US Healthcare Reform

[Happy Face 29]

I'll not take the NHS thread off topic again.

 

We started this whip count effort on June 23 because it became clear that in the course of making their deals with stakeholders, the Baucus Caucus (who were negotiating on behalf of the White House, with the participation of the White House) had very likely already dealt the public plan away.

 

On May 11, "stakeholders" including the AMA, PhRMA, the hospitals and the device manufacturers delivered proposals to the White House promising to "voluntarily" reduce cost increases over the next 10 years. In an effort to keep them "at the table," Baucus's Chief of Staff Jon Selib and Finance Committee staffer Russell Sullivan told stakeholders at a May 20 meeting that their participation in the process of crafting a health care bill was contingent on them "holding their fire":

 

Sources familiar with the lobbyist meeting described it as collegial, but they said Baucus’ aides made clear that any public opposition to the proposed financing of a reform package would be at their clients’ peril. The staffers’ message to K Street was clear: Tell your clients to let the process work and don’t torpedo it with advertisements, press releases and Web sites.

 

The goal of keeping stakeholders at the table was threefold:

 

Keep them from advertising against the White House plan

Keep them from torpedoing vulnerable Democrats in 2010 so there isn't a repeat of 1994

Keep their money out of GOP coffers

You can see the fingerprints in the deals that they made: the $150 million PhRMA was spending on ads for health care reform, the $2.5 million they spent helping vulnerable freshmen, and the total fury that Boehner has unleashed on PhRMA and other stakeholders for making deals with the White House.

 

People make a mistake when they think the battle for health care reform is about ideology, because it's not. It's about who controls K Street and the cash that flows from it, which could fund a 2010 GOP resurgenece -- or not.

 

On June 9, a lobbyist who worked for the insurance companies, hospitals, and other stakeholders said that these groups were "considering joining their Republican allies and mounting a public relations offensive to put the brakes on President Barack Obama’s overhaul plans."

 

In response, on June 11 Sullivan and Selib fired a warning shot:

 

“They said, ‘Republicans are having this meeting and you need to let all of your clients know if they have someone there, that will be viewed as a hostile act,’” said a Democratic lobbyist who attended the meeting.

 

“Going to the Republican meeting will say, ‘I’m interested in working with Republicans to stop health care reform,’” the lobbyist added.

 

Republican leaders have been meeting with health care stakeholders for months, with those sessions occurring “more frequently than once a month,” according to a senior Senate GOP aide.

 

On June 17, Roll Call ran an editorial crying foul, called "intimidation":

 

Now, as the health care debate heats up, lobbyists representing stakeholders in the debate are being frozen out of meetings and — even worse — intimidated from speaking out in their clients’ interest.

 

[]

 

Democratic leaders have health care on a fast track to passage in the House and the Senate by August. And, intimidation or no, objections are beginning to be heard to various proposals, notably a Medicare-like “public plan” and taxes on sugar to help pay for health reform.

 

And that's right at the time that Kent Conrad unveiled his faux "public plan," the "co-op" plan (June 15). It was the time I started getting really nervous. There could only be one purpose served by such a plan: pull a bait-and-switch on a public plan. Which was why when we started the whip count effort on June 23, our goal was to define a public plan as not a co-op.

 

In short order, a series of deals were announced by Baucus and the White House. On Monday, July 6, the deal with the hospitals, whereby they'd commit to reduce projected cost increases by $150 billion over the next decade. On Tuesday, July 7, PhRMA's Billy Tauzin and 5 CEO's went to the White House to seal their deal with Rahm Emanuel, Jim Messina and Nancy-Ann DeParle, Director of the White House Office of Health Reform. On July 8, Rahm tried to float the idea of triggers -- and it went over like a lead balloon. On June 10 Obama spoke to the AMA. There was a huge push to keep these groups happy during this period, and more importantly -- keep them from aligning with the Republicans.

 

And it seems to have worked. John Boehner recently wrote a scathing letter to Billy Tauzin saying that he had "betrayed" the drugmakers by failing to align himself with the Republicans. The GOP needs the money of PhRMA and other disgruntled businesses to fund its 2010 war chest. Just as it was during the bank bailout, the goal of the White House was clear: more important than saving the financial system was keeping the financial institutions happy and stop them from financing Republicans.

 

Who would think that way? Whose primary objective would be to keep anyone from funding a GOP ascendancy, to sell out health care reform worth billions for a hundred fifty million in pro-reform advertising? Who would think to ask PhRMA to run ads in the districts of vulnerable freshmen, as well as Blue Dog Mike Ross, who is anything BUT vulnerable? Certainly not some policy wonk.

 

But ask yourself -- would consider it a victory to use the "public plan" as little more than a political pawn with which to threaten stakeholders and force them to stay at the table, with no thought as to the emotional and moral consequences suffered by the people who had pinned their hope on having one?

 

Someone who had worked as the head of the DCCC. Who remembered the 54 seat swing to the GOP in 1994 after the failure to pass health care reform. Someone whose sole goal was a "political victory," so the White House could be 14-0 not "13-1."

 

Someone like Rahm Emanuel, who works through the Blue Dogs in the House to make the House bill conform to the deals he sets up in the Senate. Rahm wanted a public plan with "triggers" and had been pushing for it since January. Lo and behold, who is insisting that any public plan in the House have triggers -- Mike Ross and the Blue Dogs.

 

The PhRMA deal on July 8 says that there won't be any drug price controls, and the next day, Blue Dogs Heath Shuler and Debbie Halvorson author a letter demanding -- no drug price controls:

 

Instead, they are asking Waxman, Rangel and Education and Labor Chairman George Miller (D-Calif.) to support the drug industry’s offer to spend $30 billion help cover those costs – a deal that is backed by the White House and the Senate Finance Committee.

