Traumatic Brain Injuries

NPR and ProPublica have produced a series on returning military personnel suffering from traumatic brain injuries. Sadly, these troopers often haven't been getting proper help, and these sort of injuries can become debilitating. While the military's medical system does a good job overall, hearing about TBI and PTSD not being treated adequately - if at all – is maddening. If the actual military budget amounts to close to one trillion dollars per year, there's no reason why troopers can't get decent pay and excellent medical care, especially when they received these injuries in combat.

Here's Part One and Part Two. Check out the "related links" for more. Meanwhile, Blue Girl and the rest of the crew at They Gave Us a Republic have been following stories on TBI, PTSD and veteran treatment diligently.

 

Health Care Around the World

One of the more bizarre aspects of the health care "debate" was the strident insistence by reform opponents – and some supposedly objective reporters – that American health care was/is the best in the world. The truth is, many industrialized nations provide better overall health care for far less money than the United States. Many Americans don't know this – and some American corporations and politicians have worked very hard so that they don't know it.

The health care reform bill that passed is flawed, but is still a major step forward and should ensure basic care for millions of Americans who had none before. We'll see how the reality matches the plan and the promises. Still, the American health care system will continue to need improvement, and it would be foolish to ignore successful ways other nations have dealt with the same problems.

It's also valuable to examine what our old system really entailed and how it measured up. (Parts of the new health care law take effect this year, while other measures won't apply until 2014, so in several cases the "old system" is what we still currently have.) In the old system, if you had health insurance, and if you were given care, it could be good and even excellent. But the old system was unsustainable, and for all its cost, had major gaps. Under the old system, about 46 million Americans, or roughly 1 in 6, did not have health insurance. Other Americans with health insurance could be denied essential care. Currently, every year, many Americans die from lack of health care. Exact numbers are elusive, but studies estimate that number as anywhere from 22,000 to 45,000 deaths per year. (See the Remote Area Medical Care story for how dire it's been.) Reform should provide health care for those who don't have it now, and will actually save money in the long run – in theory, the new law will cover 95% of the population and cut the deficit by 1.3 trillion over 20 years. We'll see how it all actually plays out, but that sounds like a big improvement.

World Health Studies

There are a few different world health studies, but one of the more user-friendly I've found comes from the Organisation for Economic Co-Operation and Development (OECD). Their Health Data page has a publications tab that lists their most recent major report, "OECD Health Data 2009: Statistics and Indicators for 30 Countries." You can view web versions of its charts or download PDF versions here. Most of the charts link Excel sheets which provide further data.

The most staggering statistic is probably health expenditure per capita:


(Click for a larger view.)

The United States' cost is a staggering $7,290 per capita, while the next most expensive, Norway, is $4,763, and they cover everybody. France is at $3,601 and Britain is at $2,992, even though they cover everybody and their overall care is typically rated better than that in the United States.

Next up, here's health expenditure in relation to GDP:


(Click for a larger view.)

The United States spends 16% of its Gross Domestic Product on health care, and the OECD puts the number at 19.5% for "actual final consumption." The next closest country is France, at 11% of GDP, and again, it covers everybody and is consistently ranked near the very top for overall health care.

Here's a chart on coverage (the old system):


(Click for a larger view.)

The United States hasn't stacked up well in life expectancy, either:


(Click for a larger view.)

There are many other charts to peruse. The United States does fairly well with cancer. Some forms of cancer are much more treatable now, and it doesn't hurt that, in America, there's been a overall decline in smoking and thus lung cancer (the most common cancer worldwide). The United States doesn't measure up too well in heart disease and stroke, though, or infant mortality. We'll see how these statistics change in the coming decades.

The World Health Organization of the United Nations also puts out useful reports, their most recent major one being The World Health Report 2008. Their World Health Statistics 2009 has some more recent data. The site compiles other data, which can be searched, sorted and exported (you can make your own Excel charts). The focus of the health report has varied over the years. Their World Health Report 2000 focused more on comparative health care systems:

The World Health Organization has carried out the first ever analysis of the world's health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan...

The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18th. Several small countries – San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy.

The World Health Organization's reports focus a great deal on malaria, tuberculosis and diarrhoeal diseases (cholera, dysentery, typhoid, contaminated food and water) that tend to be less prevalent in the United States. But for those interested in statistics and learning more about health issues around the world, it's a good place to look. As for health care in the United States, we'll see how much it can improve its standings in coming years.

Sick Around the World



I've been reading T.R. Reid's 2009 book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, which is a well-written, fairly short survey of the major health care models around the world. Reid asks about treatment for his stiff shoulder, and looks at costs to patients and the benefits of each system. He also asks about flaws in each system and examines their cost controls.

Reid's book grew from an excellent 2008 Frontline episode, "Sick Around the World." You can watch it online. If your time is limited, it may be the best single introduction to how other countries approach health care and how the United States stacks up in comparison. The site also offers several helpful links. Here are the four basic models used around the world, a Q&A with Reid, and a Washington Post discussion with Reid (all from 2008). He also discussed his book on Fresh Air and C-Span. A 2009 article he wrote, "5 Myths About Health Care Around the World," covers many of the basics.

As Reid writes in his book, many of these other systems will be familiar to Americans already. The four main models are the Beveridge Model (Great Britain, Scandinavia, Cuba), the Bismark Model (Germany, France, Japan, Switzerland), the National Health Insurance Model (Canada, Taiwan) and Out-of-Pocket (rural areas of Africa, India, China and South America). Reid explains these in more depth in his book, but as he points out, they should all be somewhat familiar to Americans:

These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we're Britain or Cuba. For Americans over the age of 65 on Medicare, we're Canada. For working Americans who get insurance on the job, we're Germany.

For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital.

The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it's fairer and cheaper, too.

Sick Around America

Frontline also did a 2009 episode, "Sick Around America," but it's a mixed bag and disappointing in some major respects. It does a good job of documenting health care insurance woes, but does a poor and even deceptive job on solutions. It features many health insurance executives and lobbyists, which wouldn't necessarily be bad, but there's little to no skeptical, critical treatment of their claims. Basic, core issues raised in "Sick Around the World" are ignored. Reid was also involved in "Sick Around America." However, as Counterpunch reported:

But even though Reid did the reporting for the film, he was cut out of the film when it aired this week.

And the film didn't present Reid's bottom line for health care reform – don't let health insurance companies profit from selling basic health insurance.

They can sell for-profit insurance for extras – breast enlargements, botox, hair transplants.

But not for the basic health needs of the American people.

