Lies, damned lies, and the people who tell them

A big part of the reason I began this blog was to shed “more light than heat” on current issues.  It would be preferable to call out both parties when they need some facts (light) injected into the heated political debate.  With the changing media business model, too often the media fails in its duty to fact check and too often gives equal weight to both sides of a debate as if the facts support both sides equally.  The result is that talking points, which have been tested in focus groups for maximum impact, are presented as fact instead of what they are — points intended to persuade, not enlighten.

Context is critical in understanding comments and sorting through the talking points.  Case in point was the exchange between Sen. Lamar Alexander and President Obama at last week’s health care “summit.”  Alexander claimed that premiums would rise if the proposed reforms are enacted.  Obama countered that they would go down.  Turns out that both are correct, but the President provided the needed context to understand how that seeming contradiction could both be correct.  Yes, premiums would decline, according to the Congressional Budget Office.  But the CBO also said that many people would end up paying slightly more, and here’s where the context is critical.  They’d pay more because for a bit more money they could afford much better coverage, and many people would opt to do just that — pay a little more for a lot better coverage.

Now, let’s look at the claim about the so-called “death panels” — the supposed government plot to kill old people.  Nothing could be farther from the truth.  The provision that led to those wild claims was that Medicare (or one’s private insurance company) could be billed by doctors when they counsel patients and families either when drawing up (or revising) a living will or in guiding decisions on when palliative care might be considered instead of restorative care.  Without such plans in place, the medical profession must do everything possible to keep the patient’s heart beating, regardless of what the patient and families might want done.

Another of the GOP talking points is that reform would strip half a trillion dollars from Medicare.  Again, true, BUT not from benefits received by seniors.  What it would do is strip out the additional 14% that insurance companies charge the government for services provided under Medicare Advantage.  That’s an additional 14% that goes directly into the coffers of the insurance companies.  While it is true some seniors cannot afford insurance to pay for expenses not covered under Medicare Part B, targeted subsidies could cover them at lower cost than the 14% surcharge.

The latest deception is the conflation of reconciliation with the “nuclear option.”  Apparently, an up or down vote is only desirable when your party is in power.  The term “nuclear option” was first used by Republicans when Democrats threatened to filibuster President Bush’s judicial nominations.  But it is so emotionally powerful an image that they are now using it to describe reconciliation — the very same process that was used by Republicans in passing the Bush tax cuts!

And speaking of reconciliation… Sen. McCain, on one of the Sunday shows, harrumphed that reconciliation should never be used for entitlements.  Yet he previously voted for Medicaid cuts and cuts to docs (the precursor to the annual “doc fix”), which were both done through reconciliation.  Perhaps the most intriguing statements concerning reconciliation were made recently by Sen. Lamar Alexander.  On Sunday, he fumed that if the Democrats use reconciliation to bring the House and Senate versions of the health care bill it would be the beginning of the end.  End of what?  End of the Senate’s protection of minority rights.  Given the history, especially recent history, of GOP antipathy to minority rights, this was laughable.  But Monday he topped it, promising that the GOP would use … [drum roll] … RECONCILIATION to repeal health care reform.  That statement is laughable on at least two counts.  First, it is an indication that the GOP figures that the health care reform package, imperfect as it is, will pass.  Second, the good senator is either delusional or ignorant of the rules about presidential vetoes.  Should the Senate actually repeal health care reform, President Obama is certain to veto the repeal, regardless of how it is passed.  And it requires a 2/3 majority (even more of a super-majority than to end a filibuster) to override a veto.

And then there is Sen. Jim Bunning… currently operating as a one-man wrecking crew, thumbing his nose at the nation’s doctors, the unemployed, federal highway workers, and anyone who just happens to live in a flood plain.  That’s a pretty large number of folks when you add them all up.  Bunning has taken obstruction to new heights in the name of fiscal responsibility, but he was on board when the GOP pushed through the Bush tax cuts, Medicare Part D, and two wars — all of which were unfunded and that represent far more money than his current grandstanding.