 

The American Hospitals Association deal was signed on July 8. The hosptals want higher medicare reimbursement rates for rural providers. On July 15, the Blue Dogs threaten to block health care reform -- if it doesn't increase reimbursement rates to rural providers.

 

And suddenly, the hospitals are spending $12 million running positive ads about health care reform with PhRMA and the AMA.

 

Mike Allen said earlier this week that "this weekend’s comments by White House officials simply acknowledged the long-obvious reality that the idea of a government-run insurance plan was partly a bargaining chip."

 

If you look at the cat-and-mouse game played between the Democrats and the Republicans, support expressed by the President for a "public plan" meant "don't you dare." A commitment that the bill will be "bipartisan" (since the GOP would never agree to one) was a signal that there would be no public plan.

 

The White House never cared about getting Republican votes -- it cared about keeping the Republicans from peeling off the dollars of stakeholders like PhRMA. Giving in to "Republican" demands was cover for writing shitty things into the bill that would keep the stakeholders happy. They didn't need Republican votes, they never did, and they never truly cared. As long as the money stayed out of their campaign coffers, it was all good.

 

If a public plan gets into a final health care bill, it's going to be because of public pressure, because people who put Obama in office demand one. Because in the grand scheme of White House priorities, it was something that could acceptably be dealt away in pursuit of a higher political objective by the guy who was calling the plays: Rahm Emanuel.

 

http://campaignsilo.firedoglake.com/2009/0...itals-and-rahm/

 

If i read it right, basically Rahm (and Obama) knows and always knew there wouldn't be a public option, he made enough promises about it to get the private companies worried about it though and has been able to stop them running off and throwing money at Republicans by conceding it, going back on his word and retaining their bribe money for the democrats war chest in the next elections.

 

Any flickering flame of hope you had left for Obama should now be completely extinguished, but overwhelming public support for the public plan might still see the White House defeated and forced to use the huge majority they have which could see ANY plan they wanted pushed through autonomously. Democratic members are going on the record in increasing numbers to commit to voting no on any bill without a public option.

Edited August 20, 2009 by Happy Face

[ChezGiven 0]

Health reform

The labours of Sisyphus

 

Aug 20th 2009 | NEW YORK

From The Economist print edition

Opposition to health-care reform is mounting. Barack Obama must now decide whether to scale back his approach

 

Illustration by David Simonds

 

DO THE Republicans scent blood? One sign that they might came this week, in the form of a sharp letter from John Boehner, leader of the Republicans in the House of Representatives, to the head of the Pharmaceutical Research and Manufacturers of America (PhRMA) lobby—long a good friend to the party. Mr Boehner denounced as “appeasement” the lobby’s decision to support Barack Obama’s plans for health-care reform. But that decision was made months ago; attacking it now is surely a sign that the Republicans think Mr Obama is suddenly in trouble.

 

And with some justification. First, the Democrats failed to meet the president’s deadline for getting health bills out of both the House and the Senate by August. Next, as politicians headed home to conduct town-hall meetings during this month’s recess, they encountered many constituents angry about the dangers—real or imagined—to be wrought by health reform. Some of these grumblers were planted by conservative groups, but many others were genuinely afraid or upset.

 

A new poll conducted for The Economist by YouGov confirms that scepticism over the reform effort is widespread. Of those respondents expressing a clear view, twice as many believe reform on the scale Mr Obama is still contemplating will leave them worse off than today (38%) as believe they will be better off (19%). Over half are convinced they will end up paying more. And more people (59%) believe that any new system will lead to rationing of care than think it will lead to long-term cost savings (only 46%). Details are available at www.economist.com/yougovpoll.

 

So will health reform prove to be Mr Obama’s Waterloo, as Jim DeMint, a Republican senator, claimed recently? Not necessarily. Michael Cannon of the Cato Institute, a think-tank, opposes Mr Obama’s health proposals but believes it is still early days. The real battle is to come in the autumn session of Congress, beginning on September 8th. And the hornets’ nest of trouble stirred up by opponents of reform will not soon be forgotten.

 

This suggests that Mr Obama now faces a difficult choice. One option is to stick with his plans to tackle all the big problems of health at once, ranging from cost to coverage to quality. Another option is to scale back his ambitions, going for the less grand but still worthy goal of expanding health cover to the many tens of millions without it. A third option, giving up altogether, seems unlikely, since Democrats have big majorities in both houses of Congress (though it is possible that in-fighting among Mr Obama’s allies could yet scupper even modest reforms).

 

Officially, the White House is sticking with its original plan for comprehensive reform this year. Look closer, though, and it becomes clear that Mr Obama is signalling that he may soon backpedal in various ways. One example is the rebranding of health-care reform as “health-insurance reform”, a carefully worded phrase now repeated by all his officials. This might allow the administration quietly to back away from its “Big Bang” approach, and to claim victory if a timid health compromise manages only to improve coverage while largely ignoring questions of cost and quality.

 

Another example of back-pedalling is Mr Obama’s wavering support for a government-run health-insurance plan. Though this notion is wildly popular with the political left, conservatives and business lobbies loathe it. Concerned that moderate Democrats may vote against any final health bill containing such a controversial public plan, the administration this week softened its support for the notion. Mr Obama still advocates the idea, his aides insist, but is willing to live without it if that is the cost of a health deal.

 

Predictably, many liberals are outraged by any talk of weakening reforms. Robert Reich, a labour secretary under Bill Clinton, this week declared that leftists must march in support of the public plan in Washington, DC, on September 13th. Polls show support from Democrats plunging if no public plan is included.