Instead, the film that aired Monday pushed the view that Americans be required to purchase health insurance from for-profit companies.

And the film had a deceptive segment that totally got wrong the lesson of Reid's previous documentary – Sick Around the World...

The Counterpunch piece next quotes claims from "Sick Around America" featuring insurance lobbyist Karen Ignagni, who favors a mandate for citizens to buy health insurance, but leaves something crucial out from her claims:

Other countries do not require citizens buy health insurance from for-profit health insurance companies – the kind that Karen Ignagni represents.

In some countries like Germany and Japan, citizens are required to buy health insurance, but from non-profit, heavily regulated insurance companies.

And other countries, like the UK and Canada, don't require citizens to buy insurance. Instead, citizens are covered as a birthright – by a single government payer in Canada, or by a national health system in the UK.

The producers of the Frontline piece had a point of view – they wanted to keep the for-profit health insurance companies in the game.

TR Reid wants them out.

Reid also said that “I don't think they deliberately got it wrong, but they got it wrong.” Frontline has contested that Reid played a big role in "Sick Around America." Regardless, I can't see how someone could see "Sick Around the World," let alone help make it, and then ignore its central finding in the companion piece: For-profit insurance companies should not be in charge of basic, essential care.

For-profit health insurance companies are parasitic, providing no actual health care, which is provided by doctors. Insurance is merely a payment mechanism, and the industry is responsible for much (but not all) of the colossal waste in the American system. Most American politicians view eliminating private health insurance entirely and moving to a single payer system as too radical and impractical. That's why health care reform took the shape it did. The new law leaves for-profit health insurance companies in place, and doesn't regulate them as strongly as other countries do. However, in theory the new law will curb price-gouging somewhat, and end rescission and other abusive practices by health insurance companies. Future fixes to health care could push this dynamic further, as needed. Health insurance companies could continue to exist, but could operate more like they do in Germany, France and Switzerland.

Administrative costs for government, not-for-profit program Medicare are normally estimated at 2-3% (although it may slightly higher). In comparison, the costs of private, for-profit insurance for administration, advertising and profit run at 12% on average, can be pushed as low as 7%, yet can run as high as 26% or even 30% (risk pool size is a major factor). The executive compensation at large insurance companies is staggering – and many industry practices are appalling. As DDay chronicled this past October,

Anthem Health Plans of Maine, a subsidiary of WellPoint, is suing the state because they want to increase premium rates by 18.5% on their 12,000 individual insurance policy holders, so they can guarantee themselves a 3% profit margin...

Like many other states, Anthem Health Plans hold a monopoly on the individual insurance market in Maine, controlling 79% of all the plans. Also like many other states, they are licensed to sell insurance through the Department of Insurance, who must clear all rate increases prior to implementation. Originally, Anthem Health Plans were a nonprofit Blue Cross and Blue Shield corporation licensed to practice in Maine since 1939. In 1999, Anthem bought the business and began to operate it as a for-profit company. Since that point, Anthem has raised premium rates 10 times, and 8 of those times have been double-digit rate increases...

The average individual Maine rate-payer is paying four times as much for insurance than they did ten years ago.

But this isn't good enough for Anthem Health Plans...

The details get even uglier. WellPoint is the same company being investigated by Congress after it announced in February that it would raise premiums on some California customers by a whopping 39%. It's not the only company doing this sort of thing, either. The new law may help, but it would be wonderful to end these sort of abuses altogether.

Many of the problems in the old system – and the new system going forward – are simply unnecessary. In Sick Around America, Part 5, roughly 49 minutes in, "Healthcare Industry Consultant" Robert Laszewski says:

We have 2.2 trillion dollar health care system full of vested interests, stakeholders, and lobbyists, and I have yet to meet a doctor who thinks he should take less. Every doctor I meet thinks he's underpaid. I have yet to meet a hospital executive who thinks he can operate, he or she can operate, on less. I have yet to meet a patient who is willing to sacrifice care. Every patient I've ever met in the United States equates quality care with access to whatever they want. I haven't met anybody that's willing to take less. And until we have that conversation, we're just sort of nibbling around the edges.

Laszewski has a point, but given that other countries do much better at much lower cost, his implied suggestion about sacrifice ignores a great deal. The 'hard truths' aren't primarily about doctors or patients accepting less. The hard truths involve not defending a broken system rife with unnecessary waste and inefficiency. Let's take Laszewski's examples one at a time.

Doctors in the United States are paid much better than most doctors around the world. However, in the countries Reid examines, doctors are still generally well paid if not as exorbitantly, and the position still carries great status (and sometimes other perks). These foreign doctors spend a minimum of time on paperwork and billing, whereas American doctors face a crushing load on that front. The foreign doctors carry malpractice insurance, but most pay in a year what American doctors pay in a single month – and the foreign doctors are rarely sued. Many other nations also pay for medical educations at least partially, in contrast to the high debt American medical students incur. One idea suggested for the U.S. is to invest more money into medical students' educations, in return for stints at public hospitals or working as general practitioners. These and other reforms would ease burdens on doctors, allowing them to spend more time actually practicing their profession. Many of them would find that appealing.

Many of these factors apply to running a hospital, too. Providing basic care for the entire populace would also mean far fewer costs incurred by people using emergency care for routine treatment. Standardizing medical forms and using electronic records would cut many costs across the nation. Meanwhile, elimination (or tight regulation) of for-profit insurance companies would massively cut administrative costs for hospitals, because they would have much less paperwork and wouldn't have to fight for reimbursement as much (if at all).

As for the claim "Every patient I've ever met in the United States equates quality care with access to whatever they want," I seriously doubt that's true – or it dodges the point with the term "quality care." Laszewsk's hypothetical patient is one with money and/or health insurance. People who lack any health care now would be thrilled to get basic, essential care. As for those who currently have health insurance, when they're sick, most patients simply want to get better, not necessarily to run a series of extra tests or a specific one. Patients generally trust their doctors and their recommendations. One solution is to have basic care completely covered, and if patients want something more exotic, they can pay out of pocket or with supplemental insurance, as is currently the case under many plans in the U.S. (and also France and other nations). As Reid shows, there are several successful models around the world, and while all have their drawbacks as well, it would be foolish not to study them for ideas.

T.R. Reid isn't the only good health care reporter out there, of course, nor is he flawless. Bob Somerby has criticized Reid and other reporters for not clearly explaining how wasteful the American system is. I agree that coverage should emphasize the key statistics, because they're essential to understand. It's harder for a politician to oppose any sort of health care reform when the public knows that other countries get good or better results, with a massively lower price tag: France at $3,601 per capita and Britain at $2,992, compared to the United States at a staggering $7,290. (We'll see if that number goes down, and by how much.)

