Beth's Health Care Reform Blog

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Seven falsehoods about health care reform - from the neutral factcheck.org ... http://factcheck.org/2009/08/seven-fals ... alth-care/

Here's a similar story by Newsweek: http://www.newsweek.com/id/211981/page/1

And here's a really great resource to allow you to fact check health care advertising (just click on the link next to the ad to see the facts!): http://www.kaiserhealthnews.org/Ad-Audit.aspx

And on this page, you'll find a whole list of links to some other fact checking cites and other great neutral unbiased resources to learn the truth about health care reform legislation and issues: http://www.pbs.org/moyers/journal/08142 ... #resources

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Very good information

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We start today's coverage of health care reform with this cleverly funny article by Chris Kelly entitled "Sarah Palin Wins" ... enjoy! ,

Sarah Palin Wins
by Chris Kelly

The Senate Finance Committee has stripped a provision to reimburse Medicare doctors who provide end-of-life counseling to dying patients from its version of health care reform. Take that, Hitler.

Hitler, like I have to tell you, supports Medicare reimbursement for end-of-life counseling because he wants the Federal government to talk America's old people into killing themselves. We don't know why he wants this. Maybe he's still bitter about the Battle of the Bulge.

And he would have gotten away with it, too, if not for Sarah Palin's Facebook page.

Sarah Palin Facebook status was: "... is fearing Death Panels." (Thumbs down. Doesn't like this.) And that was good enough for Chuck Grassley.

As Grassley explains:

We dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly.
If you were really, really bone ignorant, for example, you could think they meant, "death panels."

Fair enough. You don't want to confuse people into getting Hitlered. But was this idea that complicated? You get the very real impression that if our standard for legislation was "understandable to Palins" we'd have to retire the "Yield" sign.

Does Chuck Grassley mean we can only write laws that make sense to people who can't name a newspaper?

Are we really stripping counseling from health care because of what doctors might say? (We all know, given the chance, a doctor will always talk you into suicide. That's where the money is.) Why not forbid doctors from talking to patients at all, just to be safe? Call it the Palin-Grassley Freedom from Information Act.

Of course that's not what we're really talking about. We know that end-of-life counseling doesn't mean euthanizing the gullible. (Soylent Green is Palins! Soylent Green is Palins!) Getting this bill rewritten -- or getting it killed altogether -- is about something more primal than that.

It's about how good it feels to bully someone.

(That's what the town hall protests are about to. What could be more a more basic human pleasure than to scream at someone until they give you what you want?)

(And what's the most satisfying thing to demand? Silence.)

There are thousands of words in the health care bill that Sarah Palin and the Tea Baggers could have chosen to misconstrue. They chose the counseling provision because if they could defeat that, it would mean they had to power to tell a doctor to shut up.

Doctors think they're so smart? Well, they ain't gonna tell me about medicine. Or any of their other patients, either, without they gets my say so.

Same as congressmen tellin' me about gummint. I'm a gunna hollar 'atil they shuts up too.

Just like James Madison would.

--

So Sarah Palin wins.

I keep thinking about what Robert Stone wrote about Lee Harvey Oswald.

This was a man whose only gift was the wit to compound his mistakes exponentially. A man to turn a personal fuck-up into a national disaster and make his problems everybody's.

Source: http://www.huffingtonpost.com/chris-kel ... 59395.html

Here's an interesting video piece with highlights of some of the most outlandish and outrageous claims being made at town hall meetings:
http://www.huffingtonpost.com/2009/08/1 ... 57786.html

Well, with that interesting background set, let's discuss the facts and set the record straight with calm and reason ...

Senator Bernie Sanders poses some really interesting questions for the folks attending town hall meetings ... let's have a real & honest debate: http://www.huffingtonpost.com/rep-berni ... 59468.html

More on encouraging real debate & denouncing shouting at town halls:
http://www.huffingtonpost.com/jodie-eva ... 58041.html

And you've got to love this response by Rep. Rick Larsen at a town hall meeting responding to a whacky protester "I've got facts on my side, you've got Glenn Beck!" , http://www.huffingtonpost.com/2009/08/1 ... 59571.html

Frankly, before I forget, I do want to address one issue that keeps coming up at these town halls, and that is the call for "tort reform." Perhaps the reason tort reform is not in any of these bills is because it has already been done. As a practicing lawyer, I cannot think of any of the 50 states that has not already passed substantial tort reform and imposed artificial damage caps on valid tort claims. Judges already have the power to throw out frivolous lawsuits and impose heavy fines on lawyers and parties that bring them - and they routinely do. If anything most of the tort reform legislation actually went too far to protect grievous wrongdoers from having to pay what they should for their intentional or reckless conduct. Tort reform is not the answer.

