler, cranks who think the Constitution doesn’t allow Congress to pass health care reform, and I think, maybe, I even hear someone talking about lap dances…

I like Walz a lot. He comes from a more conservative area, and he’s slightly in the Blue Dog camp; but he’s honest, passionate, and smart. I think even the “town hollers” here ended up respecting him at least a little.

Market Concentration: It sounds sort of like a game, doesn’t it?

Did you know, that for large sections of the United States, a single-payer health care system is already in place?

“There are nine states where a single insurer covers 70 percent or more of the people. In Hawaii, one insurer covers 78 percent. In Alabama, it’s 83 percent. And in at least 17 other states one insurer covers at least half the population.”

Isn’t it funny how some of these town hall protesters are from rural areas and actually have the least choice at all under the current system? And by “funny” I mean “not funny.”

The article also points out how some of the Senators most opposed to reform are from the states with the most insurance plan market concentration (i.e., fewest consumer options). I wonder how much health insurance industry money they get for campaign contributions?

Do results count?

As data begins to show how the stimulus plan is working, along with the jobs being reclaimed by the “cash for clunkers” program, it’s beginning to look like the Obama Administration might have known what they were doing, after all. Maybe those successes will convince some on the right to reconsider health care reform? Yeah, I’m not holding my breath.

Will the Screamers Win?

This article shows that, while throwing a 20-year hissy fit about liberal media bias, the conservative movement has actually built up a right-wing noise machine that has successfully hijacked the health care reform debate, and made it about killing grandmas and how Obama is Hitler. Pretty sad state of affairs.

“It’s not entirely Obama’s fault that support for the public health insurance option has dropped from three-quarters of the American people to not even a plurality, according to the latest NBC News poll. The Right’s propagandists – via radio, TV, print and the Internet – have successfully demonized reform.

The Right also has used psy-war arguments about government “death panels” and other lies to frighten gullible Americans into opposition. In the NBC poll, 45 percent think Obama’s reform would let the government stop medical care for sick old people, though the legislation wouldn’t do that.

The poll found that majorities now believe the Democratic plans would give health insurance to illegal immigrants, use taxpayer dollars for women to have abortions, and lead to a government takeover of the health system – claims that fact-checkers say simply aren’t true.

While spreading this disinformation, the Right also has promoted pistol-toting swagger and disruptive tactics as popular ways to confront Democrats and rally opposition to health reform.”

Also, Krugman has it right, again.

“At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.”

The Grand Illusion

Flow charts, like the words of politicians, can be manipulated to say anything. Here’s the Republican vision of what the current health care reform proposals would look like



And here’s the Democratic version:



What does it all mean? Beware of partisans bearing visual props.

Sincerely Wrong

I’ve been hearing the media debate whether the Town Hall protests are genuine or Astroturf. I think they’re pretty genuine. People are really upset and scared. But they’re operating from a set of lies that they’ve been told by the conservative media; Fox News and Limbaugh in particular. So yes, they’re sincere, and yes, they’re being manipulated. I would feel sorry for them if they weren’t doing so much damage to our country’s future.

ABC nails it.

One of the clearest, most concise explanations of current health reform controversies I’ve seen. And of course ABC makes it impossible to embed and difficult to find. Hopefully this will get you there. (You will have to sit through a short commercial.)

And while were on the subject of health care myths:

“Here is the real bottom line: The current state of health care is unethical. It is neither just nor fair. There is no morally defensible reason why some Americans get excellent medical care at costs they can afford and other Americans lose their homes or go into bankruptcy attempting to secure treatment for a seriously ill loved one. The current proposals being debated in Congress all go a long way towards making health care in America more just. At the same time, there is nothing in the current proposals that threatens a patient’s right to choose, a critical feature of an ethically acceptable health care system.” - Association of Bioethics Program Directors

The Empire Strikes Back

The British are getting tired of us slagging their health care system.

TPM has been running some good stories from Americans overseas and the horrors they experienced in socialist health care systems.

TPM also notes that conservatives are making progress in killing some of the provisions of the health care bill that would actually be of great help to millions of Americans. Good work, people.

Also, IBD still sucks.

Obama in Portsmouth

Some people have read the health care bill(s). Most of us have heard endless debate on them, usually by people who really don't know what they're talking about (hello, IBD). But how many people will spend an hour or so watching Obama explain his proposals and answer questions about it?

Here's your chance.

(for some reason cspan doesn't give you the option to embed video...)

About taxes...

No one on the right seems capable of processing the fact that Obama has cut taxes more than raised them...

