Public Option

Helen Thomas National Treasure

Has some advice for President Obama.

Remember, the generals work for you. Think about how Harry Truman once proved the point. He had just fired Gen. Douglas MacArthur for publicly disagreeing with his policy against expanding the Korean War into China.

Truman elaborated on the decision for reporters in his typically blunt fashion:

"I fired him because he wouldn't respect the authority of the president. I didn't fire him because he was a dumb son-of-a-bitch, although he was, but that's not against the law for generals. If it was, half to three-quarters of them would be in jail."

We do not need war. We need health care!

Food Care

Michael Pollan on how food affects health care.

But so far, food system reform has not figured in the national conversation about health care reform. And so the government is poised to go on encouraging America’s fast-food diet with its farm policies even as it takes on added responsibilities for covering the medical costs of that diet. To put it more bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup.[...]
As for the insurers, you would think preventing chronic diseases would be good business, but, at least under the current rules, it’s much better business simply to keep patients at risk for chronic disease out of your pool of customers, whether through lifetime caps on coverage or rules against pre-existing conditions or by figuring out ways to toss patients overboard when they become ill.[...]
The moment these new rules take effect, health insurance companies will promptly discover they have a powerful interest in reducing rates of obesity and chronic diseases linked to diet. A patient with Type 2 diabetes incurs additional health care costs of more than $6,600 a year; over a lifetime, that can come to more than $400,000. Insurers will quickly figure out that every case of Type 2 diabetes they can prevent adds $400,000 to their bottom line. Suddenly, every can of soda or Happy Meal or chicken nugget on a school lunch menu will look like a threat to future profits.

I wonder if the rules will ever take effect.

We Can Not Afford To Wait

You Can Not Negotiate With The Crazy

Rick Perlstein in the WaPo writes.

t used to be different. You never heard the late Walter Cronkite taking time on the evening news to "debunk" claims that a proposed mental health clinic in Alaska is actually a dumping ground for right-wing critics of the president's program, or giving the people who made those claims time to explain themselves on the air. The media didn't adjudicate the ever-present underbrush of American paranoia as a set of "conservative claims" to weigh, horse-race-style, against liberal claims. Back then, a more confident media unequivocally labeled the civic outrage represented by such discourse as "extremist" -- out of bounds.

The tree of crazy is an ever-present aspect of America's flora. Only now, it's being watered by misguided he-said-she-said reporting and taking over the forest. Latest word is that the enlightened and mild provision in the draft legislation to help elderly people who want living wills -- the one hysterics turned into the "death panel" canard -- is losing favor, according to the Wall Street Journal, because of "complaints over the provision."

Good thing our leaders weren't so cowardly in 1964, or we would never have passed a civil rights bill -- because of complaints over the provisions in it that would enslave whites.

You have to know you are right and do the right thing. The Republicans have no intention of bargaining in good faith. Here is Digby

Arlen Specter and Joe Sestak were interviewed yesterday at NN by Susie Madrak and Ari Melber. Specter made some news when he revealed that from the beginning the Republicans had circulated among themselves that they were going to "break Obama" --- and it didn't originate over health care, but even before the stimulus. They never had any intention of acting in good faith. This didn't surprise me either. But it certainly seems to have surprised the administration, or at least they thought they could win them over anyway. But they can't.

Republican Hissy Fits

That is what they are good at. Krugman on health care.

Some of us were skeptical. A couple of months after Mr. Obama gave that speech, I warned that his vision of a “different kind of politics” was a vain hope, that any Democrat who made it to the White House would face “an unending procession of wild charges and fake scandals, dutifully given credence by major media organizations that somehow can’t bring themselves to declare the accusations unequivocally false.”

So, how’s it going?

Sure enough, President Obama is now facing the same kind of opposition that President Bill Clinton had to deal with: an enraged right that denies the legitimacy of his presidency, that eagerly seizes on every wild rumor manufactured by the right-wing media complex.

This opposition cannot be appeased. Some pundits claim that Mr. Obama has polarized the country by following too liberal an agenda. But the truth is that the attacks on the president have no relationship to anything he is actually doing or proposing.

There is no lie that the conservative media will not repeat.

Special Comment

The republicans are owned by corporate profits. So are many of the democrats. 1.4 million a day to kill health care reform. That money is not going to health care. Health Insurance companies do not provide health care.

Why Do Today What You Can Put Off Till Tomorrow?

My foot is still mysteriously swollen. I came home to Baltimoe, to have it checked out but have not yet called the doctor.

They See Money

Let the insurance companies compete against the government for our health care dollars.

Health Care

Is what we need. Not necessarily health insurance. Anyway I like this graph from maha.