However, I also think Reid does a splendid job overall. "Sick Around the World" consistently shows that there are better, cheaper and less wasteful ways to deliver health care. If we had politicians whose primary goal was to improve the system, they'd do want Taiwan does in the show: examine the major countries of the world, see what works best, and adapt that for America.

Health Care Reform Passes

(The Washington Post's web page. Click for a larger view.)
There's still the reconciliation fix to go, and other details. But the biggest deed has now been done. As Paul Krugman writes:

There is, as always, a tunnel at the end of the tunnel: we’ll spend years if not decades fixing this thing. But kudos to all involved, with special praise for Nancy Pelosi, who is now a Speaker for the ages.

We still need a robust public option, or eventually single payer. The insurance companies need to be more tightly regulated. Stupak, Lieberman and the entire GOP behaved absolutely unconscionably. But as Krugman and others have pointed out, Social Security, Medicare and Medicaid needed plenty of tinkering later on. Critics from the left have raised valid points. But roughly 30 million people will have some form of health care. Premiums should go down for the same amount of care for those already covered. Insurance companies can't deny people based on pre-existing conditions or dump patients in need via rescission. Those are huge victories.

We also saw some of the most dishonest and nasty political attacks ever from the Republican party, their cohorts at Fox News, and the teabaggers. Despite all their lies and obstructionist tactics, they lost. We can continue to improve the policy, but only one side of the aisle was ever working on that in earnest. This is also a huge political victory, and it calls for some celebration.

Update: Wonkette:

HAHAHAHAH. Nancy Pelosi loves pissing off teabaggers. Here she is linking arms with John Lewis, just like in the Selma march, to remind America of how teabaggers chanted “nigger” at John Lewis fifteen times yesterday. And if anyone gets in her way, she will smash their skulls into sandhills of calcium with her Weapon, the “1965 Medicare gavel,” forged by ancient socialist hobbits in a distant epoch, as a paean to Thor.

That's change I can believe in.

Update 2: Via Balloon Juice, a statement from Ted Kennedy's widow Victoria:

"As Ted Kennedy said, across the decades, in the best and the most discouraging hours, health care was the cause of his life. Tonight that cause becomes more than a dream, it becomes America's commitment.

"This landmark moment belongs to President Barack Obama, to Speaker Nancy Pelosi and the courageous members of the House, and to the colleagues he cherished in the Senate. Most of all, it belongs to America -- and it is one of the rare legislative achievements that belongs to the ages.

"When Ted stood with Barack Obama in 2008, he said he had new hope that we would break the old gridlock and guarantee that every American -- north, south, east, west, young, old -- would have decent, quality health care as a fundamental right and not a privilege. And now they do and from now on they will.

"In the last words he wrote, Ted said that ‘if you persevere, stick with it, work at it, you have a real opportunity to achieve something. Sure, there will be storms along the way. And you might not reach your goal right away. But if you do your best and keep a true compass, you'll get there.’ Ted knew we would get here, and all of us who loved him and shared his hopes for America are deeply grateful."

“

 

To Hell with Nuns

You may have heard that Catholic nuns have broken with the Catholic Bishops (but joined the Catholic Health Alliiance) to support health care reform.

That's not swaying good ol' pro-lifer Bart Stupak:

Congressman Bart Stupak, D-Mich, responded sharply to White House officials touting a letter representing 59,000 nuns that was sent to lawmakers urging them to pass the health care bill.

The conservative Democrat dismissed the action by the White House saying, “When I’m drafting right to life language, I don’t call up the nuns.” He says he instead confers with other groups including “leading bishops, Focus on the Family, and The National Right to Life Committee.”

So, he listens to bishops but not nuns, and values the advice of far right social conservatives. Nice.

If you haven't been following the Stupak saga, he's been holding health care reform hostage based on lies. Like Lieberman, he seems to crave attention, and feels screwing over his own party and constituents is the way to get it. If Stupak is personally pro-life, fine, but that doesn't justify lying about the bills or trying to do a end-run around the law. Abortion is legal in the U.S. and federal funds for it are already restricted under the Hyde amendment. Stupak knows this. Additionally, his constituents, and the roughly one in six Americans without health insurance (let alone actual care), badly need health care reform to pass.

At least Stupak has at least one primary challenger now. Serving one's constituents, honoring one's promises, and standing up for women - what a novel idea!

Tweet (or Call) for Health Care

skippy is tweeting for health care and has a list of twitter addresses for key congresspeople.

Tim F. of Balloon Juice has a guide for calling your congresscritters.

Meanwhile, David Dayen (DDay) continues to update his whip count for the House of Representatives based on public statements.

If you live in a swing district, your voice is especially important. But as Tim F. has pointed out, even if your representative and senators are pledged to vote the way you want, it might be nice to give them a thank you call. The far right is deluging offices, and it's important that the full range of public opinion be represented, preferably accurately. I think the bill is flawed, but it's still a huge, important measure.

The Health Care Summit

If you missed all or part of the health care summit, you can watch it on the White House site here. I thought there were some very good moments. Meanwhile, DailyKos TV compiled a highlight reel:



It probably won't be surprising to learn that Repubicans were trashing the summit before it concluded and before it even started. It probably won't be surprising that Lamar Alexander was lying when he said reform would make premiums go up and Barack Obama was telling the truth. The same amount of coverage would cost less; some people might buy better coverage as a result of lower costs, but they would still be getting more for the same amount of money. It probably won't be surprising that NPR was rather muddled and timid in their fact-checking. (Substitute "highly deceptive" or "wrong" for "lying" if you want, but that would mean that Alexander was rather dumb or ill-prepared on a central point for the Republicans' opening statement, and all the other Republicans magically made basically the same mistake.)

Meanwhile, true to form, right-wingers continued their War on Compassion in mocking Louise Slaughter and the woman she mentioned using her dead sister's dentures. See Balloon Juice, No More Mister Nice Blog and Digby for more.

Digby also has sharp posts here and here on the optics of the summit. (I linked the contrasting Krugman and Brooks responses in an earlier post.) Greg Sargent has a number of good posts on moving forward. I agree with his take that Obama's summation was mainly telling the GOP it's over. Sargent also notes the public supports reconciliation if they like the bill, and reports that Obama plans to annouce the way forward this coming week. Good. "Pass the Damn Bill."