"Obama Has Cut Taxes for 98.6 Percent of working Households"

Them Vs. Us

Joseph Ellis is a history professor that wrote an op-ed in the LA Times recently with the above title. He argues the controversy over health care reform is a continuation of a long argument that Americans have been having about whether our political system empowers the individual or supports a community approach.

“Put succinctly, the dispute is between those who regard government as ‘them’ and those who see it as ‘us,’” he writes.

I’m pretty clearly in the latter camp. But take a look at his piece and see what you think.

I heard him interviewed on NPR on Monday. Something he said at the end of the interview stuck with me enough that I looked it up on the Web site:

“I think what we've discovered—historic[ally] conservatives and libertarians have opposed each of the major changes in the 20th century. They opposed the Federal Reserve. They opposed Social Security. They opposed banking legislation. The Wall Street Journal said the Glass-Steagall Act would represent the end of Western civilization. They opposed desegregation and Civil Rights Act. They opposed the Environmental Protection Agency. They opposed Medicare and Medicaid. And so that's a consistent position, and I would just simply look back at that record and say if we want to continue it.”

Health Care Roundup

August is turning out to be a bit chaotic; both personally for me (weddings, a funeral, and lots of traveling) and nationally, as some in the health care debate seem determined to have a meetup at the corner of Crazy and Stupid.

We’re seeing lots of people at these town hall meetings trying to shout down health care reform with a breathtaking array of misinformation and straight-out lies. My conservative friends bristle when they think they are being lumped in with the most extreme of their political mindset, but I’ve yet to hear a conservative friend speak out strongly against the BS. It would be nice.

Steve Pearlsten, a business columnist at the WaPo, says this:

“The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they've given up any pretense of being the loyal opposition. They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems.”

I think “terrorists” is too strong, and too loaded a word to use. But the current approach from the right does have shades of a scorched-earth, Rovian strategy of confusing, and eventually, disgusting people enough that they withdraw from the political process. In fact, it reminds me the overtly dishonest campaign ads that John McCain used last fall. 

One of the lies? That Obama is going to set up “death panels” (Sarah Palin’s term), and that end-of-life counseling is really a smokescreen for euthenaisa. I’ve had long discussions of this with folks who just seemed determined not to understand the real point of this language, so here it is
from the (Republican) horse’s mouth:

Q: “Is this bill going to euthanize my grandmother? What are we talking about here?”

A: “In the health-care debate mark-up, one of the things I talked about was that the most money spent on anyone is spent usually in the last 60 days of life and that's because an individual is not in a capacity to make decisions for themselves. So rather than getting into a situation where the government makes those decisions, if everyone had an end-of-life directive or what we call in Georgia "durable power of attorney," you could instruct at a time of sound mind and body what you want to happen in an event where you were in difficult circumstances where you're unable to make those decisions.

“This has been an issue for 35 years. All 50 states now have either durable powers of attorney or end-of-life directives and it's to protect children or a spouse from being put into a situation where they have to make a terrible decision as well as physicians from being put into a position where they have to practice defensive medicine because of the trial lawyers. It's just better for an individual to be able to clearly delineate what they want done in various sets of circumstances at the end of their life.”

Q: “How did this become a question of euthanasia?”

A: “I have no idea. I understand—and you have to check this out—I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up.”

The interviewee is Republican Sen. Johnny Isakson, from Georgia. Who has now turned around and (presumably under pressure from the base) condemned the health care reform bills. The fact remains, the end-of-life counseling language was exactly the kind of thing he's been supporting. 

Watch This, Read This

"A CNN anchor today tore down Rick Scott, the founder of an organization that's been funding anti-health care reform protests and the former CEO of a hospital company that, as Sanchez pointed out, paid $1.7 billion to settle charges of overcharging Medicare and Medicaid." Talking Points Memo



An interesting CQ article:


"Some experts on political organization say that despite the disruption of Democratic-run events -- and divided public feelings on the health care overhaul -- the shout-down strategy betrays an essential weakness on the Republican side, not a strength.

"... The nature of the protests suggest the GOP has run out of options for fighting on substance, said David S. Meyer, a sociology professor at the University of California-Irvine who wrote The Politics of Protest: Social Movements in America.

"In historical context, it's a tool of the weak," Meyer said. He said it is noteworthy "that conservatives have to throw this kind of Hail Mary pass to stop health care reform" in a political system that favors that status quo."

Tea Parties and Health Care

Say what you want to about the Tea Party crowd, they are turning into a force to be reckoned with. As lawmakers head back to their home districts and begin talking health care reform with their constituents, we’re seeing Tea Party-like gatherings organized to contribute to, and apparently, disrupt some of the public forums where health care reform is discussed.