Ezra Klein talks about “zombie lies that will not die.” He links to a ridiculous Bloomberg article by Amity Shlaes, who raises the dreadful specter of “government-run health care,” which I assume is a system in which heartless government bureaucrats decide what medical treatments you will receive. This would be a huge departure from our current system, in which heartless insurance company employees decide what medical treatments you will receive.

The whole post is worth a read.

Lucy And The Football

Lindsay Beyerstein has an article in the Washington Independent about Obama wanting to remove the birth control from the economic stimulus bill. He wants to make republicans happy.

If Democrats concede to Republicans on the issue, which appears likely according to the AP, many Democratic powerhouses, like Planned Parenthood — which endorsed Obama — will feel betrayed. Women’s advocates and health groups lobbied aggressively to convince the White House and Congress to include money for expanded birth control coverage in the stimulus bill. The groups had early success last week when the House Energy and Commerce Committee approved a version of the stimulus bill that included such language.

It just goes to show how little republicans care about abortion. People who use birth control are less likely to get pregnant and have an abortion. They are less likely to have a child in poverty. But republicans believe sex should have consequences and not good ones.

Oh and republicans are still going to complain and not vote for the bill.

Insurance Companies Are Not Health Care Providers

United Health Group agrees to settle for 50 million dollars. If they are agreeing to 50 million, you know it is worse than that. Again ans again insurance companies deny care for profits.
One of the nation’s largest health insurers has agreed to pay $50 million dollars in a settlement announced today after being accused of overcharging millions of Americans for health care.

The New York attorney general’s office launched an investigation after receiving hundreds of complaints about Oxford Insurance and its parent company, UnitedHealth Group, which claims to rely on “independent research from across the health care industry” to determine reimbursement rates. In actuality though, it relies on Ingenix, a research firm owned by UnitedHealth Group.

New York Attorney General Andrew Cuomo says Ingenix has been manipulating the numbers so insurance companies pay less. In a just-released report, he contends that Americans have been “under-reimbursed to the tune of at least hundreds of millions of dollars.” Although UnitedHealth Group and Oxford Insurance were the only entities investigated, other major insurers use Ingenix, including Aetna, CIGNA and WellPoint/Empire BlueCross BlueShield.

Remember this is only one company. Thats why Americans pay so much for insurance.

We're Number....

19 and last.

The United States fell from 15th to last among 19 industrialized nations on this measure from 2006 to 2008. The report estimated the U.S. health care system could save 100,000 lives if it matched Japan or France, the top performers.

OK maybe our health care is not that bad.

WASHINGTON (Reuters) - The United States fails on most measures of health care quality, with Americans waiting longer to see doctors and more likely to die of preventable or treatable illnesses than people in other industrialized countries, a report released on Thursday said

Americans squander money on wasteful administrative costs, illnesses caused by medical error and inefficient use of time, the report from the nonprofit Commonwealth Fund concluded.

"We lead the world in spending. We should be expecting much more in return," Commonwealth Fund senior vice president Cathy Schoen told reporters.

Just because the republicans on the TV say we have the best health care does not mean we do.

American Health Care

Sharon Astyk of Casabon's Book.

We only spend twice as much on medical care as most Europeans, but we report that we’re four times as unhappy with our healthcare system, so I bet if we worked on getting our spending up, we could be 10 times as unhappy with our medical care. One of the largest studies of end of life care in American history discovered that 65% of Americans die “in debt, in pain and alone.” Now I don’ t know about you, but that sounds pretty much like everyone’s worst nightmare. The same study found that many other nations do a vastly better job of simply making sure you don’t hurt and you have someone there. But here, the suffering costs extra.

Party Of Denial

The shrill one.

And that, surely, is the line the Democrats should be pushing in this election: Republicans have become the party of denial. If a problem can’t be solved with deregulation and tax cuts, they pretend it doesn’t exist.

Climate change is the obvious contemporary parallel with acid rain. But if the Democrats really want to pin the denialist label on John McCain, health care is the place to focus.

The health care situation, in case you haven’t noticed, is going from bad to worse. Many smaller companies stopped offering benefits between 2000 and 2005. In the past, health coverage has tended to improve when the economy recovers from recession — but the “Bush boom” brought at best a temporary stabilization.

And now that the economy is weakening again, another plunge is in progress: last week UnitedHealth warned investors that its business is suffering because fewer employers are offering coverage to their workers.

The Democrats have been offering real plans in response; they’re not perfect, but they are serious.

The G.O.P., by contrast — and this goes as much for Mr. McCain as for the Bush administration — hasn’t even tried to address concerns about coverage. Instead, it has all been about costs, which Republicans insist (wrongly) can be dramatically reduced by a policy of, you guessed it, deregulation and tax cuts.