Yes, the Dems can’t claim total innocence, but we’re currently in the midst of the greatest recession in 70 years, fighting two wars, and dealing with a health care crisis that Warren Buffet compares to an economic tape worm — demanding an ever greater portion of our total economy.  It’s time to starve the beast of corporatism by imposing some common-sense regulations.  Regulations that the Founding Fathers understood were necessary to prevent the country from devolving into an oligarchy, wherein power was concentrated in the hands of a relative few.  I suspect those august men (and women) are whirling in their collective graves at what we are rapidly becoming.

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Half a loaf or kill the bill?

As many as 60 million Americans lacked health insurance at some time in 2009.  That staggering number represents 1 in 5.  As disappointed as I am that the public option and an expansion of Medicare have been compromised away, along with a single-payer system which was compromised away before negotiations began, I’m not willing to throw the entire bill out.  Yes, it benefits the health insurance cartel.  But it covers over 30 million people who are currently without coverage.  One argument has been missing from the debate — that 45,000 annual deaths due to lack of coverage is immoral.

As a nation, we concluded that 45,000 deaths each year from traffic accidents was unacceptable.  And in response we instituted improved safety requirements for our vehicles — side mirrors, safety belts, shoulder harnesses, driver side airbags, passenger side airbags, side impact airbags, anti-lock brakes.  That has reduced the total number of deaths annually to under 40,000, despite an increase of over half a billion miles driven.  Why aren’t we similarly concerned about 45,000 deaths each and every year that result from lack of health care?  We know that the safety mechanisms that have contributed to fewer traffic deaths have increased the cost of vehicles.

Liberals and progressives are understandably angry at how much we have had to compromise, and yet a final bill remains in doubt at this late date.  In fact, some prominent progressives are playing right into the GOP’s hands by suggesting the right course of action is to kill the bill.  I’m reminded of what the late Sen. Kennedy identified as one of his greatest professional regrets — his unwillingness to compromise on a health care bill early in his career.  Are we ready to let the search for the perfect bill sidetrack us from any and all reform?

Thirty million more people insured.  Universal standards for preventive and wellness benefits.  People with pre-existing conditions will be covered.  Insurance companies will be required to spend 90% of premiums on patient care.  Exchanges will offer the opportunity for individuals to obtain group rates and will include some not-for-profit choices among them.  Lifetime caps will be eliminated.  The cost curve will begin to bend downwards.  Medicaid will be expanded to cover more people, and subsidies will be available to those in need but who do not qualify for Medicaid.  Excess payments made to insurance companies through Medicare Advantage will be cut.

Nate Silver posted a graph — the proverbial picture that’s worth 1000 words — using CBO figures to show how insurance will be made more affordable under the bill than by retaining the status quo.

If we can make health care more affordable and more accessible, we can then work to make our health care system better.  I for one am willing to take half a loaf at this moment.  But I will continue to press for more reforms.  For to do otherwise is immoral.  We must not forget those 45,000 people who die each year from a lack of health care.  We owe them no less.  They are human beings who love their families and who are loved by them.  And if we take seriously the words of the Declaration of Independence, that we are all created equal and that we all have the right to life, liberty, and the pursuit of happiness, then we all have the right to health care.

John Podesta has a piece on Think Progress that defines in more detail why progressives should get on board with the bill.  Again, it’s not perfect.  Not by a long shot.  But in our frustration, let’s not forget that politics is the art of the possible.  There are lots of things that will become possible if the Senate bill passes.  Things that aren’t part of the status quo that killing the bill represents.

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A gift for Joe?

It’s the season for giving, and Joe Lieberman of Connecticut may find that his gifts may be something less pleasant than he might like.  Since he announced yesterday that he will filibuster health care reform unless both the public option and the Medicare buy-in are dumped, an effort has begun to support an opponent for the senator.  Already over $1.5 million has been pledged by some 30,000 people via a Facebook page.  Here‘s the press release.  This approach seems more productive, if less emotionally satisfying, that Huffington Post’s call for suggested Hannukah gifts for the senator.