Here in the Twin Cities, Twila Brase, longtime opponent of anything that even hints of government involvement in health care, sent out a notice from her Citizens Concerned for Health Care site alerting people of a Keith Ellison town hall meeting. I’ll share some YouTube of that, along with other examples, throughout this post.



Tea Party-type crowds at these events are becoming common. There was a well-known one in Missouri involving a soldier and Sen. Claire Msciascal’s staff. (He demanded an apology because, if I remember correctly, there’s nothing in the Constitution about the government providing health care.) There was also this event in Pennsylvania where Democratic Sen. Arlen Spector spoke.



(Sorry for the shaky video)

Talking Points Memo and Think Progress has been covering this story, and have posted a document which provides talking points to some of these groups. These include suggestions to shout down the speakers, stand up, “rattle them,” etc.

If you do watch the videos, note that some of these tactics are indeed being used. It seems to me (and watching such scenes can be very subjective) that in both the Specter forum and the Ellison forum, the Tea Party types are a minority. The Specter forum has quite a bit of shouting from the TP attendees; the Ellison meeting is more restrained. Minnesota Nice? Or maybe the fact that Ellison himself went person-to-person to get comments. It’s a little harder to shout when the person is right in front of you. In any case, note his politeness and attempts to quiet the crowd so the TP people have their say.

As we’ve explored here, there’s been a lot of crazy on the right wing side lately. Claims that Obama was born in Kenya, claims that he’s a racist (so I guess he hates half of himself), claims that health care reform will lead to euthanasia, and so on. The heat is rising, and some are not keeping their heads very well. Josh Marshall says this latest development is an example of “civic vigilantism.”

My feeling is that if these folks show up at meetings, they have every right to speak their minds and contribute to the discussion. However, shouting down speakers and trying to disrupt the events could further add to the right’s growing reputation of being a wild-eyed, fringe element in our society.



But on the other hand, there are a lot of folks out there who seem to have a problem with our President, for whatever reason. They’ve been fed a lot of misinformation and have been pushed to be angry and outraged. They are now organized to some degree, and determined to shout down pro-reform speakers without really listening to what they have to say. It’s a scary and unfortunate example of mob rule. And it could well be that this vocal minority is able to push the discussion to a point where the average voter just says, “Enough, a pox on both your houses.” At which point the Tea Party folks have won, because they’ve killed the support for change.

Zombie Lies: they're slow, they're stupid, but there sure are a lot of 'em

Almost evey day now, I get some Facebook friend posting the latest zombie lie (you know, you can't kill them, they just keep coming) about health care reform. Euthanasia for Seniors! The Public Option is the Same as Single Payer! The Government will Take Over Your Computer! (Oops, that one was about the Cash for Clunkers program, but still.)

So these things are posted, and I usually can find a complete debunking of them within in 24 hours, and I try to point out the evidence on why this is totally false... but as far as I can tell it's not doing much good. The zombies keep marching.

The White House is now taking one of these head-on; they've posted a response to a video that cherry-picks a 2007 Obama interview to make it sound like he's talking about phasing out private health plans. The words are edited in such a way that I have no idea what he's really talking about, but the video-makers splice that with some very old footage of him expressing support of single-payer to claim that his "real" goal is to phase out private plans.

The White House responds with some very explicit statements from Obama that clearly state that his current plan will not phase out private insurance. I'm not sure it will have much effect. And I would've liked them to explain what the context of the 2007 clip was. But regardless, the same problem is still there: what Obama says versus what the right-wingers think he "really" means.

These folks are determined (for whatever reason) to not trust what Obama is actually saying. It's hard to see how any meaningful debate can take place under such circumstances.

Either Bill O'Reilly is really stupid, or he thinks his viewers are.

And I don't think he's stupid.

"This guy has a problem"

There have been several clips of the Fox crazies going off in one direction or another lately. Here's some of Glenn Beck's incoherence in just under half a minute...

"This president ... has a deep-seated hatred for white people or the white culture..."

"I'm not saying he doesn't like white people..."

"This guy is, I believe, a racist!"

One of the Fox people point out that many of his closest advisors are white. Not to mention his mom. And his grandparents, who helped raise him.

I've mentioned before the clip I saw where Beck and O'Reilly talk about how Obama supports the Black Panther idealogy. Then one of them says, "I can't prove it, but I believe it." Wow.

I don't know what is wrong with Glenn Beck. But this guy has a problem.