Lastly, as usual, The Daily Show offered some of the best coverage on the summit:

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Summit's Eve
www.thedailyshow.com
Daily Show Full Episodes Political Humor Vancouverage 2010

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Bipartisan Health Care Reform Summit 2010
www.thedailyshow.com
Daily Show Full Episodes Political Humor Vancouverage 2010

Anthony Weiner on Health Care

Weiner's a scrapper, and for the right things. Gotta like that. This was posted on 2/24/10, so I'm assuming this House speech occurred then or the day before. David Dayen has a little more.

Summit Fever

Not safe for work, but funny:



Via.

I caught most of the summit. Obama was genuinely impressive. The Republicans mainly trotted out the same old BS. A few Republicans made some decent suggestions, but they're either a) already in the bill, or b) too small to make a difference on their own. If this gives the Dems some cover to pass health care reform via reconciliation, great.

Also.

Obama Meets with the House Republicans

If you haven't seen this footage yet, you really should. The House Republicans had a retreat in Maryland this past Friday, and invited Obama. He accepted, and his staff suggested that his brief speech and longer Q&A be aired and taped. The Republicans agreed.

Basically, Obama has the usual false talking points thrown at him, and he bats them down, one by one. There are maybe two Republican ideas with merit, but as Obama points out, they're good only with caveats and as part of a larger framework that's been ignored by the GOP. It's unfortunate but unsurprising that the GOP now regrets that they allowed the session to air. America would be much better off with more sessions like this. If the Republicans (and to a lesser degree the Democrats) actually offered good, reality-based policies that would benefit the country as a whole, that would be absolutely fantastic. Sessions like this can only help that.

If you can only see some of it, Talking Points Memo has many clips up, including Obama objecting to health care being portrayed as a Bolshevik plot:



You can see most of Obama's exchange with Jeb Henserling here (it's one of the best bits, and it's the last question he takes). Steve Benen has a good post on the cash-and-trash strategy by Republicans Obama refers to (although not in those words) - Republicans are happy to take credit back home for the stimulus money they voted against in D.C.

The whole thing is definitely worth the time to watch or at least listen to, though. Here's the C-Span page for the event, and Steve Benen has the MSNBC footage of the Q&A posted. The Washington Post has a transcript. Here's the YouTube version posted by the White House:



Meanwhile, if you missed the State of the Union, you can view it here. It was better than I expected, but I'm very concerned about the spending freeze talk. Eliminating waste is great, but boxing one's self in isn't, and exempting military spending ignores the biggest problem. See Krugman here and here, as well as Spencer Ackerman. The public seemed to like it in at least one poll, though. Some of the other proposals, including a reduction in the costs of student loans (more generous for those going into public service), and a targeted tax cut for small businesses, could be great. We'll see how it all plays out.

Health Care Reform and Football

Sports metaphors can be overused, but the Super Bowl is fast approaching and football works pretty well as a metaphor for some current political situations.

First up, Tom Toles from Friday, 1/22/10:


The little tag in the lower right, if you can't read it, says "We can kick ourselves after." (I'm assuming most people know basic football scoring rules.)

Moving on, Steve Benen wrote on 1/27/10, before the State of the Union:

Post Script: Paul Glastris, the Monthly's editor in chief, will be on NPR's "Talk of the Nation" in a few minutes, talking about this and other issues related to the State of the Union. (Paul served as President Clinton's chief speechwriter, and offers a great perspective on this.)

When I talked to Paul earlier, he told me the line he'd like to hear the president say tonight: "Health care reform is the Super Bowl of issues, we're on the one yard line, and the other team has walked off the field. Let's pick up the ball and walk across the goal line."

Maybe Glastris saw Toles cartoon, but that's pretty good.

This next one requires more set-up. Back to Steve Benen, in a piece on Evan Bayh (emphasis mine):

EVAN BAYH'S MORAL WRONGS.... The solution to the health care reform debate seems pretty obvious -- the House approves the Senate bill; the Senate agrees to improvements through reconciliation. One of the obstacles, of course, is the group of center-right Democrats who not only don't want to return to the issue, but are staunchly opposed to using reconciliation.

It's worth fully appreciating, though, why reconciliation is considered so distasteful. Sen. Evan Bayh (D-Ind.) explained that the procedure should be avoided because it may bother Republicans. And if Republicans are bothered, they may not work with Democrats on bipartisan solutions. Seriously, that's the argument.

"There would be some real consequences from that for the legislative agenda for the rest of the year," Bayh told me last night, "the other things the president called for: cooperation on education, financial reform, a whole host of other things."

Bayh says he sees a real prospect for bipartisanship on those issues, but that Republicans will walk away if Democrats play hardball on health care.

"The problem with reconciliation is that it runs a real risk...of poisoning the well on progress on some of these areas," Bayh said.

This is so hopelessly misguided, it's hard to know where to start. I'd remind Bayh, for example, that reconciliation has been used plenty of times in recent years, and the institution and its members survived just fine. I'd also ask why on earth Bayh think Democrats giving up on their signature domestic policy initiative would suddenly make Republicans -- who've run a scorched-earth campaign since Day One -- open to bipartisan compromise on a whole host of issues.

But let's put all of that aside and characterize this in a way that too often goes overlooked. Bayh isn't just wrong about the legislative process; he's wrong about morality.

Read Benen's post for the links, and his moral argument – helping out tens of millions of Americans obviously should be more important: "Helping those who are suffering isn't as high a priority as maybe getting some GOP help on a few issues?" Glenn Greenwald also provides some good background on Bayh in "The face of rotted Washington."

Bayh and the Blue Dog Democrats remind me of the Cincinnati Bengals of the 90s under owner Mike Brown. The Bengals actually won their division this season, and made the playoffs, although they lost in the first, Wild Card Round. Before that, though, they had one winning season out of 19 and were the worst team of the 90s. One sportscaster called them "an embarrassment to sport," as in, the entire human endeavor of sports, where a team supposedly should try to win, perhaps out of basic competitiveness or pride or shame. During the 90s, some critics felt that Mike Brown had no real interest in or commitment to fielding a competitive team. This was because he could field a lousy team and still make a tidy profit – and his profit margin would actually be higher. Sure, he wouldn't sell out the stadium, or sell as many seats, or sell as much merchandise, but there were enough Bengals fans out there, and enough NFL TV cash coming in, to make him good money.