 

If reform were to be scaled back, would that be a disaster? The loss of a public-plan option need not be. One reason is that support is growing for non-profit “co-ops” instead of a government-run plan to compete against private insurers—though it looks as though the Republicans are gearing up to attack these, too. A bigger reason is that pioneering reformers in Europe and in Massachusetts have shown that universal coverage is achievable without a government-run insurer. Among the policies needed are strong regulation of insurers to prevent bad behaviour, subsidies for the poor and the creation of health-insurance exchanges.

 

But surely going only for coverage now just delays the task of cost control until later? Yes, but that is a good thing, argues Jon Kingsdale. As head of the Commonwealth Connector, the official insurance exchange set up in Massachusetts, he has seen at first hand how the raucous politics of reform have unfolded in his state. Michael Dukakis, a former governor, tried to fix health care 20 years ago, but the law he pushed through the legislature eventually came undone in the teeth of business opposition. The new reforms, passed three years ago, have cut the number of uninsured in half, so that only 2.6% of people in the state are now without insurance.

 

Hasn’t this politically attractive entitlement simply made the cost problem worse? After all, many economists argue that national health reforms must tackle costs hand-in-hand with coverage or else be deemed reckless. On the contrary, says Mr Kingsdale, sequencing reforms slowly and building support through expansion of coverage has now made it politically feasible for his state to tackle the cost problem. The key, he insists, is to see reform not as a Big Bang but a continuing process.

 

To bolster his contrarian argument, he points out that an officially appointed committee of experts has just recommended that his state scrap the fee-for-service model of reimbursement, which many economists believe is at the heart of America’s health-inflation problem. Doing so would require his state to get a special waiver from the federal government, but this radical and hugely worthwhile proposal is now being seriously considered. Sadly, the idea is nowhere to be found in the leading bills in Washington, DC.

 

Mr Kingsdale does acknowledge that it is easier to pull off reform in a small and wealthy state like his than it would be at the national level, and accepts that his state has not yet actually passed any legislation that would curb health inflation. And given Congress’s history of fiscal irresponsibility, it is surely right to be sceptical about any strategy that expands entitlements today in the hope of forcing a fiscal crisis to win support for cost cuts tomorrow.

 

Mr Kingsdale sums it up this way: “Trying to anticipate and address related cost, quality and access issues in one national reform would be more than Herculean—it would be Sisyphean…Herculean effort, followed by failure, then a renewed attempt at reform, ad infinitum.” Sadly, that infernal tableau describes all too well the fate of most health reforms attempted since the days of Theodore Roosevelt. Lyndon Johnson was the only exception. Can Mr Obama provide another one?

[Happy Face 29]

There are some days when it almost seems like the national press is making a conscious effort to prove Noam Chomsky’s Manufacturing Consent gospel. If the national commercial media really did exist solely to perpetuate the attitudes of the political elite, and to create phony debates around unthreatening policy poles, endlessly pitting a conservative/reactionary status quo against an “acceptable” position of dissent — if that thesis were the absolute truth, then you’d see just what we’re seeing now in the coverage of the health care debate.

 

All across the country the news media reacted to the White House leak about the possibility of the public option being dropped with, well, an oddly circumspect tone. Although some initial stories carried a sensational tone, within a day or two the debate had settled down, and the country’s most prominent pundits were considering this treacherous and cowardly development in a pragmatic light. In Eric Etheridge’s review-of-reviewers blog in the Times, the “Opinionator,” the situation was described this way:

 

The debate is primarily on the left, or among the Democrats, where partisans are furiously arguing along two intersecting fronts: First, the public option is or is not an essential element of reform. Second, abandoning the public option will or will not make passing the remainder of reform more likely.

 

This superficially is true, I guess. There were a few voices arguing that the public option is the bare minimum “reform” that the public should tolerate, and a few who argued that if it is not in the final version, progressives should reject the proposal.

 

But overwhelmingly the pundits went the route predicted by Manufacturing Consent. The most prominent voices in the last two days have mostly chosen one of two sides to argue. Many attacked the public uproar over the White House’s apparent surrender, blasting the public option as an unrealistic and meaningless affectation, a policy kewpie doll for unrealistic liberals who “don’t want to be bothered with the real-life dynamics of the health care market,” as the Washington Post’s Steven Pearlstein put it (in his column with the amusingly obnoxious title, “Enough Already With the Public Option!”). The White House itself is covertly putting itself in this camp via “unnamed” sources who are expressing rank insider astonishment over the rabble’s naivete, for instance here in the Washington Post:

 

“I don’t understand why the left of the left has decided that this is their Waterloo,” said a senior White House adviser, who spoke on the condition of anonymity. “We’ve gotten to this point where health care on the left is determined by the breadth of the public option. I don’t understand how that has become the measure of whether what we achieve is health-care reform.”

 

“It’s a mystifying thing,” he added. “We’re forgetting why we are in this.”

 

Where the chief executive of any administration is on almost any issue, one can also usually find Hobbit understudy and professional White House apologist Joe Klein. Here he is on health care, licking as usual the presidential jellyring:

 

Meanwhile, I never had much interest in a public option. I think the perils of government-delivered (as opposed to funded) services are obvious and immense. Sarah Lyall had an excellent piece in the Times today about her dealings with the British National Health System, which has some very real strengths, but also some terrifying weaknesses…. I spent the weekend traveling through the west with the President, watching him perform at health care forums in Montana and Colorado. He did quite well, I thought.

