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Archive for August, 2009

In all the hate and discontent that dominated the health care debate during the August recess, the facts have been the biggest casualty.  The “death panel” myth has been largely debunked, although significant numbers of people, and a vast majority of Fox News viewers, cling to it.  Interestingly, they are many of the same people who cling to the myth that Saddam Hussein was actively connected to the 9/11 plot, despite the fact that even President Bush finally tried to dispel that one.

Another myth is that a public option will kill private insurance.  The doomsayers contend that it will suck so many people into “free” medical care that employers will drop health insurance benefits like a hot potato, forcing everyone into the government-run program.  That line contains a number of canards, the first being that the public plan would be “free.”  It would, in fact, be paid for through premiums, just like private insurance, whether provided by the individual or partly funded by employer contributions.

The second canard is that it would be the death knell for private insurance.  The Congressional Budget Office, in its evaluations, has stated categorically that it would do no such thing.  In fact, there are good reasons to want a hybrid system.   People’s needs differ when it comes to medical care, as do their ideological preferences.  So it makes sense to have a series of options.  More importantly, public and private systems each have their strengths and weaknesses.  So having the ability of both in the mix will serve to take advantage of the strengths of each.

One of the key reasons for public plan choice is that public plans can offer a set of valued features that private plans are generally either unable or unwilling to provide. Stability, wide pooling of risks, transparency, affordability of premiums, broad provider access, the capacity to collect and use patient information on a large scale to improve care—these are all hallmarks of public health insurance that private plans have inherent difficulties providing. On the other hand, private plans are generally more flexible, and they have, at times, moved into new areas of care management in advance of the public sector. The bottom line, then, is that both public and private plans have unique strengths and weaknesses, and all Americans, not just the elderly or the poor, should have access to the distinctive strengths of a public health insurance plan, as well as the strengths of private plans.

Those people who believe that health care is a privilege, not a right, will not be moved.  They come to the debate from a definite ideological perspective, one that has complete faith in the ability of the free market to provide the necessary access and controls.  I disagree. The market will not put people first.  It cannot by law put people ahead of profits.

As a nation, we agree that there are some things that are best socialized — i.e., done by government.  Public safety is a perfect example.  Just imagine what would happen if fighting wildfires, like the ones currently plaguing California, was privatized.  People who could afford to hire a fire-fighting company or purchase their own equipment to fight it on their own would do so.  People who could not would have to sit by and watch their homes burn.  And what would the additional risk be to those who could afford it if 1/6 of their neighbors (either immediate neighbors or those upwind) could not?  I would wager that not one of the people whose property has been or currently is or may be later today or in the weeks until the fires are put out would argue for privatizing fire fighting.  We turn to the city, the county, the state, and even to federal resources to fight the fires.  If your area is prone to other forms of natural disasters, simply substitute your disaster of relevance.

For me, there is a parallel argument regarding health care.  Making sure that a nation’s population has access to affordable health care is a matter of enlightened self-interest, and ultimately a matter of national security.  A healthy population is more productive.  Healthy children are better able to learn.  And an educated population is required if we are to be competitive in a globalized economy.  Not having a viable social safety net puts American business at a competitive disadvantage.  I support a public option as one among multiple choices simply because ensuring that all Americans have health care is the right thing to do.  It is more economical for individuals, for businesses and for the country at large if we can get costs under control.  Having a public option is part of that process.

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We spent Friday evening in Pasadena, with long-time friends.  It was an evening filled with much love and laughter, great food, good wine and sharing memories that go back half a century.  It was also a time of concern for friends and loved ones who are affected by the Station fire above La Canada Flintridge as that was the childhood home to the four guys whose friendship was the impetus for the occasion.

We spent the night in the area at the home of one of the couples and as we drove up the hill to their home, we could see not only the glow from the flames above La Canada but flames that were crawling east up the ridge line toward Altadena.  At first light this morning, we were awakened by the sound of the choppers as they began anew doing water drops.  The terrain is so rugged that it is almost impossible to gain access on the ground.  So hand crews are concentrating on structure protection — saving homes, the Jet Propulsion Laboratory, and the communications and astronomical observation sites on the nearby peaks.