As much as I’d like to see Sen. Lieberman dumped by the good people of Connecticut, I’d also like to see some more immediate pressure put on him.  Let’s not forget that as recently as 90 days ago, Joe Lieberman supported expanding the pool of Medicare recipients. His new line is that the Finance Committee bill already had reforms included in it that would help people in the 59-64 age group and the Medicare buy-in plan is therefore duplicative.  The fact that he opposed the Finance Committee bill seems to have been lost on him.  His office is trying to explain his sudden change of heart, but their reasons ring hollow.

Just last week he promised to wait until the Congressional Budget Office had come back with their scoring of the revised Senate bill.  Could it be that he has figured out that expanding Medicare won’t actually be a budget buster after all and that in order to placate his insurance company masters, he had to undercut the CBO report?  Unless he’s as petty as Chris Matthews suggests — that his stance is revenge served cold, payback for the Democratic Party’s failure to support him in his last Senate race — it’s about the only thing that makes sense.

I’d respect him a bit more if he just told the truth — the health insurance giants, many of whom are headquartered in Connecticut own him lock, stock and barrel.  No matter that 60% of the people in Connecticut support a public option.  He doesn’t care about that because he knows that the insurance companies will fund his next campaign.  And that brings me back to where I started.  We the people simply must support those who follow through on their promises to stand up for the people.  If they do not, we have the power of the ballot box.  We can vote them out.  It takes work to stay engaged, to keep track of what our legislators say when they talk to us and then how they vote.  We must hold them accountable.

President Obama wasn’t given much of a chance by the pundits when he began his campaign for the White House.  But he organized people.  And they, we, worked phone banks, gave money, rang door bells.  And we voted.  Let’s work to give Joe, and others like him the boot.

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Large type for challenged readers

The Republicans have made a lot of political hay about “the massive” health care reform bills — comparing them to Tolstoy’s novel War and Peace, often cited as the world’s longest novel.  Once again, their political hay is full of little more than hot air.  It’s easy to expand something written by increasing the margins, enlarging the font and setting extra wide margins.  While that may make it easier to read, much like the large print books for visually challenged readers, those tricks don’t make it longer.  It just kills more trees.

The official version of the Senate’s health care bill has been printed in the Congressional Record.  It comes in at 208 pages — not over 2000!

A more accurate way of gauging the length of a written piece is to count words.  The House version of the health care reform bill comes in at just over 318,000 words;  the Senate bill is some 1500 words shorter.   As a matter of comparison, No Child Left Behind came in at 280,000 words.  Tolstoy’s War and Peace, depending upon which translation is used weighs in at a whopping 560,00 or even 670,000 words!

So, once again, the GOP leadership is using sleight of hand deception to create the image of big government.  Let’s be honest.  The conservatives would like nothing more than to see 100% of the federal budget used for defense.  All these regulations just get in their way.  And if that’s what you like, I would caution you to consider what has happened to our economy each and every time in our history when unfettered capitalism gained primacy.  The stock market crash of 1929, followed by a decade-long Great Depression; deregulation of the savings and loan industry, followed by its collapse in the early 1990s; and our current financial debacle.  The common causal thread in all of those events was a distaste for regulation and the inevitable greed that deregulation unleashed.

Republicans as a group seem to be plagued by short memories.  While ignorance of history might be understood (not forgiven, just understood), Dana Perino’s latest pronouncement takes the cake.  After demonstrating her ignorance of “ancient” history (apparently defined as anything prior to her birth) when she allowed as how she didn’t know about the Cuban Missile Crisis, she has topped that by stating on Fox News that there wasn’t a terrorist attack during George W. Bush’s term while condemning the Fort Hood attack as terrorism.  To be sure, 9/11 happened before she became Bush’s press secretary, but it cannot be denied as a seminal event of his presidency.  Pathetic.  Ignorant.