 

So that’s that camp. Then, on the other side, there was a whole rash of others who took the pragmatic, chin-scratching route, embracing in advance the possibilities of a public-option-less health care reform. A lot of the people making this argument seemed to have good intentions. One example was Matthew Yglesias:

 

A set of consumer protections that would cap out-of-pocket health costs, guarantee access to preventive care, and prevent insurers from treating people well as long as they’re healthy only to start monkeying around when they get sick. This would be a big deal. The bills in Congress also envision expanding the Medicaid program that currently serves the poor. This would only help a relatively narrow slice of the near-poor, but for those who are helped, the help would be enormous.

 

And Kevin Drum at Mother Jones:

 

So as much as I’d like to have a public option (primarily for its ability to force more robust price competition), I just don’t see it as something to threaten nuclear destruction over. If insurance reforms are robust and low-income subsidies are decent, that’s a huge win for millions of people, and it’s a win we can build on. And contra Atrios, social legislation does have a history of getting better after it’s first passed. Just ask Henry Waxman.

 

Then there was Nate Silver:

 

The fundamental accomplishments of a public option-less bill would be to (1) ensure that no American could be denied coverage because of a pre-existing condition or because they became sick; (2) subsidize health insurance coverage for millions of poor and middle-class Americans.

 

These are major, major accomplishments. Arguably, they are accomplished at too great a cost. But let’s look at it like this. The CBO estimates that the public option would save about $150 billion over the next ten years — that’s roughly $1,100 for every taxpayer. I’m certainly not thrilled to have to pay an additional $1,100 in taxes because some Blue Dog Democrats want to placate their friends in the insurance industry. But I think the good in this health care bill — the move toward universal-ish coverage, the cost-control provisions — is worth a heck of a lot more than $1,100.

 

So this is where the “debate” is being framed. One side argues that the public option isn’t anything to write home about. The other “side” argues that a bill without the public option won’t be a disaster after all. Of course if you’re paying attention these are both actually the same argument, arguing the same side.

 

I get that the public option isn’t a cure-all and I also get that it would be nice if they passed a law preventing insurers from denying patients with pre-existing conditions. But what strikes me the most is how the instant the public decides it’s fed up and really wants something, all these arguments suddenly appear in the press showing why they are unreasonable and uneducated and should take a more “nuanced” (God, I hate that word) view of things. It seems to me that if you pay careful enough attention to the underlying theme of a lot of these articles, the pundits’ biggest concern about the public option is that their readers are demanding it in spite of what they are being told. Me personally, I think the time to consider what good stuff might be in a public-option-less bill is after you’ve lost that battle, not before.

 

http://trueslant.com/matttaibbi/2009/08/20...f-the-woodwork/

[Happy Face 29]

Even better....

 

I was about to write a post today sort of apologizing in advance for the tone of my forthcoming article on the health care business. I was worried all weekend that I had been too negative and too harsh with regard to the Democrats. It had struck me that in the month and a half or so that I spent on health care I spoke with a great many staffers and members of congress who seemed genuinely committed to fixing health care — people like Bernie Sanders, Ron Wyden, Sherrod Brown, Lynn Woolsey, and numerous others in and around the House and Senate. I was suddenly feeling very guilty for ignoring (to a degree) their efforts and focusing instead in my piece on the treachery of the Democratic leadership — Pelosi, Reid, the White House — for bargaining away real health care reform before this process even started.

 

Then I came home this afternoon, turned on my computer and read this latest smoke signal emanating from the White House, indicating that the “public option” is now being walked a few more steps forward along the plank. And I stopped feeling guilty about hammering the leadership. The latest news:

 

As President Obama finishes a western swing intended to bolster support for his signature policy initiative, Health and Human Services Secretary Kathleen Sebelius opened the door to a compromise on a public option, saying it is “not the essential element” of comprehensive reform. White House press secretary Robert Gibbs said on CBS’s “Face the Nation” that Obama “will be satisfied” if the private insurance market has “choice and competition.”

 

Now, obviously (and this is will be explored in more detail in the forthcoming piece, which will be out this week), the public option was not a cure-all. In fact, the Democrats had in reality already managed to kill the public option by watering it down to the point of near-meaninglessness. But the notion that our president not only does not have any use anymore for a public option, but in fact “will be satisfied” if there is merely “choice and competition” in the market is, well, disgusting.

 

I’ll say this for George Bush: you’d never have caught him frantically negotiating against himself to take the meat out of a signature legislative initiative just because his approval ratings had a bad summer. Can you imagine Bush and Karl Rove allowing themselves to be paraded through Washington on a leash by some dimwit Republican Senator of a state with six people in it the way the Obama White House this summer is allowing Max Baucus (favorite son of the mighty state of Montana) to frog-march them to a one-term presidency?

 

To quote Method Man’s Calvin “Cheese” Wagstaff character from The Wire, “This is some shameless shit right here.”

 

 

http://trueslant.com/matttaibbi/2009/08/17...t-com/#more-681

 

[Happy Face 29]

Health Insurance company prices have grown about 6% the last few days, since the public option was deemed not critical...

 

http://www.google.co.uk/finance?catid=us-52935503

 

They're now at almost a year long high (since Obama won basically).

 

Obama's feeding the Horse.

[Billy Castell 0]

I don't know the details of all these reforms, but something that aspires to the original priniples of the NHS has to be a good thing. I can't imagine anyone happily writing off 40 million of their population as unimportant and criticise any attempts to make sure everyone has a good level of healthcare. Oh, sorry, this is in the USA isn't it? They have masses of mindless dribbling cretins who think such ideals are 'commie talk' that will bring about a Bolshevik revolution led by those famous Nazis who were all either half black or Jewish .

 

I would find a clip that explains what I think of the US right wingers, and their hypocracy that is influencing the US public, but I don't think you'll approve of a video of Rupert Murdoch and his mates gang raping a retarded child.