Krugman Nails It, Limbaugh Lies, The Right Weeps for Health Insurers... Health care reform part six

The debate has moved from frenzied to chaotic to oppressive, but nothing to do but put our heads down and soldier on. As I said to someone on Facebook recently, I've been watching health care experts talk about reform for more than ten years. It's past time to actually do something. We can choose to continue to watch this train wreck in slow motion, or we can enact reforms that may be painful and imperfect but at least start addressing the problems.

First up, Paul Krugman boils things down very nicely; Many of those politicians now worried about cost had no problem adding $1.35 trillion to our deficit by voting for GWBs tax cuts. And by opposing things like mandates and the public option, they look like they are not serious about delivering reform and controlling costs at the same time.


Also in the NYT, some good analysis by David Herszenhorn that brings up some CBO numbers that we're not hearing much about (and lately the CBO has not been a friend to reform efforts -- it's been good at pointing out the cost but doesn't seem able to estimate the cost savings from reform). The CBO recently projected that yes, some people would drop their private insurance for the government plan being proposed. About 9 million, by this estimate. But, the CBO says, "12 million people who would not be enrolled in an employment-based plan under current law would be covered by one in 2016, largely because the mandate for individuals to be insured would increase workers’ demand for insurance coverage through their employer.”


So that doesn't sound too bad for the private insurance industry. Which is good, because a lot of folks who oppose reform are really, really worried that the insurance industry is not going to get a fair shake with reforms. Listen, we heard the same arguments about Medicare when it was introduced. It would destroy the insurance industry, etc. Right now, one of the most profitable lines of businesses for private health insurers is the administration of Medicare plans (which is done by companies like Blue Cross, UnitedHealth, etc.). They make more money on these plans than they do on some of their employer-based plans. So Medicare did not destroy the private insurance industry, in fact, it is a profit center for it. Next argument, please.



On a side note, I recently had a discussion with someone who thought Rush Limbaugh and Sean Hannity were truth-tellers and not hate-mongers. Well, as much as I find it hard to believe, I guess you could say such things are in the eye of the beholder. All I know is this latest line of Rush's, that Obama is a tyrant who wants to impose a totalitarian dictatorship on the US so he can torture people and control their lives, well, it sounds like a whoppin' big, hate-filled lie to me.

Odds and Ends from a Busy Week; Health Care Reform Part Five

(I forgot my subhead on So, Canada. Oops.)

Lots going on, so this will be sort of a grab-bag summary of health reform stuff.

Let’s start with this recent Gallup poll on uninsured Americans (from July 22). Here’s the bottom line finding:

“The Gallup-Healthways Well-Being Index finds that while a large majority of Americans have health insurance, one in six in this country is without coverage. The current percentage of uninsured Americans (16.0%) represents a small, but measurable increase over last year. Hispanic Americans, at a rate approaching triple the national average, are the most likely subset of the population to be uninsured. Those making less than $36,000 per year are the second-most-likely group to be uninsured, with 18- to 29-year-olds following closely behind.”

This lines up with what my other research is showing, that uninsurance is disproportionately a problem for the young, poor, and non-Caucasian. Must be why all those rich old white men in Washington can’t see the need to change things any time soon.

This US News report attempts to give some basic facts about the reform efforts, and while I could quibble about some of the assertions about what the “plan” (there are several) would or wouldn’t do, I think the basic numbers here are helpful.

Here are the numbers that jumped out at me:
*Healthcare spending as a percentage of income, for those earning less than $20,000 per year: 15.5 percent
*For those earning between $55,000 and $70,000: 5.1 percent
*For those earning more than $70,000: 3 percent
*Average increase in employer-based health insurance premiums since 1999: 120 percent
*Average increase in wages since then: 29 percent
*Proportion of personal bankruptcies related to illness or medical bills: 62.1 percent
*Increase since 2001 in the proportion of personal bankruptcies caused by medical problems: 50 percent.

Cheerful stuff, I know.

To make you feel better I recommend two reports from the Commonwealth Fund, one which begins, “The individual health insurance market is not a viable option for the majority of uninsured adults…”

The other says “including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020.” One of the conundrums of this debate is reform opponents say that 1) health care reforms proposals will cost too much, and 2) a public plan is a very, very bad idea. Turns out, though, that most analysts (including the CBO) are finding one of the major ways to reduce costs is to have a public plan as part of the reform.

And then there was the IBD editorial the other day that claimed that the House reform bill would end all private insurance plans. I honestly don’t know what these guys were thinking. “Ah ha! If we hadn’t caught this, no one would’ve realized that Obama was wiping out an entire sector of the US economy!” I mean really, guys, does it make sense that they would try to make such a dramatic change and think they could sneak it by everyone?? All I know is, if I were an investor, I’d have to re-think my opinion of the publication’s analytical skills.