For those of us who live in Southern California, and probably in much of California, choppers at dawn is a sound that is both frightening and comforting.  Out on the deck with our first cup of coffee, we eagerly opened the LA Times to check on the fire’s progress.  It was already quite warm, and ash was falling even though the sky above was blue.   After a leisurely breakfast, we headed back up to the high desert and home. We live some 50 miles or so from the fire, almost due north over the mountains.

As we drove through the pass that separates the LA Basin from the high desert, the sky grew dark, but an eerie reddish dark, with the sun overhead nearly obscured by the thick, billowing smoke.  The smoke was so thick that the temperature dropped 10 degrees in as many miles.  Were it not for the ominous red cast, you would have expected the area to be about to be hit with a massive thunderstorm. We arrived home in the early afternoon, to a virtual “snowfall” of ash and smoke so thick that it might have been mistaken for fog except for the color and the smell.  By mid afternoon it was so dark that lights were needed indoors for all but the simplest tasks.  Eyes burn, even indoors.

Smoke from the "Station" fire

The particular part of the forest that is burning hasn’t burned in over 40 years.  Prolonged drought combined with high temperatures and low humidity have turned the forest into a tinderbox.  Fire is almost inevitable under those conditions.  The good news in all this is that there are no Santa Ana or devil winds in the forecast.  Surely, were that to occur, hundreds of homes would be destroyed as burning embers are carried into older neighborhoods with their cedar shake and shingle roofs, dried out over the years.

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Senator Edward M. Kennedy was witness to and participant in some of America’s greatest triumphs and tragedies over the last half century and more,  but perhaps the greatest irony is the timing of his final illness and death.  His absence during this year’s August recess has been critical.  He represented one of the last members of the Senate who understood and practiced the collegiality that characterized that body for most of its history and allowed rivals to work together to accomplish important work.  He was an important champion of the little guy.  But the singular issue of his public life remains ahead, still to be accomplished.

[Q]uality care shouldn’t depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to.

This is the cause of my life. It is a key reason that I defied my illness last summer to speak at the Democratic convention in Denver–to support Barack Obama, but also to make sure, as I said, “that we will break the old gridlock and guarantee that every American…will have decent, quality health care as a fundamental right and not just a privilege.” For four decades I have carried this cause–from the floor of the United States Senate to every part of this country. It has never been merely a question of policy; it goes to the heart of my belief in a just society. Now the issue has more meaning for me–and more urgency–than ever before. But it’s always been deeply personal, because the importance of health care has been a recurrent lesson throughout most of my 77 years.

– Ted Kennedy Speaks Out on Health-Care Reform in Newsweek

His goal was remarkably simple — quality, affordable health care as a fundamental right, not a privilege.  And yet it has eluded us ever since the Great Depression.  Every other industrialized nation in the world recognizes health care as a fundamental right.   Not just access to health care in the emergency room because you can’t afford or obtain private insurance. But health care that comes with a measure of basic human dignity.

I don’t understand why President Obama didn’t speak early on to the moral obligation we have to the weak among us.  That is an obligation that is common to people of faith and to non-believers alike.  In a perverse way, that obligation was what Sen. Tom Coburn (R-OK) was alluding to when he suggested that a desperate woman turn to her neighbors for help with her husband, who suffers from a traumatic brain injury.   Unfortunately, the needs of her husband are most likely beyond the ability of her immediate neighbors.  But we are all her neighbors.  And we share in our obligation to her husband and to the millions of other Americans in need.  Individually, we cannot do much.  But together we can accomplish the goal of a healthy nation.