[Park Life 71]

I don't know the details of all these reforms, but something that aspires to the original priniples of the NHS has to be a good thing. I can't imagine anyone happily writing off 40 million of their population as unimportant and criticise any attempts to make sure everyone has a good level of healthcare. Oh, sorry, this is in the USA isn't it? They have masses of mindless dribbling cretins who think such ideals are 'commie talk' that will bring about a Bolshevik revolution led by those famous Nazis who were all either half black or Jewish .

 

I would find a clip that explains what I think of the US right wingers, and their hypocracy that is influencing the US public, but I don't think you'll approve of a video of Rupert Murdoch and his mates gang raping a retarded child.

 

Nice post.

 

Reminded me to write to my pen pal buddy in Texas.

[Cid_MCDP 0]

I don't know the details of all these reforms, but something that aspires to the original priniples of the NHS has to be a good thing. I can't imagine anyone happily writing off 40 million of their population as unimportant and criticise any attempts to make sure everyone has a good level of healthcare. Oh, sorry, this is in the USA isn't it? They have masses of mindless dribbling cretins who think such ideals are 'commie talk' that will bring about a Bolshevik revolution led by those famous Nazis who were all either half black or Jewish .

 

I would find a clip that explains what I think of the US right wingers, and their hypocracy that is influencing the US public, but I don't think you'll approve of a video of Rupert Murdoch and his mates gang raping a retarded child.

 

Sadly, you're really not far off with that assesment.

 

I think the reason everyone over here is so stupid and reactionary is because our media tries to keep us in a constant fear loop. Even the local news over here does that kind of stuff, "Is your child in danger? Be sure to catch tonight's Action 10 news to find out!"

 

People make really stupid decisions when they're emotional (i.e. scared or angry). Also the fact that we've decreased government spending on education basically every year I've been alive save for a couple under Clinton in his first term probably has a lot to do with it too.

 

That's why I'm kind of torn on legalizing marijuana- on one hand, I think it's hypocritic that it's illegal. On the other hand, I think a lot more folks (including me) would just smoke out all the time and become even more detached and apathetic than we already are if it was legal.

 

But yeah- we bailout multinational banks under Bush by buying up stock and it's necessary. We talk about fixing healthcare and it's communism. I don't get it either.

 

Course, I still don't get the whole Obama/ Joker communism picture thing. The Joker's a communist? Obama's a joker? I dunno.

[trophyshy 6481]

When I was in Montreal two weeks ago I saw a street petitioner, with his table, with his propaganda. ALL of his pictures were Obama with a Hitler 'tash. He was calling Obama the new Adolf.

 

Now with hindsight I should have listened to his case but I was too busy looking for a non sports bar.

 

N. American cousins, what say you about this slander?

[Cid_MCDP 0]

When I was in Montreal two weeks ago I saw a street petitioner, with his table, with his propaganda. ALL of his pictures were Obama with a Hitler 'tash. He was calling Obama the new Adolf.

 

Now with hindsight I should have listened to his case but I was too busy looking for a non sports bar.

 

N. American cousins, what say you about this slander?

 

Montreal is pissed at Obama?

 

Sacre Bleu!

 

Montreal is just pissed that Carey Price didn't turn out to Patrick Roy II as had been hoped/ prayed upon/ banked on. Well that, and they seem to have a track record with signing the most apathetic UFAs on the face of the earth and then acting shocked that they don't seem to care about their performance on the ice. I mean seriously, Alexi Kovalev playing like he doesn't care? WHAT???

 

Nah seriously though, that's a new one on me. Hitler Obama?

 

Y'know, Hitler gets thrown around way too much these days. There were a lot of Bush= Hitler people. Doesn't surprise me that now those same folks are saying Obama is Hitler too. What about somebody being the new Mussolini? What about being the new Stalin? Hell, the new Vlad Dracul? Those dudes get no love...

Edited August 28, 2009 by Cid_MCDP

[trophyshy 6481]

 

Thanks Cid.

 

It was a tad zut alors. My overriding assumption is that he was a mentalist, but then I was in some bizarre offshoot of France...

[Cid_MCDP 0]

 

Thanks Cid.

 

It was a tad zut alors. My overriding assumption is that he was a mentalist, but then I was in some bizarre offshoot of France...

 

Are they still wanting to seccede from Canada? Haven't heard much about that lately. When they were making a big stink over it, the Habs were pitiful. I've always had a theory that Montreal's destiny as a province is largely dependent on how good or bad the Habs are playing at the time.

 

I have no idea what a tad zut alors is.

[Happy Face 29]

While it's lovely that The New Republic has now joined that movement and decided that corporate-owned "centrists" need to be purged from the Party, Chait is laboring under complete blindness about the reasons these problems have arisen. Chait accuses me, Dan Froomkin and "liberals" generally of "confusion" because we believe that the Obama White House bears some of the blame in the dominance of corporate interests generally and in the health care battle specifically. Chait echoes the facially absurd excuse of the most hardened Obama loyalists everywhere: namely, that Obama, Rahm Emanuel and friends are just helpless, impotent observers who wield no influence over the health care debate and can do nothing but sit back and hope and pray that the Senate will pass a good, progressive health care reform bill free of excessive servitude to the health care and drug industries. If the Congress refuses to, well that's obviously not Obama's fault -- a President isn't in the Congress and can't really influence what it does, so this excuse-making goes.