Evan Bayh and most of the Blue Dog Democrats (we'll include Lieberman) aren't really interested in reforming health care, helping their constituents significantly, or making the country a better place. They're happy with the status quo, and as long as they think they can stay in business and make a profit, they want to field, or sell, an inferior product. In fact, they don’t like it when they're any pressure to win, to deliver to the loyal fans, and will actively seek to hobble their teammates. It's contemptible, but that's the way it is.

Let's take another look at Bayh's line: "The problem with reconciliation is that it runs a real risk...of poisoning the well on progress on some of these areas." At this point, only an idiot or a shill would pretend that the GOP is acting in good faith and will vote with Democrats. Republicans have practiced obstructionism at unprecedented levels, and they've expressed their intent to continue. Giving up on health care will only make them much, much bolder, and it's easy to write the midterm campaign ads now. It's deeply unfortunate that American politics is currently a zero-sum game between the two major political parties – but that's the way it is – and that's primarily the fault of the GOP.

So, in football terms, Evan Bayh (a senator from Indiana) is saying that, in the upcoming Super Bowl, the Indianapolis Colts shouldn't score on the New Orleans Saints, because that might make the Saints upset, and if only the Colts don't make the Saints upset, the Saints might allow the Colts to score later. Hey, maybe not in this game, but at some point in the future. (After the November midterm elections, maybe.) Maybe they'll let them score - but maybe only if the Colts don't play to win now, because winning (even with a big lead and good field position) would be terribly rude.

Did we mention this was the championship game?

Bayh's argument is that stupid. Bayh is openly rooting for his own team to lose, and working to make it happen. Sadly, he's not alone in the Democratic caucus. The Blue Dog crowd is almost as bad as the Republicans.

(It might be more apt to say Bayh is telling the Colts to throw the Super Bowl and let the woeful Detroit Lions win. This will alllow the Colts to maybe have a shot at winning again in 20 years.)

As for the Democrats dealing with the GOP - strangely, when a group openly seeks your defeat and destruction, the best move is to kick their collective ass.

As for our vapid Beltway chatterers, they mostly consist of gossip columnists and bad sportscasters. To borrow from an earlier post:

Even if we view the press as sportscasters, or even home-team sportscasters, our press corps lacks good play-by-play announcers, but is positively overflowing with really bad color commentators.

To strain this metaphor even further (and apologies to all non-sports fans), say the Green Bay Packers were playing the Chicago Bears and scored the first two touchdowns. If our political reporters were sportscasters, David Broder would insist that the Packers should let the Bears score, Sean Hannity would loudly proclaim that the Bears did score, and Cokie Roberts would misreport the score and then proceed to ignore the game.

There's a saying that politics is the blood sport of Washington, but we've got awfully idiotic sportcasters for it.

There's one more metaphor plenty of people have used to describe how foolish it is to trust the Republicans on health care reform. We'll end with it, because it still may be the best:



(Previous posts using sports to discuss politics: "Hall of Fame Material", "The Sporting Life" and "Political Football Theater.")

(Updated with one link.)

The State of Health Care Reform

Josh Marshall has posted an e-mail by a Democratic Hill staffer that's well worth a read. The standout paragraph is probably this one about the Democrats:

The worst is that I can't help but feel like the main emotion people in the caucus are feeling is relief at this turn of events. Now they have a ready excuse for not getting anything done. While I always thought we had the better ideas but the weaker messaging, it feels like somewhere along the line Members internalized a belief that we actually have weaker ideas. They're afraid to actually implement them and face the judgement of the voters. That's the scariest dynamic and what makes me think this will all come crashing down around us in November.

This doesn't surprise me - many politicians are establishmentarian, and really don't want to do anything - but it is pretty discouraging.

The Balloon Juice crew have been pressing hard on for everyone to call their House representative immediately to urge them to agree on the Senate bill. If the whole thing passes, then the reconciliation process could be used to pass amendments to make it better. There are still pitfalls, but that looks like the best route at the moment.

There are plenty of lousy aspects to the current bills. Watching all the political ineptitude of the Democrats, the corruption of the Blue Dogs, and the screw-you-all-and-my-constituents-too attitude of almost the entire GOP, has been maddening. Most of the Beltway commentary has been inane as usual, made more frustrating by the high stakes of health care reform.

I keep coming back to a Krugman column from 12/18/09, "Pass the Bill":

Bear in mind also the lessons of history: social insurance programs tend to start out highly imperfect and incomplete, but get better and more comprehensive as the years go by. Thus Social Security originally had huge gaps in coverage — and a majority of African-Americans, in particular, fell through those gaps. But it was improved over time, and it’s now the bedrock of retirement stability for the vast majority of Americans.

Look, I understand the anger here: supporting this weakened bill feels like giving in to blackmail — because it is. Or to use an even more accurate metaphor suggested by Ezra Klein of The Washington Post, we’re paying a ransom to hostage-takers. Some of us, including a majority of senators, really, really want to cover the uninsured; but to make that happen we need the votes of a handful of senators who see failure of reform as an acceptable outcome, and demand a steep price for their support.

The question, then, is whether to pay the ransom by giving in to the demands of those senators, accepting a flawed bill, or hang tough and let the hostage — that is, health reform — die.

Again, history suggests the answer. Whereas flawed social insurance programs have tended to get better over time, the story of health reform suggests that rejecting an imperfect deal in the hope of eventually getting something better is a recipe for getting nothing at all. Not to put too fine a point on it, America would be in much better shape today if Democrats had cut a deal on health care with Richard Nixon, or if Bill Clinton had cut a deal with moderate Republicans back when they still existed.

Even passing the Lieberman/Blue Dog/GOP savaged bill will be tougher now. But "tough" always seems to come with giving a damn, doesn't it?

Franken Versus the Hudson Institute

This is an old item from late October, but it's great and I never got around to posting it. The short clip is from a Senate Judiciary Committee hearing on medical debt. Senator Al Franken is questioning Diana Furchtgott-Roth of the right-wing Hudson Institute. She's claimed that (as Think Progress puts it) "moving towards a European-style system of universal health care would increase bankruptcies." Franken challenges her on this:



A partial transcript:

FRANKEN: I think we disagree on whether health care reform, the health care reform that we’re talking about in Congress now should pass. You said that the way we’re going will increase bankruptcies. I want to ask you, how many medical bankruptcies because of medical crises were there last year in Switzerland?

FURCHTGOTT-ROTT: I don’t have that number in front of me, but I can find out and get back to you.

FRANKEN: I can tell you how many it was. It’s zero. Do you know how many medical bankruptcies there were last year in France?

FURCHTGOTT-ROTT: I don’t have that number, but I can get back to you if I like.

FRANKEN: Yeah, the number is zero. Do you know how many were in Germany?