Senator Kennedy’s Senate career wasn’t about him.  It wasn’t about the rich and powerful.  It was about the regular guy.  Sure, he came from privilege.  But he grew up hearing that the very fact of his privilege meant that much was expected of him.  Little did he know the extent of those expectations!  There are those who discount the impact that Ted Kennedy had on all of us, those who choose to focus only on his failings, especially on Chapaquidick.  But we all have failings, and the measure of a man is not just his failings but what he accomplishes despite those failings.  None of us is perfect.  We all have failings. If we truly believe in the power of redemption, we look beyond the failings to see what comes after.  Can we band together, enough of us, to find common ground and make the cause of his life a reality?

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From what we’ve been seeing from Republicans supposedly “negotiating” on health care reform, it’s reasonable to ask if they are negotiating or obstructing.  Negotiating presumes a willingness to compromise.  Each side gives something to arrive at a solution.  While nobody gets all they want, neither do they have to give up everything.  But compromise seems to be operative only among Democrats.  Republicans, on the other hand, continue to throw up roadblock after roadblock each time the Democrats show any signs of compromise.  Is compromise viewed as weakness among Republicans?  It would seem so.

Perhaps this debate has brought into focus a fundamental difference between today’s Democrats and Republicans.  I saw the first indications of it during a GOP governor’s first term in New Mexico nearly 20 years ago.  But the mantra can be characterized by Ronald Regan’s pronouncement that government is the problem.  A Republican who had run a successful business ran for and was elected governor of New Mexico.  As owner of a business, he was accustomed to getting his way, to having people do what he asked them to do.  After all, if they didn’t, he could fire them.  But he quickly discovered that governing is an entirely different activity, requiring both the ability and the willingness to negotiate and to compromise.  And therein lies the difference.  It appears that Democrats truly want to govern, while Republicans prefer ruling.

The kind and tone of the opposition has made it apparent that the only “reform” the GOPers are interested in is no reform.  Oh, they mouth words that say they support reform, but they aren’t contributing anything positive to the debate.  They talk privatization, letting the market rule.  Well, just look at the financial collapse last fall and you have a really good assessment of how well unregulated markets work.  Why, even Alan Greenspan, that beacon of free-market capitalism, has admitted that it didn’t work very well.

Finally, a member of Congress has called it like it is in an op-ed piece in USA Today.  He says it’s time to forget bipartisanship and use the tools available to make the large Democratic majorities in both houses of Congress work like they’re supposed to.

The Gang of Six seems to be crumbling.  Yesterday there were hints that even without a public option, the GOP members of the group were demanding additional concessions.  Sen. Grassley (R-IA) allowed as how he wouldn’t vote for anything but a “perfect” bill.  By today he is saying that bipartisanship is impossible. Also today, Sen. Jeff Bingaman (D-NM) suggested that the reconciliation process might be the only path to reform.  That is unfortunate, but without cooperation from Republicans, it’s the only way.

It’s time to listen to the American people instead of the corporate shills.  The shills have stirred up enough trouble, enough hate and discontent.  In case you’re still laboring under the impression that “ordinary Americans” are populating those raucous town hall meetings, ask yourself why they only show up at meetings held by Democrats.  Then, look at the chart below, which was published today by the Campaign for America’s Future.

Who's Paying to Kill Health Care Reform?

We’ve been waiting for health care reform for decades.  It’s time to stop letting Sen. Grassley’s perfect become the enemy of the good.  Let’s pass it, see how it works, then tinker with the parts that need improvement.  Otherwise, we’ll continue to see the numbers of uninsured rise along with costs.  Republicans cried that Social Security and Medicare were socialism.  Democrats ignored the naysayers and passed both.  Now, they are integral parts of our social safety net, programs that while imperfect, are considered essential by all but the most reactionary people among us.

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Yesterday’s announcement by Attorney General Eric Holder and the release of the CIA’s IG report finally confirmed what many Americans had figured out long ago — the CIA, and its contractor interrogators, working at the behest of the Bush Administration had, in fact, engaged in torture.  Even though about half of the report is still redacted, what isn’t catalogs a litany of actions that can only be described as medieval, worthy of the Inquisition.  Furthermore, these actions are clear violations of the federal laws against torture.  And people who are familiar with the entire report say that the redacted portions contain information of even more egregious actions.