What seemed to trip them up was the idea of an insurance exchange, a fairly common industry reform idea that Gov. Tim Pawlenty—a Republican, by the way—has promoted for years. Yes, it would change the regulations a bit but it is not designed to do away with private plans!

OK, on a more positive note, I attended an Organizing for America (formerly Obama for America, so you know where they’re coming from) rally for health care reform. About 500 people showed up, stood in line for hamburgers and chicken sandwiches, and watched a few speakers call for passage of health care reform this year.

It just made me think of all the health care events I’ve covered in the past ten years where physicians and CEOs sit around and talk about how terrible the health care situation is in this country and politely exchange views on what should be done, and then they all go home and repeat the process in three or six or nine months. And nothing really changes. The thing that always strikes me about these industry events is how rarely patients are ever at the table. You know, everyday people who are actually affected by all this stuff.

There were lots of them at this event, and they were tired of being told that the health care system can’t be fixed.

So, Canada

One of the most contentious issues of the current health care debate is how our health care system stacks up against Canada’s, or for that matter any nationalized, universal health care system.

I mean there are a lot to pick from. Canada, England, France, Norway, Germany, Sweden, Italy, Spain, Finland, Austria, Japan, Singapore, Australia, New Zealand, Israel, Iceland … well, the list goes on. Makes you wonder why all of those countries can provide universal care and we can’t. Oh, that’s right, socialism. That clears it right up.

Ok, sorry, getting a little snarky. But it is ridiculous, this to-the-death fight we have about which system is better. Take Canada. This is a country that has been one of our closest allies and a valued trading partner. There is probably no society—or economy, for that matter—in the world that more closely resembles ours. And yet this issue of health care has people in the US fuming that Canadians are a bunch of socialists. Come on.

In this country, when Canadian health care comes up, folks on the left and right assail each other with a blizzard of anecdotes, polls, testimonials, and opinions, but despite all the arguing, it seems that few minds are changed. So my collection of google search results may not impress you. But here they are.

One of the enduring claims on the right is that Canadian health care can’t be all that great since so many Canadians come to the US for health care. In “Phantoms in the Snow: Canadians’ use of health care services in the United States,” a report in Health Affairs, researchers looked at this issue. Here’s what they found:

“Throughout the 1990s, opponents of the Canadian system gained considerable political traction in the United States by pointing to Canada’s methods of rationing, its facility shortages, and its waiting lists for certain services. These same opponents also argued that "refugees" of Canada’s single-payer system routinely came across the border seeking necessary medical care not available at home because of either lack of resources or prohibitively long queues.

“This paper … depicts this popular perception as more myth than reality, as the number of Canadians routinely coming across the border seeking health care appears to be relatively small, indeed infinitesimal when compared with the amount of care provided by their own system.”

But Canadians and people in other nationalized systems don’t have the choices that we do here, right? That has to be frustrating. Well, maybe. But in a survey the Gallup company did (it’s a little old, 2003), Gallup found that Canadians and citizens of the UK were generally more satisfied with their access to affordable health care than were US citizens. However, citizens in all three nations rated the quality of care more or less the same.

For access to affordable health care, 57 percent of Canadians gave their system good marks. Sixty three percent of UK citizens gave their system good marks. And 47 percent of US citizens said they were satisfied with access to affordable care in their country.

For overall quality, 52 percent of Canadians were satisfied, 42 percent of UK residents gave a thumbs up, and 48 percent of US residents said they were satisfied. The US had the highest mark of “Very unsatisfied” at 26 percent. (Canada: 22, UK: 23)

As I mentioned, there are a million anecdotal stories about Canadians and how they either can’t wait to have a system like the US or think that our system is crazy. My personal anecdote is a trip to Canada in 2000 where I heard a health care conference by Canadian nurses on the CBC. The nurses were quite passionate about how they would never want to go to a system like the one here in the US. But I can’t claim to know firsthand how the Canadian system works.

One person who can is Rhonda Hackett , a Canadian psychologist who wrote an opinion piece in the Denver Post. The article, Debunking Canadian Healthy Care Myths, goes through the arguments one by one; government control, long wait times, higher taxes, etc. The whole thing is worth reading, but here’s one paragraph that I think is especially interesting:

“Myth: The Canadian system is significantly more expensive than that of the U.S. Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services. “

Who picks up the tab for the much higher costs of health care in the US? Businesses, health plan enrollees, and hospitals through charity care. Of course the highest price of all is paid by the uninsured, though perhaps not always in monetary terms.