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Needed: Primary Care Physicians

One aspect of the health care discussion hasn’t gotten nearly enough attention.  This nation is woefully short of primary care physicians.  And, assuming something passes that brings at least some of those currently uninsured into the health care system, providing that care via primary care docs will be a huge challenge.  The reality is that doctors can make more money (and thus pay off the debts incurred during college and medical school) in a specialty rather than as a front line provider.  So, rather than leaving more people out of the system, let’s look at creative ways to encourage more medical students to go into internal medicine, family practice or general practice.

A generation ago, California lacked teachers to educate the baby boomers’ kids.  So, a policy was adopted to forgive 10% of a student’s debt (up to 50%) for every year they taught.  I benefited from that policy, as did thousands of other people.  Today, New York City has a program to pay for teachers’ masters programs if they teach in the inner city schools.  My niece’s daughter has a masters degree from Fordham University, courtesy of that program.  In the process, she gained experience as well as education, having taught two years in a Bill and Melinda Gates Foundation-sponsored school.  Why couldn’t we do something similar to encourage doctors to go into primary care?  The need is great, and there are a number of things we can do both immediately and in the long term.

Urgent care facilities:  Hospital emergency rooms are the most expensive option to obtain primary care.  Yet, many cities and towns have urgent care centers that are closed at night.  These are a lower cost option than the hospital emergency room.  Why open them at night and come up with a way to pay them to service the uninsured until we can get everyone covered?

Physician assistants and nurse practitioners: These professionals can provide routine care.  They need to be utilized to the maximum extent possible as front line providers.  While there are limitations in what they can do to provide care, their skills are not only adequate but appropriate for routine health care needs, freeing up physicians for those cases that require more detailed diagnosis and treatment.

Recently my husband spent about eight hours in the ER for a situation that required attention in the middle of the night but which was not life threatening.  We arrived at about 3 a.m., and like most ERs, it was busy and became busier once the sun came up.   Patients were stacked up waiting for a bed to clear, and during the wait, there were two and three EMTs for each patient who had to wait until their patient could be transferred from their gurney to a bed.

Here’s my proposal for immediate implementation:

Develop urgent care centers that work in concert with hospital ERs.  A triage process already exists to ensure that critical cases are seen ahead of non-emergency ones.  Those non-critical cases could be diverted to the urgent care facility.  And the urgent care centers could be staffed with physician assistants and nurse practitioners, with a physician available if needed.  The physicians there would not need to be emergency medicine doctors, as the cases seen there would have already been determined not to require that level of training.

In the mid-term range, if we lack sufficient PAs and nurse practitioners, a crash program could be initiated to increase their numbers.  Incentives to encourage people to enter this profession could come in the way of forgiveness of loans or even paying outright for their professional education, provided they commit to a given number of years of service — at prevailing wages.  It’s an investment in our health care future.

In the long term, the need for additional primary care doctors remains.  Yet, the same incentives outlined above could be used as incentive for doctors — albeit with a longer commitment of time.

Do we really need more plastic surgeons to do face lifts and breast implants?  I think not.

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Is anyone listening?

My current Congressman is a conservative Republican… not so conservative that he falls into the wingnut category, but close.  I’m what someone called a faint blue light in a sea of red.  So I make a point to communicate with him fairly regularly, if only to remind him that he also represents people with views that don’t conform to his own.  And if I get any response, it’s a blanket canned one repeating all the GOP talking points.  It’s as if he doesn’t have an original thought in his head but simply responds out of obligation, using the same pre-recorded message to everyone.

My most recent communication was on health care.  I use the term recent rather loosely, because I had forgotten what I said.  After reading through the tirade on how we must protect the insurance industry from the inevitable collapse that would result from “government-run” health care — at least he’s gotten off the death panel bit — my blood pressure was rising, so I fired off a response.