In our national panic following 9/11, we chased security.  It’s not the first time in our history that we’ve done that.  The internment of thousands of Japanese-Americans following the attack on Pearl Harbor was a similar over-reaction.  We now know that those people were no threat, that they were in fact loyal Americans.  But at the time, they were the “other” and anything we did to them sort of didn’t count.  So long as it made us feel more secure.  Our response after 9/11 was similar.  Except that the “other” was thousands of miles away.  So we pulled out all the stops, turned to the “dark side” and operated in the shadows.  We’re still paying for those excesses, and we will continue to do so for years and decades.

The arguments against using torture are well-known.  There are other, more reliable means of obtaining information.  Torture in the long run puts our own troops and civilians in more danger should they be captured.  And, finally, simply that torture is morally wrong.

But even the moral argument doesn’t hold much water with members of the GOP leadership — those same people who are so worried about “pulling the plug on grandma.”  Once again, they’re pulling out that tired card from their arsenal — fear.  No sooner than AG Holder had announced the appointment of a special prosecutor to look into the CIA abuses, they fired off a letter to him warning that such an investigation would most certainly put us in greater danger of another terrorist attack.  That’s the same card they’ve played ever since 9/11 relative to any criticism of the Bush Administration.  And it’s the same fear card they’re playing on health care reform.  It should surprise nobody for it’s the same card the GOP has played during previous attempts at health care reform, at the initiation of Social Security, of Medicare.

It’s time to call them out.  The Senators who wrote AG Holder were U.S. Senate Republican Whip Jon Kyl (Ariz.) was joined by U.S. Senator Kit Bond (R-Mo.), Vice Chairman of the Senate Intelligence Committee, U.S. Senator Jeff Sessions (R-Ala.), Ranking Member of the Senate Judiciary Committee, U.S. Senators Richard Burr (R-N.C.), Saxby Chambliss (R-Ga.), Tom Coburn (R-Okla.), John Cornyn (R-Texas), Chuck Grassley (R-Iowa), and Orrin Hatch (R-Utah).  The names are a familiar bunch.  They are the same bunch who opposed the nomination of Justice Sotomayor, who deny that our addiction to fossil fuels has anything to do with climate change, who oppose health care reform.  And, if asked, they would all assure us that they are firmly pro-life.   But they’re also firmly pro-war, so I guess it all depends on which lives are in question.

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A number of  news stories caught my eye in the last day or two.

  1. Despite the fact that there are some 1300 health insurance companies in the US, Blue Cross Blue Shield is the behemoth, cornering more than 50% of the market in at least 16 states.  The past decade has seen massive consolidation of health insurance companies.  In my own case, our local HMO has been purchased by another in the past year and the insurance company has been bought up by one of the other major carriers.  Sen. Olympia Snow (R-ME) acknowledges that lack of competition leads to higher premium costs.
  2. The Commonwealth Fund, a 90-year-old nonprofit health care charity predicts that unless we can figure out how to rein in costs, premiums are on a trajectory to double in the next decade.  By 2020 they predict that a family of four will be paying nearly $24,000 for health insurance, plus whatever deductibles, co-pays, etc. will be required to actually obtain health care services.
  3. Sen. Joe Lieberman (I-CT) thinks that we ought to wait until the recession is over (whatever that means) to worry about covering the uninsured.  Anyone care to guess how many million more Americans will have to forgo medical insurance if the Commonwealth Fund’s estimates are correct?
  4. We’ve known that medical/dental tourism is rising, especially among seniors and the uninsured as a way to fight costs.  Yet, now we hear that some insurance companies are considering covering treatment obtained in places like India, Costa Rica and Thailand.  I’m not saying that the care in those places is not good.  I don’t know.  But I’m sure not happy about outsourcing medical care along with everything else we’ve sent offshore.
  5. And the last story will appear in tomorrow’s Los Angeles Times.  It reports that under most of the plans under considerations, the big winner will be…. you guessed it — the insurance companies.