For the Record: Obama and Taxes so far

Obama's record so far on taxes:

Tax cuts of $400 per worker and $800 per couple annually for two years, phaseouts beginning at $75K for individuals and $150K for joint filers. Various tax credits for education, child tax credit, energy efficiency measures, home and auto owners. Total $237 billion.

Tax credits and refunds to businesses equaling $51 billion, mostly to offset losses from recession, some energy credits.

Tax increases: Increased the federal cigarette tax by 62¢ per pack.

I wouldn't be surprised if there's something I've missed, but this is what I've found so far. Thanks to TPM for giving me the idea.

Socialism is the Least of our Worries; Health Care Reform Part Three

I think this article by Robert Reich is a very good summary of some of the problems with the sausage-making now going on in Congress. Congress and Obama hoped to avoid the industry opposition that the Clinton effort ran into. So they have been making deals with industry players, and some of those deals are obstacles to the goals of real reform. The concessions to the pharma industry particularly bother me. Any reform that doesn’t let Medicare negotiate directly for lower drug prices… well, it would be crazy to exclude that. That’s a Bush-league move, and I mean that literally.

I have been holding out hope that the final bill will resolve some of these issues, but there’s no denying that trying to please all the stakeholders is creating problems.

And then there’s the ongoing debate on how to pay for it. I think Obama’s pledge not to raise taxes on the middle class has always been a problem; there are just too many things to fix in our country to think we’re not all going to have to chip in and pay a little more. But I’d probably make a spectacularly unsuccessful political advisor. One thing to watch is a possible tax on health insurance companies. If I’m not mistaken, that sounds like the “provider tax” we have here in Minnesota. It’s extremely unpopular with physicians, hospitals, and health plans, but it has provided a stable source of funding for MinnesotaCare, one of our best public health programs.

Another issue that we’re hearing a lot about here in Minnesota is Medicare reimbursement. The system currently doesn’t do enough to reward quality over quantity, and it reimburses inefficient regions better than more efficient regions, such as the upper Midwest. Obama was going around talking about these regional differences in early July; I haven’t heard much about it lately, and that’s unfortunate. Without finding efficiencies, without changing the way some docs and regions practice, we will continue to have unsustainable increases in costs.

I’ve always supported the idea of getting the ball rolling on health care reform and refine it as it goes. But I very much want the best legislation possible, and the pressure is on the pro-reform lawmakers to deliver it.

46 Million Losers? Health Care Reform, Part Two

There are 46 million uninsured people in the United States. To me, this is pretty much the beginning and end of the health care debate. When the greatest nation on earth cannot provide adequate health insurance coverage to a huge chunk of its population, something is very wrong. This needs to be addressed, in my view, and the sooner the better.

But not everyone agrees. And one of the most interesting developments of the health care debate is how those opposing reform have tried to rationalize why it’s OK to leave 46 million people out in the cold, so to speak.

The rationalizations are many. The uninsured are lazy; they qualify for public programs but don’t take advantage of them. Or, they’re young and healthy (and selfish) and they don’t think they need health insurance. Or, as one person charmingly put it, they’re “ILLEGALS.”

A recent editorial in the Washington Times entitled “Who Are the Uninsured?” summed up these arguments pretty thoroughly. It concluded that many of the uninsured qualify for Medicaid, some are illegal immigrants, and others are uninsured by choice. “The truly uninsured are, thus, largely young people who can afford insurance but who make the decision to temporarily go without it as they move between jobs.”

This is, to put it kindly, a distortion of the true picture.

Many people who are uninsured are young. “The lack of health insurance has become especially acute for young adults,” says a report on the uninsured by the New England Public Policy Center at the Federal Reserve Bank of Boston. “Over the past 25 years, the likelihood of being uninsured has more than doubled for 25- to 44-year-olds.” But contrary to the Times conclusion, the PPC report concludes that the rising number of uninsured is due in part to the fact that many of the uninsured have either lost or never had access to employer-sponsored health plans. “Between 2000 and 2005, the share of Americans covered by health insurance fell from 64 percent to 60 percent, representing a drop of 3 million people,” the report says. “Over the same period, the share of establishments, both public and private, offering coverage declined from 69 percent to 60 percent.”

I can tell you that the employer surveys I’ve seen since 2005 show that this trend has continued.

Dr. Rani Whitfield, writing for the Urban Thought Collective, puts it this way: “Young adults between the ages of nineteen and twenty-nine with low income and unstable jobs are the fastest growing population of the uninsured in America.”

That low-income part is important. The Kaiser Family Foundation, in its report, “Who are the Uninsured? A Consistent Profile Across National Surveys,” says that surveys consistently show that the majority of the uninsured are in fact employed, but more than half of the uninsured are in low-income families. Poor-paying jobs generally don’t offer health care, or offer plans with high deductibles and copays that may be unaffordable for the workers.