FURCHTGOTT-ROTT: From the trend of your questions, I’m assuming the number is zero. But I don’t know the precise number and would have to get back to you.

FRANKEN: Well, you’re very good. Very fast. The point is, I think we need to go in that direction, not the opposite direction. Thank you.

The partial transcript comes from , which has a number of other links on the hearings, and the staggering, crippling rate of medical bankruptcies in America:

Medical bankruptcies are an epidemic in the United States. According to a peer-reviewed study published earlier this year in the American Journal of Medicine, nearly 62 percent of all U.S. bankruptcies in 2007 were due to health care costs — and 78 percent of people who were driven into bankruptcy by their medical bills had insurance.

Franken has been doing this sort of debunking since at least 1996 in Rush Limbaugh is a Big Fat Idiot. What's refreshing is that while Furchgott-Rott is an unconscionable hack, Franken's done his homework and exposes her for what she is. Health care wonks do debate on various measures for reform, but the hacks are there to deceive to impede any improvements. It's doubtful that if Furchgott-Rott had studied health care in any depth she wouldn't know the answer to Franken's questions. Nor if she actually wanted to improve the health care system would she outright lie as she does here (Think Progress links her prepared testimony, which contains much more bullshit). Furchgott-Rott may not be as successful in her hackery as the loathsome Betsy McCaughey, but her goal is the same - lying for pay, all to derail health care reform. If more people die as a result, well, too bad. She's got hers.

It'd be nice to have more honest policy debates, but hackdom is ever in fashion, and it seems hacks are rarely challenged, debunked, and exposed. It was refreshing to watch Al Franken do just that, and I hope he continues.

We're Committed to Saying No, But Let's Debate at Length First

Many hurdles still exist, but yesterday, the Senate voted to bring their health bill to the floor for debate. From what I've seen so far, the House bill is better overall (apart from the Stupak amendment), and many progressive measures have been severely watered down, most of all the public option. Still, it's a big step.

There's plenty of circus to come, though. As Ezra Klein points out, there are many other votes to come, including many other cloture votes. Then there would be committee meetings about merging the bills, and a final vote in each house. DDay outlines several of the other pitfalls, made more perilous by Harry Reid's claim not to use the budget reconciliation process.

Meanwhile, as Steve Benen writes:

On Fox News yesterday, Senate Minority Whip Jon Kyl (R-Ariz.) explained, in no uncertain terms, that "every single Republican" in the Senate "will oppose" health care reform. Kyl conceded that the reform bill may change before a final floor vote, but every Republican already realizes that the legislation "will only get worse."

Benen quotes a good point from Sam Stein:

...Kyl's prophecy of across-the-board opposition does seem to undercut that other GOP tactic. Why do Senate Republicans need six weeks to debate and consider the legislation if they're already determined to vote against it?

As Benen concludes:

I'm going to go out on a limb here and guess that GOP demands for six weeks of debate has very little to do with genuine interest in good-faith deliberations, and everything to do with pointless delay tactics. Call it a hunch.

The need for reform is real and urgent. Benen also covers the recent free health care fair in Little Rock, Arkansas, and some of the other recent ones. There will be a bigger one on December 9th and 10th in Kansas City, Missouri. In an earlier piece I posted 60 Minutes piece on Remote Area Medical, and more recalcitrant legislators need to be forced to respond to pieces like this, and pressed on how they plan to fix it.

For most of the health care "debate," we've seen the conservative Blue Dog democrats fighting for bad (and corrupt) policies, and the Republicans offering almost nothing at all. (Benen does a great job of tracking and debunking politicians' claims if you search back through his archives, and he should be a regular read.) Back near the start of November, the Republicans finally unveiled their big plan, and... well... over to Ezra Klein (from 11/5/09):

Late last night, the Congressional Budget Office released its initial analysis of the health-care reform plan that Republican Minority Leader John Boehner offered as a substitute to the Democratic legislation. CBO begins with the baseline estimate that 17 percent of legal, non-elderly residents won't have health-care insurance in 2010. In 2019, after 10 years of the Republican plan, CBO estimates that ...17 percent of legal, non-elderly residents won't have health-care insurance. The Republican alternative will have helped 3 million people secure coverage, which is barely keeping up with population growth. Compare that to the Democratic bill, which covers 36 million more people and cuts the uninsured population to 4 percent.

But maybe, you say, the Republican bill does a really good job cutting costs. According to CBO, the GOP's alternative will shave $68 billion off the deficit in the next 10 years. The Democrats, CBO says, will slice $104 billion off the deficit.

The Democratic bill, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan. And amazingly, the Democratic bill has already been through three committees and a merger process. It's already been shown to interest groups and advocacy organizations and industry stakeholders. It's already made its compromises with reality. It's already been through the legislative sausage grinder. And yet it saves more money and covers more people than the blank-slate alternative proposed by John Boehner and the House Republicans. The Democrats, constrained by reality, produced a far better plan than Boehner, who was constrained solely by his political imagination and legislative skill.

This wasn't much of a surprise. If the Republicans had ever been serious about health care reform, they could have done it while they were in power, or they could have engaged in serious debate during all of 2009. Apart from a few exceptions, that just hasn't happened.

As for the politics of reform, and the hostage-taking tactics of the Blue Dogs and their ilk, Matthew Yglesias summed up my frustrations very well back in October when he wrote "Compromise is a Two-Way Street":

Al From has one of these op-eds where you urge liberals to drop hopes for a public option in the interests of being pragmatic and passing health reform. I sort of agree with this—reform is worth doing even without a public option. But what these exhortations to practicality always miss is that this is a two-way street. If you think the public option isn’t that big a deal and it’s not worth spiking health reform over it, then you ought to think that it’s not worth spiking health reform in order to kill it either. But here’s Joe Lieberman not only expressing opposition to a public option, but saying he might filibuster any health reform package that includes a public option...

So far there’s been basically no pressure in the media on members who take this position to justify their extreme level of opposition. I get, for example, that Kent Conrad supports the Finance Committee version of health care and opposes adding a public option to it. But suppose a public option does get added. Does that suddenly take a vast package of reforms that he played a key role in crafting and turn it into a terrible bill? Why would that be? Surely Conrad is as aware as anyone else in congress that in order to pass a large, complicated health reform bill many senators are going to have to vote “yes” on a bill that contains some provisions they oppose. After all, the health reform bill contains hundreds of provisions! Are moderate members really so fanatically devoted to the interests of private health insurance companies that they would take a package they otherwise support and kill it purely in order to do the industry’s bidding on one point?