I pointed out to him that when he first ran at least 5 terms ago, he promised to serve only 2 terms.   So much for that promise.  I also pointed out to him that he was already receiving government run health care as he is eligible for Medicare.  Whether he also uses one of the health insurance plans available to Congress and all other federal employees, he is automatically enrolled in Medicare Part A.  I challenged him to give up his government-funded, government-run health care programs.  Will he?  Certainly not!  So I asked how he figured he could in good conscience participate in something that he obviously didn’t think his constituents were worthy of.

I’ve probably had a wider range of experiences in the health care system than he has.  I benefited from the federal health care system for a number of years, thanks to my former husband’s employment as a civil servant.  I’ve had employer-provided health insurance (and paid my portion of the premiums).  I’ve been in the private insurance market, with its high-cost-low-benefit policies, been denied coverage, had coverage canceled after filing a claim, and been uninsured.  I have experienced first hand the limitations of “managed care” with its gatekeepers, limited choice of providers and the like.  And next year, my husband’s company has eliminated choice of plans altogether — there is one insurance plan for all employees.  In contrast to my own experiences, this summer I’ve seen how Medicare with a private supplemental policy works, thanks to my mother-in-law’s health crisis.

If I had a vote on health care reform, it would be Medicare Part E (for everyone).  It is a system that has been in operation for over a generation — i.e., no new bureaucracy and a proven track record.  Participants pay a monthly premium of about $100 and most supplement that with a secondary, private plan.  By bringing millions of additional people, many of them healthier than the senior population, into the system, per capita costs would automatically go down.  Everyone would be covered.  And the insurance companies would be able to sell those supplement policies to a huge pool of people.  Just as they do with the current Medicare supplements, insurance companies would compete with each other in that secondary market.

Medicare cannot refuse people because of a pre-existing condition — nor can the insurance companies who provide Medicare supplements.  And they cannot cancel your coverage when the bills start coming in.  Everyone 65 or older is included now.  Why not simply remove the age restrictions?

It is true that reimbursement rates for Medicare are lower than for other insurance plans.  But doctors would be able to streamline their administrative activities.  The bills would automatically go to CMS for payment.  Currently, doctors must maintain a billing department whose function is to deal with insurance companies — getting prior approval for treatment and fighting for payment afterward.  That cost of doing business would go away, more than making up for the reduced reimbursement rates.

Younger people argue that they are paying for the care of the elderly because their own medical costs are low.  True, UNLESS you get into an accident or contract an illness.  And if they do have a medical catastrophe, those who are uninsured can still get treatment.  If they can pay, they are generally bankrupted.  If not, the providers absorb the costs.  And those of us who are insured pay for the care of the uninsured — to the tune of about $1000 each per year in increased premium costs.  Every rational person admits that the current system isn’t working.  The challenge becomes how to have a real discussion — looking at what is best for the American people, rather than how to preserve campaign contributions.

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Speaking up works

In the months since President Obama was inaugurated, many people who voted for him have been disappointed that change hasn’t happened more quickly, that some of the cherished changes haven’t happened yet.

Sen. Reid has just announced that he is sending a consensus health care reform bill to the Congressional Budget Office for scoring.  The good news is that a public option is still alive and well.  Apparently, the “opt-out” version is the one that will be going to CBO for scoring.  This represents huge progress for the millions of Americans who are struggling to pay for health insurance and health care.  And it demonstrates that when people speak up, the Senators listen.  Despite repeated polls that consistently showed public support for increasing choice and competition, the lobbyists’ voices seemed to be carrying the day.  Late last week, the tide began to turn.  Why?  Because hundreds of thousands of people took the time to telephone their elected representatives, voicing support for the public option.