“More than half of the uninsured are in low-income families and about half are ethnic or racial minorities. The majority of uninsured adults are working, but their lack of education makes it more difficult for them to get jobs that offer employer-sponsored coverage.

“Those with low incomes (less than 200% of the poverty level; or $37,620 for a family of four in 2003) are less likely to have jobs that offer employer-sponsored coverage and are also less likely to be able to afford their share of the premium. Roughly a third of the nonelderly population comes from low-income families, but they are disproportionately represented among the uninsured because their chances of being uninsured are over three times greater than those with higher incomes,” the report finds.

And Factcheck.org has a nice summary of the issue, drawing on the KFF data:

“Ever since health coverage became a major issue in the 2008 presidential campaign, we've received periodic questions from readers who wonder whether a large percentage of the uninsured are non-citizens or illegal immigrants. They're not. According to the nonpartisan Kaiser Family Foundation, 79 percent of the uninsured are native or naturalized U.S. citizens. The remaining 21 percent accounts for both legal and illegal immigrants.

“What else can we say about the uninsured? More than 80 percent are from families in which at least one person works (70 percent from families where at least one person works full-time, and an additional 12 percent from families with a part-time worker). Two thirds are near or below the poverty line, making less than 200 percent of the federal poverty level. Only a small number (20 percent) are children, but nearly half are below the age of 30. Non-Hispanic whites make up two thirds of the population but less than half of the uninsured, and they are also more likely than any other race to have private insurance.

So there we have it, young, poor, and often minority people are more likely to be uninsured. Sounds like an important part of Obama’s coalition, no? Maybe that’s one reason he’s pushing health care reform.

Or maybe he just thinks 46 million uninsured in the United States is inexcusable.

Health Care Reform - Part One

This looks to be a very eventful week for the health care reform movement. The plans that Congress and Obama have been promoting are getting some real serious pushback, and Obama’s going to have to work hard to find success in achieving serious reforms.

At the end of the day, Democrats still have a majority in both houses, so it’s likely that something will pass. Worst case scenario, I think, is that we see some serious reforms to health insurance boundaries – for example, no more canceling policies after someone got sick because of a newly-discovered “pre-existing condition.” Just reforms like that will be an improvement, and Obama may be forced to settle for small-scale improvements and declare victory.

But I would hope that the country can do better. I do know that I’m seeing a lot of lively debate among friends, some of whom believe that we’re heading down the road to socialist Armageddon if we follow Obama’s lead.

Some of this debate I’ve ignored, some of it I’ve participated in. But after a while it seems to me that there are quite a few serious issues that keep coming up. So rather than, say, go back and forth on FaceBook with a few people, I’m going to make an effort this week to post some health care reform thoughts here, and provide at least some documentation to back up those views. Feel free to comment.

This could be a historic moment. The more discussion, the better.

And just to start things off on a lighter note:


Study: Most Children Strongly Opposed To Children’s Healthcare

Sarah Palin, WTF?

Sorry for the crude title, but really, it's pretty appropriate. Palin has shown herself to be a pretty erratic character, and I cannot see how this helps her if she does indeed have presidential ambitions. Half a term as governor, and then she quits? If it was *anyone* else, people would be saying this is political suicide, but because Palin is seen as the populist face of the Republican party, some are still, amazingly, trying to spin it as a ultra-special-maverick-y move. Come on.

All in all, not a great coupla months for Republicans in the public image department.

That's Senator Franken to you.

Is it my imagination or is Al Franken starting to look like the late Sen. Paul Simon from Illinois? All he needs is a bowtie.

Well, so that didn't take long. Congratulations to Tall Guy who predicted the Franken win during the final days of the campaign.

I recommend Chris Cillizza's short but insightful take on the final outcome. Basically, he says, it came down to organization, discipline, and money. Three cornerstones to any winning political campaign.

All I can say is Minnesotans are relieved this thing is over.

And hey, Bill O'Reilly? YOU'RE WELCOME!

Shepherd Smith Tells The Truth

For me, it's kind of a big deal, because I honestly don't expect Fox News talkers to be in touch with reality. Nice to see, but what he says is scary.



In the last year, we've seen a guy shoot up a church because he wanted to kill liberals. We've seen a guy kill three cops because he thought Obama was going to take away his guns.
We've seen a guy assasinate a ob/gyn physician in his church.
We've seen a guy who hated Jews and Blacks and questioned Obama's birth certificate go on a rampage and kill a security guard at the Holocaust museum.