This is what drives me up the wall, in legislation and its coverage – the "debate" is so skewed, and it has everything to do with Beltway Convention Wisdom about hippie-punching, the establishment and reform, and little to do with reality. If Olympia Snowe, Max Baucus, Chuck Grassley, or Joe Lieberman has a position, fine. They get their say – that's how the process works. But they shouldn't be able to hijack the entire process, opposing both good policy and the will of the people, including their own constituents. At the very least, the obstructionists should be grilled on their positions and their reasons for them. It would great if Lieberman had to explain his massive conflicts of interest and constantly shifting, incoherent reasons for opposing reform. The media constantly trumpeted that the public option was dead, but never seemed to ask an obvious question - if four of the five initial bills on health care contained a public option, why should the one that be the one to prevail?

Why are Lieberman, the Blue Dogs and the entire Republican party treated as if they're acting in good faith, even when there's glaring evidence to the contrary? And why must the media treatment of health care reform always be so skewed when it's not outright inaccurate? For that matter, did they completely forget how disastrous the past eight years were, on almost every front? On the recent Senate vote, NBC's Chuck Todd claimed the vote wasn't "momentous" for health care reform - but also claimed it would have been news if the vote lost. As John Cole put it:

Shorter Chuck Todd: It’s only big news if the Democrats fail!...

Can anyone imagine the feeding frenzy for the next two weeks if they had failed to get 60 and advance the debate? Can you imagine the Sunday shows tomorrow? Can you imagine all the headlines speculating if Obama was a lame duck? “Senate fails to advance health care reform. Is Obama’s entire agenda at risk?” and “Obama’s signature legislation killed in Senate. Can he recover?” and “Republicans, spurred by sagging Obama poll numbers and grass roots support from tea party, stop Obama administration in their tracks.”

And Chuck Todd would be leading the goddamned charge with that crap.

Exactly. Our politicians are neither wise nor representative, and our media is in love with a conventional wisdom they manufacture without regard to (and often in contempt of) reality. Despite all this, the Senate can now debate the bill. There are many obstacles to go, but that vote was a positive step.

Preventing People From Dying is Just Like Genocide

These photos from the teabagger rally of Congresswoman Michelle Bachmann (R-MN) have thankfully been getting some exposure:



The sign says “National Socialist Healthcare, Dachau Germany – 1945." I first saw this item via Richard Blair of All Spin Zone. Distributorcap also has a brief item on this, and notes, "This was no Glenn Beck or Sarah Palin event - this was an event sponsored and pushed by the Republican leadership in the House and Senate - including Eric Fucking Cantor." Richard's post has contact information for Bachmann, Boehner and Cantor.

There's a point at which idiocy isn't funny, and being outrageous isn't so much offensive as it is grossly irresponsible and dangerous. It’s not as if there aren't legitimate criticisms of various health care reform proposals. But this isn't about respectable, 'different points of view' when one group is claiming that a government measure – one that could help people – is the same as one of the greatest evils ever perpetrated. One has to be pretty idiotic, or crazy, or irresponsible, to claim that giving people health care – which might save 22,000 – 45,000 lives a year, or more – is just like genocide, mass murder. And it's not as if this is an isolated incident, since this type of crap has been around for months now. This merely may be the most prominent example yet. It's sad that the light of day and being at the United States Capitol doesn't dissuade Michelle Bachmann, the Beck and Limbaugh fans, and the teabaggers from this poisonous bilge. Perhaps it only eggs them on.

I already linked an August post, "Deny Me Health Care or Give Me Death" in the previous post, and I have several more on the Holocaust. (Then there's more comically inept Holocaust references by right-wingers.) Sometimes Nazi analogies are appropriate, and sometimes they are irresponsible. I'm just very sick of the cavalier comparisons to Hitler and Stalin, especially when they're aimed at pretty centrist, establishmentarian politicians by far right authoritarians. It's all the more absurd when one considers - which group exactly is running around screaming about the dread menace of those who aren't real Germans, err, Americans, in our midst? This crap is dishonest, irresponsible, idiotically ahistorical, and just disgusting.

In late October, Scott Horton published a powerful short piece called "A Trip to Chon Tash" about novelist Chingiz Aitmatov and Aitmatov's struggle to deliver "a critical view of the legacy of Soviet rule in Central Asia and his native Kyrgyzstan." In 1938, Stalin had Aitmatov's father and 136 others among the intelligentsia murdered. This pattern will sound tragically familiar to those who know the history of Stalin. (Robert Conquest's book The Great Terror gives an overview, and I heard some heartbreaking stories in Russia during my brief study there.) In his piece, Horton visits the memorial erected near the pit where the bodies were buried (emphasis mine):

What transpired in Chon Tash occurred dozens of times across the vast frozen expanse of the Soviet Union, part of the policy that historians have come to call “decapitation,” the systematic murder of intellectuals and political leaders because of Stalin’s fear—part paranoid delusion and part real—that they would present some threat to him. Stalin’s object in dealing with the “nationalities” was to leave them leaderless and docile, and he was prepared to reach to the most brutal tools to achieve this.

In his novel [The Day Lasts More Than a Hundred Years], Aitmatov turns to the ancient Turkic legend of the mankurt. The head of a man taken prisoner is shaved and the moistened skin of a camel is applied to it. He is then sent into the desert, where the drying of the skin produces horrible torture. If the prisoner survives, his personality is destroyed by the process, and with it any recollection of the past. He is reduced to subservience to his master. The mankurt may look outwardly like a human being, but he is not. Aitmatov’s message, which struggled to escape censorship, was plain: this was what Stalin had done to Central Asia. And for Aitmatov, the lost memory was never more poignantly presented than in the fate of his father, a fate he learned only after the Soviet Union fell and the truth could be told.

Saturday was a brilliant autumn day in the foothills of the Alatoo Range of the Celestial Mountains. I traveled to Chon Tash to visit the memorial, ringed with blood-red roses, still in bloom after the season’s first snowfall. I went to pay respects to Chingiz Aitmatov, who died in June of last year leaving instructions that he be buried alongside his father at the site of that Stalinist act of terror. The sun shone with special intensity and the sky was cloudless. The willow birch trees had not yet released their golden leaves. A brook rustled in the valley below, and stately tall cypress-shaped pine trees could be seen on the hills above. A group of military cadets were there for an oath-taking ceremony held directly above the ground from which the remains had been excavated, and the message of the setting was clear to all: don’t forget the great wrong that can occur when the power of the state is wielded brutally and the spirit of the law is disrespected.