 

For the moment, leave aside all the evidence to the contrary: that, as Chait's colleague Jonathan Cohn detailed, the Obama White House secretly entered into a deal with the drug industry not to negotiate for lower prices; that Obama has repeatedly sought to empower the Baucus-dominated Senate Finance Committee at the expense of more progressive committees; that the White House aggressively threatens, berates, and cajoles House progressives who impede the President's agenda but hasn't done anything against Blue Dogs; that the strategy of the White House from the start has been to ensure that the health care and drug industries are pleased so that they continue to use their ample largesse to fund the Democrats rather than get behind a GOP takeover in 2010; and that Emanuel built his career and power base by controlling the Congress through the expansion of the Blue Dogs and other "centrist" and "conservative" members and by pleasing corporate donors, thus rendering the image of him as a helpless, passive bystander in the health care debate transparent fiction. Even Dick Durbin -- the Senate's number two Democrat -- acknowledges that, even with a huge Democratic majority, the banking industry "frankly owns" the Congress.

 

More important than all of that is the fact that there is one principal reason that Blue Dogs and "centrists" exert such dominance within the Party: because the Party leadership, led by the Obama White House, wants it that way and works hard to ensure it continues. While Chait seems to envision himself as the pioneering inventor of the primary challenge strategy (something he first articulated six weeks ago), Accountability Now has actually been working continuously for the last year on recruiting credible primary challengers and building an infrastructure to support those challenges -- all in order to unseat the unresponsive, corrupt and corporate-owned incumbents who ensure that the same factions control government no matter which party is in control. But the principal barrier to those efforts has been the accurate perception that the White House and President -- along with key party institutions such as the DCCC -- will use their vast resources to keep Blue Dogs and "centrists" in office and crush any efforts from within the party to unseat them.

 

It's hard to overstate how many promising potential primary challengers with whom we've spoken -- highly energized and impressive members of City Councils or County Commissions or state legislatures or just private citizens -- who are eager to run against their corporate-owned Democratic Congressional incumbent but are deterred by one primary fear: that Obama and the Party infrastructure will undercut their efforts by actively supporting the Blue Dog incumbent. That fear is particularly pronounced for potential African-American challengers in districts where the corporate-serving "centrist" incumbent is wildly out of step with the interests and views of the typical (and sometimes overwhelmingly African-American) Democratic voter. Such potential challengers anticipate that Obama will intervene on behalf of the Blue Dog against the progressive challenger -- as he's done before -- and sabotage not only their primary challenge but perhaps their future viability as a candidate in their community and district.

 

That's what makes Chait's insistence that the Obama White House is just an innocent, impotent bystander in all of this so painfully naive and wrong (Obama says he wants a public option, so doesn't that settle it?, asks Chait, vacantly batting his eyes with child-like trust and innocence). When the White House genuinely wants a bill to pass -- rather than paying irrelevant lip service to it -- they know how to apply pressure on the defiant members of Congress:

 

The White House is playing hardball with Democrats who intend to vote against the supplemental war spending bill, threatening freshmen who oppose it that they won't get help with reelection and will be cut off from the White House, Rep. Lynn Woolsey (D-Calif.) said Friday.

 

"We're not going to help you. You'll never hear from us again," Woolsey said the White House is telling freshmen.

 

Rahm Emanuel, Tom Delay, and the Bush/Cheney White House have left no doubt that where there's a will to influence the actions of Senators and House members in one's own party, there's a way. But the Obama White House has done nothing in the way of attempting to change the behavior of the supposedly obstructionist Blue Dogs and centrists whom Obama-defenders are eager to blame for the health care standstill. In fact, they've done the opposite: Emanuel has repeatedly leapt to their defense and attacked progressives who sought to influence or otherwise put pressure on them to change behavior. White House threats that "you'll never hear from us again" are issued to defiant progressives only. Not only are such threats never issued to "centrists" and Blue Dogs who are supposedly impeding the President's health care agenda, but the White House does everything it can to protect those ostensible obstructionists and further entrench them in power. Isn't all of this fairly strong evidence that the White House knew, accepted and likely even desired from the start that -- despite the President's public assurances to progressives -- the "public option," understandably despised by the insurance industry, would be dropped from bill?

 

Nobody suggests that the President could easily or single-handedly change the behavior of Kent Conrad or Mike Ross. But there's certainly things -- effective things -- he could do to try, including making it more difficult for those politicians to stay in office, exactly as they threaten to do with defiant progressives. But they don't do that. They do the opposite. The reason that Blue Dogs and "centrists" exert such control in the Democratic Party and are able to ensure the Party remains beholden to corporate interests is because that's how Party leaders want it. That's how the Democratic Party has been built and it's how they continue to maintain their power.

 

* * * * *

 

It's certainly true that the faces of the Republican Party (Rush Limbaugh, Glenn Beck, Sarah Palin, Bill Kristol, James Dobson) are significantly more warped and repellent than the standard Democrat, but the central fact in American political life is that the same narrow factions continue to control our political process regardless of which party is in control (note this recently leaked memo from GE executives emphasizing that "the intersection between GE's interests and government action is clearer than ever" and thus urging that all GE resources continue to be devoted to ensuring the enactment of favorable legislation, such as the Democratic Waxman-Markey climate and energy bill, something accomplished by flooding both parties equally with corporate largesse).

 

All of this hasn't happened despite the best efforts of the Obama White House to battle against it. To the contrary, Obama himself has been a major beneficiary of this process -- helping Democrats to be the leading recipient of corporate money -- and key Obama allies like Rahm Emanuel and Chuck Schumer have built their power bases through servitude to corporate interests. The very idea that Obama is valiantly struggling to cleanse the party of its corporate and centrist dominance, yet is just haplessly and helplessly unable to do so, is ludicrous beyond words.