True, the proposal Sen. Reid is sending to the CBO may not be as robust as some would prefer.  It’s a long way from single-payer.  But it represents a sea change from what health insurance reform looked like just a few weeks ago.  The opt-out system as currently proposed would give individual states a year after implementation to decide they don’t want their citizens to be able to participate in a publicly-run, not for profit, self-sustaining insurance plan.  The challenge facing the Senate leadership is essentially a political and procedural one — how to ensure that a threatened filibuster can be avoided or broken.  That requires all 58 Democrats and the 2 Independents who caucus with them to stick together.  Should any one of them not vote for cloture, meaningful reform could not happen.  A final vote would require only 50 Senators to approve it, with the Vice-President casting the tie-breaking vote.

Sure, in an ideal world, this issue would have some measure of bipartisan support.  But as Sen. Reid pointed out, unlike in previous years, he can count the total number of moderate Republicans on two fingers.  In the past, moderate Republicans were able to work with Democrats to forge the kinds of compromises necessary to get bills passed.  Things have changed.  Those two GOP moderates are under enormous political pressure to block change.  So Democrats must go it alone.

One of those moderates, Sen. Olympia Snowe, prefers a trigger to the opt-out plan.  It presumes that the industry will voluntarily comply work to lower rates.  Absurd!  Rather, the public option should be open to anyone who is dissatisfied with their current insurance, not just those who are currently or find themselves uninsured.  And it should be implemented much sooner than 2013.  Else, like the banks have done in anticipation of the new credit card regulations taking effect that would limit interest rates, rates will rise before the new requirements are implemented.

My personal belief is that health insurance companies should not profit from the misery of their customers.  Being not-for-profit doesn’t mean that they should operate as a charity or that their executives shouldn’t be compensated, but the greed that is an inherent component of capitalism shouldn’t get between consumers and their health care.

The lesson of the past few weeks in the health care reform debate is that concerned people do matter.  As horror stories of real people who were denied coverage, or had coverage rescinded or found that despite insurance, they had been bankrupted by medical bills began to cut through the stories of doom and gloom promoted by the industry, people got angry.  And they spoke up.  On a single day, over 300,000 calls came into Congressional offices.  Think about it.  One in ten people took the time to get involved.  We are, in fact, the change we’ve been waiting for.  We just need to take action.

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Several pieces worth reading and considering — UPDATED

Over the past year, I’ve repeatedly said that we need a strong two-party system and that the GOP’s current incarnation isn’t helpful to the democratic system of give-and-take.  I’ve wondered why the party seems to lack adult participation.  I recommend several recent pieces for your consideration.

First, a Tom Friedman op-ed piece that’s nearly a month old.  Friedman has been on the “green” bandwagon  for some time, and I’m finally getting into his most recent book Hot Flat and Crowded in which he follows up on the thesis that our global economy, assisted by communications technology, is flattening the world and offering opportunities to provide services and reach customers regardless of where the parties to the transaction are located.  In order to survive this sea-change, we need to recognize both its threats to the status quo and the opportunities it presents.  His latest work makes the case that China is doing a better job than the US is in preparing for a world that will necessarily rely more heavily on alternative forms of energy.  In this op-ed piece, he points to the autocratic nature of the Chinese political system to force the necessary changes and in a similar vein bemoans the stagnation of the US political environment, even though it is effectively, at the moment, also a single-party system.

Then, today Neil Gabler penned an op-ed piece in the L.A. Times that may shed additional light on the same debate.  Gabler compares our current political climate to fundamentalist religion, in which negotiation and compromise have given way to a doctrinaire certainty that there is only one correct solution and that any disagreement is tantamount to heresy.  While I’m not totally objective, I do think that the Dems have shown more willingness to compromise and to negotiate than have the Repubs — the health care debate being the most current example.  Many Democrats actually prefer a single-payer system — Medicare for everyone — as the optimal solution.   But that was taken off the table even before the debate and the compromising began.  Indeed, the compromises have been driven by the need to have a solution that can obtain the 60 votes necessary to end a certain GOP filibuster.  Meanwhile, despite what Sen. McConnell claims, there have been few efforts on the part of the GOP to do more than obstruct.