I think it’s time to talk about a national single-payer system.  It’s simple, easy to administer, and it’s on the table.  Just think, it would cover everyone.  Think of it as Medicare-for-all with its minuscule administrative costs.  People could opt out, provided they obtained private coverage.  As with Medicare, you could choose your own doctor and hospital.  Employers wouldn’t have to provide health care benefits, so those funds could actually go to the employee as salary — funds that could help go toward secondary insurance to cover the 20% that Medicare doesn’t cover.  Secondary insurance costs seniors in the neighborhood of $250 a month, depending on what all it covers.  It would mean that our emergency rooms would be returned to serve actual emergencies, not as primary care facilities for the uninsured.  By including everyone (or nearly everyone) in the pool, the per person cost plummets because the pool includes lots more young, presumably healthy people.

Let’s stop the trash talking and the intimidation.  Let’s stop the lies.  It’s time to get on with real reform.

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Remember the woman at one of the town halls a couple weeks ago who tearfully pleaded with the Congressperson that she wanted her country back?  Well, so do I.  But I doubt that she and I would agree on any of our respective reasons.

I want my country rescued from the extremists on the right — the people who are so paranoid that they bring armed assault weapons outside the President’s appearances, just because they can, the people who are so fact-deprived that they believe the myths promulgated by the corporate public relations operations to scare people.  Those actions don’t help the cause of debate, and they aren’t intended to do so.  The guns and the shouting are pure intimidation.  I want my country rescued from media outlets (on both sides) that seem to think it’s necessary to give these nutcases exposure in the guise of “fairness.”  I’m tired of the fact that so few in the media are calling the extremists out.  It’s time to label them extremists and to marginalize them.

A majority of Americans voted for Barack Obama and his promise of health care reform.  The Democrats have large majorities in both houses of Congress. A majority of Americans (much larger than the majority that voted for Obama) favor having the choice of a public option in the mix. In theory, this thing ought to be a slam dunk.  So, what’s the problem?

The latest GOP ploy is to up the ante.  They’ve made it clear that they aren’t going to support reform, no matter how much it’s watered down. Senator Jon Kyl (R-AZ) has finally admitted as much.  So, frustrated that there are 60 members (a filibuster-proof majority) in the Senate’s Democratic Caucus, they want to change the rules.  They want to play Calvin Ball*.  They’re claiming that health care reform is sooooooooo important that it should require a 75 or 80 vote supermajority.  Talk about the tyranny of the miNOrity!

A supermajority of Americans just about that size — 77% — support not just health insurance reform that would end shutting people out of insurance for pre-existing conditions or rescinding coverage because they get sick.  But 77% support giving Americans the choice of a public option.  Americans understand that a public option is needed to “encourage” the insurance companies to rein in their costs in order to be competitive.  It’s called accountability. So, one must ask why Congress isn’t getting that message.  It’s pretty simple.  It’s called the color of money… the vast amounts of campaign contributions and lobbying money coming from the interests who want things to stay just as they are.

This whole debate has brought into sharp focus just how corrupt the system is.  Not only do Americans need health care reform — both individually and as a society if we are to regain our competitive status in a global economy as we work our way out of the worst recession in 70 years.  But we need reforms in how we finance elections and in how much power corporations and special interests have over Congress.  We are no longer a government of, by and for the people.  We are a government of by and for the corporations and the lobbyists and the special interests.  A good start would be to change the law that gives corporations “personhood.”  Then, we need public financing of campaigns (or at a minimum had small limits on the amount of money any entity (person, company, union or whatever) could give to a candidate OR an issue.  Those two things would go a long way to put government back in the hands of the people.

We’ve seen how supposedly grassroots efforts, financed by corporate public relations budgets and publicized by the likes of right-wing talk radio and right-wing news sources, have captured the debate — in the halls of Congress, in the town halls, and certainly in the media reportage.  I say, ENOUGH.

*Calvin Ball — a game played in the comic strip “Calvin and Hobbes” where Calvin would arbitrarily change the rules any time he thought he might be losing.

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