You can say these were all lunatics and loners if you want. But don't tell me these are isolated incidents. This is a trend. This is exactly what the DHS memo on right-wing violence predicted.

"...conservative commentators tried mightily to paint the memo as an underhanded attempt by the Obama administration to smear its honorable critics by equating "right-wing" with "terrorism." It made no difference to these loudmouths that the number of hate groups around the country has increased by more than 50 percent since 2000, according to the Southern Poverty Law Center. It didn't matter that the memo was backed up by solid intelligence and analysis. For these infotainers, the point isn't to illuminate a subject with light but to blast it with heat."
-Eugene Robinson

(I highly recommend you read that article, by the way.)

Those "infotainers" have always bothered me, and never more so than now, when they daily rail against Obama, calling him a socialist, communist, fascist, saying he is destroying the country. A couple weeks ago I saw a clip of O'Reilly and Beck talking about how they "believed" Obama supported the Black Panther ideology. "I can't prove it, I don't have evidence, but I believe that," O'Reilly said. What a statement. And it sums up too many on the right. They want to believe the worst about Obama, so they do. No evidence required. If they say it, it's so.

If you think that violent movies and video games influence people to become more violent, what effect do you think this daily barrage of hate has? Glen Beck is the most delusional, paranoid person I have ever seen on television, and he's a huge hit with the Fox viewers. The same viewers Shep Smith was talking about.

In the end, I have only a question, not a solution.

Where is this all going to end up?

Facebook: blog killer??

Totally neglecting the blog lately. I blame facebook.

Not that there's not a lot to talk about. Here in MN, Pawlenty announces he's running for president, er, I mean, not running for another term as governor. I had a whole lot to say about that but it's a little late now.

There's a whopping health care debate going on right now, we're likely to see the biggest reform in the nation's health care system since Medicare. Lots to say about that too, hopefully I'll get to it before long.

But the thing that I've been thinking most about is the uptick in violence by far-right-wingers in this country. I'll have more on that soon, I hope.

Arlen Specter, Democratic Senator from Pennsylvania

I think this is big, not so much because now AS will be a liberal and vote for everything Obama wants, but in that it adds to the perception that the Republican Party has no room for moderates any more.

Specter can now help Obama most by voting for cloture on controversial or close bills. He doesn't have to vote for cap and trade, for example, he just has to vote for ending debate, thereby ending any chance of a filibuster, thereby allowing the D's to pass the bill with a simple majority.

I really doubt we're going to see Specter change position much; he will be a moderate-to-conservative Dem. That breed still exists. The moderate to liberal Republican is almost entirely gone.

Kos and others argue that R's are becoming a regional party that cannot win national elections because they simply are too limited in their appeal. I think it's a little early to call them a "regional" party, after all, one of their most visible idealogues, our lovable Michelle Bachmann, comes from right here in Liberal Minnesota.

But it does again raise the question of the value of "bipartisanship," when the party is so dominated by hard core conservatives that even a moderate like Specter has to out and out leave the party to survive politically. These folks aren't interested in bipartisanship, because that would involved compromise. And compromise is something they just don't do.

Maybe, in a way, that's admirable. But mostly, lately, it's just been good for Democrats.

Leave It

We probably shouldn’t take this secessionist talk of Texas Gov. Rick Perry and a few hard-right partisans too seriously. They’re just throwing red meat to the crowd, and there’s not much to indicate that they really want to secede.

But it’s interesting that the subject is even raised. I don’t recall a Democratic governor ever talking about leaving the Union, no matter how much he disagreed with a Republican President.

Now there seems to be a race among talk show hosts, Republican politicians and conservative pundits to see if they can top each other with sensational, alarmist and dishonest talking points about the Obama administration.

When I was growing up, the hard-right crowd had a favorite saying: “America – Love It or Leave It!”

Ironic that now that the majority of Americans support a liberalsocialist President, some right-wingers are now talking about the latter.

Keeping the tone civil

I've gotten some feedback from the previous post and I think perhaps it was a bit of overreaction on my part. Sure, I saw some pretty bizarre, offensive, and downright dumb stuff in the coverage of the tea bag events, but as many have pointed out, that's what the media will play up. And I might be swimming in the lefty blog echo chamber a bit too much, if I may mix my metaphors, which also plays up the nuttiness.

So, OK, conservatives are allowed to have their day to speak their minds, even if it largely a bunch of events sponsored by Fox News. And they have every right to be angry about the lousy economy and the deficit. I just think their anger is very misdirected. And I'm still not getting answers on why people who hate taxes are mad at a president who just cut theirs.

Conservatives?