Much has been made of the influence on and even control of the GOP by the likes of Limbaugh, Beck, Hannity and others, including the right-wing bloggers.  Since last November, several conservative voices have tried to criticize Limbaugh, only to be taken to task by the base to the point where they’ve had to beg for his forgiveness.  David Brooks, who I’ve long considered one of the more sane voices coming from the right is the latest to try to marginalize the likes of Limbaugh and Beck and their corrosive effect on the way we do politics these days.  And Sen. Lindsey Graham (R-SC) recently opined that the “birthers” are crazy, and that Beck is not so much a Republican as he is a cynic.

Could it be that there is a growing recognition among the pragmatists in the GOP that the party is becoming even less appealing to the independent center, around whom elections turn?  Sen. Olympia Snowe (R-ME) is one of those pragmatic Republicans who dares to ignore the pressure from the GOP leadership and use reason and the genuine needs and wishes of her constituents in determining how to cast her vote.  She recognizes that while Maine has two GOP senators, the state does have voters of both parties and that ideological purity isn’t always in the best interest of her constituents, let alone of the nation at large.  Ideological purity is corrosive, regardless of which party’s ideology is at issue.  And John McCain, rather than retreating into political oblivion after his defeat last November is, according to sources at Politico, seeking to find pragmatic and moderate Republicans to re-invigorate the party.  Unfortunately, if Gabler’s view is correct, his efforts will be in vain.

[UPDATE: Paul Krugman’s op-ed piece in Monday’s New York Times sums it up a bit differently, but in a manner entirely appropriate given the reaction on the right to Chicago’s failed Olympics bid. Given Krugman’s assessment and Glaber’s, it is clear that what needs to be done by people on all sides of the political spectrum who seek a more honest and rational discussion of issues.  The radical right needs to be isolated from the discussion.  They will not change.  That segment has been present in American politics for many decades.  But like a recalcitrant child, they need to be marginalized, not given additional power by virtue of attention.  Sure, we must be aware of them, especially when the level of violent rhetoric rises.  But awareness does not necessarily equate to attention.  The media loves conflict, thus the attention they receive from the likes of Rupert Murdock.  He sees them as a cash cow.  As soon as the ratings decline, they will be out on their collective ear, not because their masters have changed their stripes, but because, as David Brooks put it, they are no longer raking in the cash.  Beck’s decline in sponsors served only to raise his ratings, and allow Fox to charge more to his other sponsors, making the whole episode a financial wash.]

Yes, I am liberal in my political views, and proudly so.  After all, liberalism has brought many of the advances and achievements that have made America great — the abolition of slavery, the Civil Rights movement, women’s suffrage, public education.  Government, for all of its ills and faults, can be made to work for the benefit of the people.  Capitalism can be a powerful creative force, but even Adam Smith understood that it cannot be allowed to succumb to greed.  But more than simply a liberal, I am an American.  I want the country to succeed.  And that means that even when I disagree totally with a  President’s policies, I want him to do right by the country.  I want him to succeed in making our country better.  I not only accept the theory of an opposition but support its creation and benefit.  But in order to be a loyal opposition, it must be willing to propose as well as to oppose.  I fear that the United States body politic has become so focused on the “me” that it is losing sight of the “we” that made us what we are.

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Some people need to get out more

Rep. John Boehner has made the outrageous claim that he hasn’t come into contact with a single person who supports the public option.  Maybe he should spend less time in the tanning booth and more time talking to real people.  If he’s serious, I know lots of people he could talk to — people ranging in age from their 20s to their 80s; people who were long-time Republicans (until the party decided to hang out in the swamps).

And then there’s Rep. Michele Bachmann, whose speeches and pronouncements seem often to border on certifiable paranoia.  Ms. Bachmann informed the House last night that school based health clinics are sex clinics in disguise and a plot to provide abortions to teens without notifying their parents.  Her claim is, of course, totally spurious in that all existing law requiring parental permission is upheld.