The crimes of the old regime were on exhibition to those swearing an oath to uphold the new order. In the museum at the site the possessions of many of the victims were displayed with some biographical details. Documents from the archives of the NKVD/KGB showed the trappings of legal formalism that accompanied the brutal deeds, every murder judicially authorized with a sentence stamped and sealed. The execution of the sentence was scrupulously documented. And on one wall was a simple display that spoke powerfully: a portrait of Stalin, and below it a skull, resting on stones taken from the pit.

In America today, the name and image of Stalin are invoked heavily by fringe critics of Barack Obama. The critics disagree with his policies on health care and see in it the basis for increasing power of the state. The role the state will play in the healthcare system is a legitimate political issue on which well-informed citizens can have different views. But the comparison to Stalin makes clear that these critics really have no inkling of who Joseph Stalin was, what he did, and why his name lives in special infamy at hallowed spots like the pit at Chon Tash. This frivolous use of his name and image cheapens our nation’s political dialogue, and it is also a mark of disrespect to his victims. And it points to the fundamental crisis of which Aitmatov wrote so powerfully: the failure to know the past, to be informed by it, and to distill guidance from it. The age of the mankurt, alas, has not passed.

Horton puts it very well. What's true of Chon Tash and Stalin is true of Dachau and Hitler, and I would hope that at the United States Capitol some basic sense, and sense of decency, would prevail. There's a common thread that runs through every account of a Holocaust survivor I've heard, and every tale of Soviet oppression: memory can be an act of conscience. Simply remembering things accurately, or grieving and honoring the dead, can become an act of virtue. I've no illusions that the sort of noxious crap the teabaggers are shilling will stop any time soon. But there's no reason it should go unchallenged.

Update: I forgot to mention the teabagger slurs against the Rothchilds, but it gets worse. Nobel laureate and Holocaust survivor Elie Wiesel denounced the Dachau poster, and in their wrath the teabaggers went even lower. Make sure you've got a strong stomach before reading the comments at the link.

Personally, when I read that crap, I think of a steady stream of obscenities, interlaced in a sentence like: "If Auschwitz survivor Elie Wiesel thinks your Dachau poster is inappropriate, you're on the wrong side of that argument, you historically illiterate people." Wiesel's short book Night remains one of the best introductions to the Holocaust, and I heard him speak back in the 90s. It's fine to disagree with the man on specific contemporary issues, but I felt he radiated a spiritual maturity, he spoke exceptionally well on the Holocaust, and it was a moving and inspiring address. The teabaggers are on one level experts at unintentional self-parody, as attacks on Wiesel show, but their authoritarian, delusional (and occasionally anti-Semitic) assaults aren’t just ironic – there's something dangerous there.

The GOP's Non-Existent Health Care Plan

The GOP still doesn't have a health care plan. They never have. This has rarely seemed to bother them, or the media. It's been pointed out again, though, this time by Harry Reid. Maybe it'll get some coverage this time.

This comes via John Cole, who has some thoughts on the enduring myth-making around nasty partisan and policy dunce John McCain and his magical kumbaya powers.

Remember Republican hack Alex Castellanos telling Alan Grayson on CNN that the GOP did so have a health care plan? In addition to Castellanos making dubious claims, it turns out CNN failed to disclose Castellanos's ties to the insurance industry and the GOP campaign to kill health care reform. Speaking of Grayson – who movingly read stories of the dead on the House floor – there's a money bomb movement for him.

Why can't the GOP produce a health care plan? One answer is that they don't want to. Another is that they can't. As Anonymous Liberal points out, "The problem the GOP faces is a very simple one: it is impossible to translate their "principles" into a functional plan." The same goes for most movement conservative policies. Conservatives have opposed Medicare since its creation, and have constantly tried to slash it or destroy it altogether. Yet in the past few months, some prominent Republicans have pretended to champion the program, and claim to be protecting it against those evil Democrats. Added to this hypocrisy is the glaring incoherence of the GOP defending Medicare, a government-run health care program, while denouncing the evils of a national... government-run health care program. The lack of consistency and coherence is one of many tip-offs that they're bullshitting.

On the ideology front, we can see the same trend in the election in New York's conservative 23rd District. The local Watertown Daily Times has decided to endorse the Democrat, Bill Owens, over the right-wing teabagger Douglas Hoffman:

Mr. Hoffman is running as an ideologue. If he carries out his pledges on earmarks, taxation, labor law reform and other inflexible positions, Northern New York will suffer. This rural district depends on the federal government for an investment in Fort Drum and its soldiers, environmental protection of our international waterway and the Adirondack Park, and the livelihood of all our dairy farmers across the district, among other support. Our representative cannot be locked into rigid promises and policies that would jeopardize these critical sectors of our economy.

Again, this lack of grounding in reality is the case for most conservative policies.

On the incoherent, dangerous bullshit front, this also precisely describes Joe Lieberman. He's whining that people question his motives and won't debate him on substance when he's repeatedly shown he has no principles and no substance. His excuses for opposing reform (despite campaigning on it in the past) have kept shifting, and have never been coherent or sensible on their own, either. He is a corrupt shill for the insurance industry. His current position is radical and unconscionable. But for Lieberman, the only agenda is promoting Joe Lieberman.

Singing Protest by Billionaires for Wealthcare

I've seen this several places. Billionaires for Wealthcare got creative in raising issues at a America's Health Insurance Plan (AHIP) conference:



From Sam Stein's piece on the event:

Republican pollster Bill McInturff was the keynote speaker on the final day of the America's Health Insurance Plans's state issues conference on Friday morning.

But his speech on how the health care reform debate was playing among the public was interrupted before it even began. A group of protesters began aggressively cheering McInturff for the work he has done for AHIP (he's a hired pollster for the private insurance lobby and, most infamously, was the force behind the 'Harry and Louise' ads in 1994)

McInturff, initially thinking that the cheering was legitimate, thanked the "AHIP officials" in the back of the room for giving him mental encouragement for his speech. He was not being paid for his appearance, he noted...

McInturff, who remarked earlier that he didn't have a joke to lead off with, pointed to the exiting protesters and said "there's my joke." But while his speech had been interrupted, the pollster actually admitted to being mildly impressed.

Stein also has the full lyrics. From the group's site, here's Rachel Maddow's coverage of the event:



This stunt gets major style points - all the more so because of the positive reactions from those not in on the gag. Most conferences get pretty dull, and this group performed very well. Watch out, corporate stooges! Guerilla theater is coming after ya!