 

It's possible to reasonably defend those actions as a necessary, pragmatic and prudent strategy for keeping Republicans out of power. But it's not possible to reasonably deny that the Democratic Party is how it is because that's how its leaders, including Obama, want it to be. Their actions permit no other conclusion. Indeed, one potential bright side with what's happening with the health care debate -- the Party's total devotion to the health care and drug industries despite huge majorities and a massive electoral mandate -- is that these truths have become so glaring that it is finally forcing even the most "sensible" Democratic partisans (TNR) to recognize how fundamentally flawed the Party is. That also appears to be making the prospect of recruiting credible challenges easier, and Accountability Now hopes to have some significant announcements soon.

 

If the Democratic Party is to become a meaningful alternative, free from corporate control, that will happen not because party leaders such as Obama cause it to happen. Instead, it will only occur from efforts on the part of Democrats to cease support for, and begin working to eject, those elements which keep the Party beholden to the same interests as the ones who own and control the so-called "other party." Systematic, credible primary challenges -- to impose a price for the Party on this behavior (by forcing them to divert resources to fending off primary challenges) and to make incumbents more accountable to their constituents -- is the best, perhaps the only, means for accomplishing that, if it can be accomplished at all.

 

http://www.salon.com/opinion/greenwald/200...rats/index.html

 

Corporations will buy the elections for whomever will legislate in their favour....and the average American isn't well informed enough to vote in their own interest. Accountability Now can bring in challengers, but their campaign war chest come the mid-terms will be non-existant.

 

Unless they pass legislation to vastly reduce the amount of lobbying and campaign spending that's allowed before then, it's all bound to get the Republicans back in the White House come 2012. Emmanuel's just doing his job to make sure that doesn't happen.

Edited August 28, 2009 by Happy Face

[ChezGiven 0]

Lexington

The politics of death

 

Sep 3rd 2009

From The Economist print edition

Americans fear health reform because they fear the Reaper

 

Illustration by Peter Schrank

 

THE first patient Dr Sherwin Nuland ever treated died horribly in front of him. James McCarty, a 52-year-old construction boss, had eaten too much red meat, smoked too many Camels and suffered a heart attack. Dr Nuland, then but a student, was asked to keep an eye on him while he recuperated. Suddenly, McCarty threw his head back, bellowed out a wordless roar and hit his own chest with balled fists. His face turned purple, his eyes bulged out of his head, he took “an immensely long gurgling breath”—and he died. Since this was half a century ago, Dr Nuland did what the textbooks then recommended. He cut open his patient’s chest and tried, unsuccessfully, to massage his heart back to life with his bare hands. It felt like “a wet, jellylike bag of hyperactive worms”. And it did no good. The “dead McCarty… threw back his head once more [and gave] a dreadful rasping whoop that sounded like the hounds of hell were barking.”

 

That story is one of several that make up “How We Die”, a book Dr Nuland wrote in 1993, after a lifetime of watching the effects of terminal illness. Because modern life is so clean and orderly, he argued, people expect to die with dignity. But this may be wishful thinking: death can be dirty, ugly and often involves the “disintegration of the dying person’s humanity”. Despite its gloominess, “How We Die” was a huge success, because it addressed with excruciating honesty mankind’s greatest fear.

 

The current debate about health-care reform is in part a debate about death, which is why it evokes such fear. Some of this fear is absurd. Outside a town-hall meeting in Reston, Virginia, last week, a few buffoons likened Barack Obama to Hitler. But most of the protesters are sane. Mr Obama plans to cover millions of uninsured people, says Brittany Tomaino, a young would-be oncologist. He will have to find the money somewhere. That means cuts to Medicare, the government health plan for the elderly, which covers her 95-year-old grandfather, she reckons. “If he needs care, they’re going to give it to someone younger,” she predicts.

 

A slim majority of Americans support Obamacare. But that majority is declining, and the passion is mostly on the other side. Pro-lifers, for example, worry that reform will mean taxpayer-funded abortions. Half of all Americans believe this will happen. Democrats point out that the bills in question do not mention abortion. Pro-lifers respond that the language is vague enough to allow bureaucrats to add abortion funding after the bill is passed. They also fret, like Ms Tomaino, that Mr Obama will deny life-saving treatment to Grandpa to save money. This possibility alarms Grandpa, too. Americans over 65 currently receive, through Medicare, fantastically generous health insurance for which they pay only a small fraction of the cost. Only 23% of them think Obamacare will make them better off, while a growing plurality think it will hurt them.

 

Health reformers always smash up against two unpalatable truths. We are all going to die. And the demand for interventions that might postpone that day far outstrips the supply. No politician would be caught dead admitting this, of course: most promise that all will receive whatever is medically necessary. But what does that mean? Should doctors seek to save the largest number of lives, or the largest number of years of life? Even in America, resources are finite. No one doubts that $1,000 to save the life of a child is money well spent. But what about $1m to prolong a terminally ill patient’s painful life by a week? Also, who should pay?

 

There are no easy answers. Unfortunately for Mr Obama, some of his academic chums have pondered seriously and publicly about the questions. Cass Sunstein, an adviser, has written extensively about which life-saving rules are most cost-effective. Ezekiel Emanuel, a doctor whose brother is Mr Obama’s chief of staff, wrote a paper for the Lancet, a medical journal, in which he proposed a system for determining who should be first in line for such things as liver transplants or vaccines during an epidemic. Among other factors, he suggested taking age into account, with adolescents and young adults getting priority, because they have fully developed personalities and many years of life ahead. This may be philosophically defensible, but it is political poison—Dr Emanuel even included a graph showing voters above and below the ideal age how much less their lives are worth. Conservative talk radio predictably dubbed him “Dr Death”. Republicans vowed last week to outlaw the rationing of care by age.