But Sen. Mitch McConnell has finally made the ultimate gaffe — by telling the truth.  He has announced that the GOPers wouldn’t support health care reform even if the Dems caved in and accepted ALL of the GOP’s amendments and recommendations.

At one point the GOP said that they were developing an alternative health care reform plan.  That was several months ago, but nothing has been presented since then, other than a multitude of “message” amendments.  Could it be that they are finding that developing such a plan requires hard work?  After all, it’s so much easier to just say “no” to whatever the Democratic majority proposes.

Is it any wonder that the GOP brand is in the tank?  It is as if sanity and reason have been completely rejected by the GOP leadership and elected representatives in Washington.  It comes as no surprise that so many Americans think that the GOP members of Congress are playing politics with health care reform, that they put a higher value on gaining political points than on doing what’s best for the country.  Enough.

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Is the public option really dead?

Two amendments that would have included a public option in the Senate Finance Committee bill went down to defeat today.  But is it really dead?  All three House bills include a public option.  Assuming that they will be combined to one bill to be debated by the full House of Representatives, the House bill will include a public option.  The HELP committee in the Senate also includes a public option.

Sen. Chuck Grassley, erstwhile member of the so-called Gang of Six, and when not working hard to delay and derail health care reform in committee was busy over the summer warning that reform could mean “pulling the plug on Grandma” was at his hypocritical and illogical best today.  Arguing against the public option proposal, he trotted out the now well-worn GOP mantra that government run health care would be a disaster.  Chuck Shumer asked him if he supported Medicare — a government-run, single payer system, to which Grassley admitted that he supported popular government-run health care programs.  Well, Sen. Grassley, a majority of Americans support a public option.  Doesn’t that make it popular, too?  Try to wiggle out of that corner you managed to paint yourself into.

Apparently one of the sticking points that caused those five (or three) conservative Democrats to vote against a public option is the differential in Medicare reimbursement rates between urban and rural hospitals.  At least that’s how Sen. Kent Conrad (D-ND) explains it.  Seems that rural hospitals “enjoy” a lower reimbursement rate than do urban ones.  But if solving that issue would bring them on board, it would seem that’s the place to focus efforts.  How much would it cost to re-wicker the reimbursement rates to allow rural hospitals to survive?  Sen. Rockefeller’s amendment addressed Medicare reimbursement for hospitals, but it contained a two-year waiting period.  Would making the adjustment sooner have made a difference for those five conservative Democrats?  Sen. Conrad has proposed allowing the reimportation of name brand drugs (not generics) whose production was equal to FDA standards and whose quality pedigree could be tracked at the lot level.  We know that prescription drugs are more expensive in the US than in other countries.  Conrad used the example of Lipitor; Americans pay over $4.50 per tablet while the exact same drug can be obtained in a Canadian pharmacy for under $2.  It’s clear that we’re being ripped off, and not just seniors facing the Medicare Part D “donut hole.”

Sen. Baucus said that his opposition was based on his ability to count to 60.  Perhaps the more surprising news was that Chuck Shumer’s public option amendment failed by only two votes.  If the Medicare reimbursement issue could be solved, would Olympia Snowe come on board?  If so, would her fellow Mainer Susan Collins?

The more Americans find out about the public option, the more they support it.  Yes, the boisterous town halls put a temporary damper on support — just like the astroturf organizations wanted.  But support is returning.  I’d like to see the cost savings of Conrad’s reimportation of drugs weighed against the cost of adjusting the Medicare reimbursement for rural hospitals.  I suspect that trade-off would result in a net savings.  And maybe, just maybe, we wouldn’t be subjected to all those drug ads on TV.  And maybe, just maybe, the Senate would decide that supporting a public option would be more palatable.  Would the health care industry lobbyists be upset?  Sure, but for once the legislative process would result in a bill that actually helps regular people and not the corporate interests who’ve managed to co-opt the Congress.

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