Voodoo Health Economics

McCain just does not care about the American people. Krugman

Elizabeth Edwards has cancer. John McCain has had cancer in the past. Last weekend, Mrs. Edwards bluntly pointed out that neither of them would be able to get insurance under Mr. McCain’s health care plan.

It’s about time someone said that and, more generally, made the case that Mr. McCain’s approach to health care is based on voodoo economics — not the supply-side voodoo that claims that cutting taxes increases revenues (though Mr. McCain says that, too), but the equally foolish claim, refuted by all available evidence, that the magic of the marketplace can produce cheap health care for everyone.

As Mrs. Edwards pointed out, the McCain health plan would do nothing to prevent insurance companies from denying coverage to those, like her and Mr. McCain, who have pre-existing medical conditions.

The McCain campaign’s response was condescending and dismissive — a statement that Mrs. Edwards doesn’t understand the comprehensive nature of the senator’s approach, which would harness “the power of competition to produce greater coverage for Americans,” reducing costs so that even people with pre-existing conditions could afford care.

This is nonsense on multiple levels.

Read it all.

National Embarrassment

Remote Area Medical is a charity that flies doctors, nurses, and dentists into remote areas of the world for medical care because it is not available. Now they are doing it in the US, you know the place with the best health care in the world.

In a matter of hours, Remote Area Medical set up its massive clinic, for a weekend, in an exhibit hall in Knoxville, Tenn. Tools for dentists were laid out by the yard, optometrists prepared to make hundreds of pairs of glasses, general medical doctors set up for whatever might come though the door. Nearly everything is donated, and everyone is a volunteer. The care is free. But no one could say how many patients might show up.

The first clue came a little before midnight. Stan Brock, the founder of Remote Area Medical, opened the gate outside. The clinic wouldn't open for seven hours, but people in pain didn't want to chance being left out. State guardsmen came in for crowd control. They handed out what would become precious slips of paper - numbered tickets to board what amounted to a medical lifeboat.

It was 27 degrees. The young and the old would spend the night in their cars, running the engine for heat, but not much - not at $3 a gallon. At 5 a.m., Pelley took a walk through the parking lot.

"We got up at three o’clock this morning and we got here about four. We’ve been out where a little while it's cold," Margaret Walls, a hopeful patient from
Tennessee, told Pelley.

"Why did you come so early?" Pelley asked.

"'Cause we wanted to be seen," Walls replied.

Marty Tankersley came with his wife and his daughter, asleep behind the front seats. Tankersley says he drove some 200 miles to get to the clinic and slept in the parking lot for hours.

"Just to have this done?" Pelley asked.

"Yes, sir. I've been in some very excruciating pain," he replied.

Canadian Health Care

Some myths busted by Sara Robinson.

I'm both a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border. As such, I'm in a unique position to address the pros and cons of both systems first-hand. If we're going to have this conversation, it would be great if we could start out (for once) with actual facts, instead of ideological posturing, wishful thinking, hearsay, and random guessing about how things get done up here.

To that end, here's the first of a two-part series aimed at busting the common myths Americans routinely tell each other about Canadian health care. When the right-wing hysterics drag out these hoary old bogeymen, this time, we need to be armed and ready to blast them into straw. Because, mostly, straw is all they're made of.

Read it all.

We Are Number One!

Oops, I see we no longer had the highest standard of living in the world. Well, at least we have the best health care.

France is tops, and the United States dead last, in providing timely and effective healthcare to its citizens, according to a survey Tuesday of preventable deaths in 19 industrialized countries.[...]

"It is startling to see the US falling even farther behind on this crucial indicator of health system performance," said Commonwealth Fund Senior Vice President Cathy Schoen, who noted that "other countries are reducing these preventable deaths more rapidly, yet spending far less."

The 19 countries, in order of best to worst, were: France, Japan, Australia, Austria, Canada, Denmark, Finland, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, the United Kingdom and the United States.

Some countries showed dramatic improvement in the periods studied -- 1997 and 1998 and again between 2002 and 2003 -- outpacing the United States, which showed only slight improvement.

White the United States ranked 15th of 19 between 1997-98, by 2002-03 it had fallen to last place.

"It is notable that all countries have improved substantially except the US," said Ellen Nolte, lead author of the study.

(bolds mine)

Where is that money going? Could it be huge profits and overpaid CEO's?

Republican Health Care

Health care guru Ezra Klein on republicans health care.

Right. When it comes to health care, conservatives use policy the way pick-up artists use astrology: It's something to talk about while they try to screw you.