 

Blithe and distrustful

 

Mr Obama’s supporters say that objections to his reforms are largely based on misunderstanding, fuelled by Republican scaremongering. They have a point. But the Democrats’ bigger problem is that most Americans have pretty good health insurance and no idea how much it costs. Taxpayers foot the bill for the old. Most workers with employer-provided health insurance imagine that their employer is paying for it, when in fact it comes out of their wages. Soaring medical inflation depresses Americans’ standard of living and threatens to bust the budget. The system is riddled with waste. Yet most Americans feel little urge to make it more efficient. When asked if insurance firms should be obliged to pay for expensive treatments that have not been proved more effective than a cheaper alternative, 56% say yes.

 

Few Americans have a clear idea how Obamacare will affect them—unsurprisingly, since even quite basic details are undecided. The uninsured have the most to gain, but they are only 15% of the population. Everyone else has something to lose. Many Americans do not trust the government to do anything much, let alone make decisions about life and death. Small wonder Mr Obama finds the headwind against health reform so blustery.

[Fop 1]

The system is riddled with waste.

 

They need to take the uninsured, chop em up and use their organs to pay off their debt/feed Hilary.

[Park Life 71]

Eaten too much red meat and smoked too many camels??? Poppycock!!! Must have been a gayer.

[ChezGiven 0]

The system is riddled with waste.

 

They need to take the uninsured, chop em up and use their organs to pay off their debt/feed Hilary.

 

Means 'fee for service' reimbursement incentivises physicians to needlessly over-use healthcare resources. Like 'imaging services' that have no benefit but make the doc richer.

[Park Life 71]

The system is riddled with waste.

 

They need to take the uninsured, chop em up and use their organs to pay off their debt/feed Hilary.

 

Means 'fee for service' reimbursement incentivises physicians to needlessly over-use healthcare resources. Like 'imaging services' that have no benefit but make the doc richer.

 

There's a €10 charge here if you visit the doc too much....The Germans love a visit to the "doctor".

[Fop 1]

The system is riddled with waste.

 

They need to take the uninsured, chop em up and use their organs to pay off their debt/feed Hilary.

 

Means 'fee for service' reimbursement incentivises physicians to needlessly over-use healthcare resources. Like 'imaging services' that have no benefit but make the doc richer.

 

It does? Seems to be more than just that.

 

Soaring medical inflation depresses Americans’ standard of living and threatens to bust the budget. The system is riddled with waste. Yet most Americans feel little urge to make it more efficient. When asked if insurance firms should be obliged to pay for expensive treatments that have not been proved more effective than a cheaper alternative, 56% say yes.

Edited September 6, 2009 by Fop

[Fop 1]

The system is riddled with waste.

 

They need to take the uninsured, chop em up and use their organs to pay off their debt/feed Hilary.

 

Means 'fee for service' reimbursement incentivises physicians to needlessly over-use healthcare resources. Like 'imaging services' that have no benefit but make the doc richer.

 

There's a €10 charge here if you visit the doc too much....The Germans love a visit to the "doctor".

 

Cheap Liverwurst.

[ChezGiven 0]

The system is riddled with waste.

 

They need to take the uninsured, chop em up and use their organs to pay off their debt/feed Hilary.

 

Means 'fee for service' reimbursement incentivises physicians to needlessly over-use healthcare resources. Like 'imaging services' that have no benefit but make the doc richer.

 

It does? Seems to be more than just that.

 

Soaring medical inflation depresses Americans’ standard of living and threatens to bust the budget. The system is riddled with waste. Yet most Americans feel little urge to make it more efficient. When asked if insurance firms should be obliged to pay for expensive treatments that have not been proved more effective than a cheaper alternative, 56% say yes.

 

No, the two bits in bold are part of the same framework, evidence based medicine or "comparative effectiveness' research.

 

If a new imaging procedure has no benefit over an older one, the new one will be used since the payment to the doctor is higher, no matter whether the new imaging techniques leads to better patient care.

 

For new medical treatments, the same issue applies but through very different organisational and financial structures, the principle is the same though.

[Renton 18188]

Btw Chez, I'm starting my diploma in health economics at York in a couple of weeks. I've got my work to pay for it but I have to find the time to do it myself. Basically it'll mean no more fucking around on here for a couple of years I imagine . Anyway, thought I'd let you know as I may be sending PMs to you to help me with my homework.

 

Still going to look on here for social events etc.

[ChezGiven 0]

Thinking about going back to school myself. I started a PhD in 1998 but never finished it as i joined industry in 2000 (i was also working full-time at the university so found it a bit hard to juggle everything).

 

Looking at York, LSE, Newcastle and Karolinska institute in Sweden. On a part-time basis obvioulsy. Few things to sort at work first but it could be on.

 

Should be at the QPR match if your about?

[Renton 18188]

Thinking about going back to school myself. I started a PhD in 1998 but never finished it as i joined industry in 2000 (i was also working full-time at the university so found it a bit hard to juggle everything).

 

Looking at York, LSE, Newcastle and Karolinska institute in Sweden. On a part-time basis obvioulsy. Few things to sort at work first but it could be on.

 

Should be at the QPR match if your about?

 

Aye, I should see you there. With it being a wednesday night I'm not sure how many people are going to be around, I'll PM you my mobile number.

[Park Life 71]

Thinking about going back to school myself. I started a PhD in 1998 but never finished it as i joined industry in 2000 (i was also working full-time at the university so found it a bit hard to juggle everything).

 

Looking at York, LSE, Newcastle and Karolinska institute in Sweden. On a part-time basis obvioulsy. Few things to sort at work first but it could be on.

 

Should be at the QPR match if your about?

 

Got to be Sweden.......