Here's another article from sitting U.S. Senator Robert Menendez on "The Politics of Fabrication and Fear" ... http://www.huffingtonpost.com/robert-me ... 59577.html

Go here, to hear NPR's interview with Senator Menendez about the town halls & the realities of health care reform: http://www.npr.org/templates/story/stor ... h-20090814

Sarah Palin actually supported end of life counseling while she was Governor, now she flip-flops and calls them "death panels" ... the article notes that Newt Gingrich has also flip-flopped on the issue. My how the political winds do shift to suit whatever might work to oppose Obama! http://thinkprogress.org/2009/08/13/pal ... -flipflop/

Yet, despite having been debunked by the neutral unbiased factcheck.org and others (see e.g., http://factcheck.org/2009/08/seven-fals ... alth-care/ ), Sen. Grassley continues to push fear of make believe "death panels" onto his constituents at town halls and falsely claim that the bill would allow the Government to "pull the plug on Grandma": http://www.huffingtonpost.com/2009/08/1 ... 57677.html

Interesting editorial in the NY Times by Paul Krugman on the Republican Death Trip strategy: http://www.nytimes.com/2009/08/14/opini ... ugman.html

Of course, spreading false rumors of "death panels" to create fear for purposes of defeating health care reform are nothing new - the Republicans used the very same tactics to defeat universal health care reform when Hillary proposed it in the mid-90s: http://www.nytimes.com/2009/08/14/healt ... panel.html

While certainly some people are afraid of changes, and the unknown, or have legitimate questions about the cost or the fears & unknowns of governmental involvement, just as certainly some of the opposition at town hall meetings is manufactured and financed and coached by well financed interests opposing any meaningful reform.

Here's a really funny PDA denouncing scare tactics & supporting reform: http://www.youtube.com/watch?v=c733cWzfLPs

Dr. Andrew Weil poses this question for all Americans, particularly conservative Americans, to consider:

But here's my question: Since when is it conservative to embrace new, overpriced, corrupt systems, like the health-destroying and ruinously expensive protocols of much of modern medicine? "Conservative" has several meanings, but two central ones are "favoring traditional views and values," and "avoiding excess." I hold that nothing could be more wild, unconstrained, and downright liberal than the path medicine has taken in just the last 20 years -- an unprecedented bacchanalia of excess and contempt for traditional American values.

See Dr. Weil's full article here: http://www.huffingtonpost.com/andrew-we ... 59869.html

The real danger to health care reform as I see it, and one I may soon expound on further in a separate piece, is it's price tag. More specifically, not just the cost of the bill itself, but the fact that it's price tag follows closely on the heals of a multi-billion dollar bailout of the auto industry and a trillion plus dollar bailout of wall street. Not to mention the mega trillion cost of the Iraq war, which we never should have entered, and our military's on-going efforts in Iraq. It's unfortunate that health care reform and it's financing follows on the heals of these tremendous expenditures, most of which I and a lot of us supporting health care reform would not have voted to support. The reality is, however, that if we can find money to bail out rich CEOs that run their companies into the ground and finance killing people who didn't attack us on 9/11, then surely we can find a way to finance meaningful health care reform that provides coverage to all Americans, prevents deaths and improves our health. In the battle of societal priorities, it seems to me that the latter certainly trumps the former.

"When I look at the federal budget and realize that if we don't control costs on health care, there is no way for us to close the budget deficit, it will just keep on skyrocketing . . . ," President Obama said at a town hall meeting Tuesday, "I say, we have to get it done."

Anyway, here's an interesting piece from the Washington Post discussing the current proposals and ideas being debated on Capitol Hill related to the costs and financing for health care reform: http://www.washingtonpost.com/wp-dyn/co ... 01712.html

I agree with Arianna Huffington's comments about what President Obama needs to do to obtain meaningful reform in her interview with Keith Olbermann on MSNBC's "Countdown" program on Wednesday:

President Obama needs to give up his delusion that both parties and industry interests can all come together to achieve real health care reform. She said the president needs to realize that "there is a whole industry here working against reform and the president needs to stop acting as though everybody's interests are aligned." Arianna added that to accomplish meaningful reform with a public option and the ability to negotiate for lower drug prices, Obama should be saying: "If you are with us, come on board. If you are not, get out of the way."

Watch Keith Olbermann's great editorial denouncing Republican fear tactics and his interview with Ms Huffington on why a bi-partisan approach will not work. Source (with video): http://www.huffingtonpost.com/huff-tv/a ... 58193.html

Finally, we close today with this greatly entertaining piece that hopefully will help put an end to death panel rumors once and for all:

If Only Healthcare Reform Covered Full Insanity
by Robert J. Elisberg

I was going to ask, "How stupid do you have to be to believe that the government is creating a health reform bill that will include killing our senior citizens?"

But I realized that's the wrong question. The proper question is:

"How angry at losing political power or how frightened about liberals or how scared at any change or how terrified at having a black president or how stupid do you have to be to truly believe the United States is creating a public health bill to kill senior citizens?"

Mind you, I'm not talking about people against health care reform. That's another matter entirely. The topic at hand here is one thing only -- believing that the U.S. government wants to kill its senior citizens and weakest members.

That's the issue. And that's what is incomprehensibly insane.

And if right now you are reading this and sputtering, "No, it's not insane because..." then you are among those who, while likely a level-headed and good-hearted person at most times, are being too stupid or angry or frightened or entrenched or racist.

Pick one.

(Just to be clear, you don't have to be all the above. Any one will do. But of course, feel free not to limit yourself to just one, if you are so inclined. That's totally your choice.)

The only thing not your choice is thinking that the U.S. government wants to kill its weakest citizens. Try to justify that, and you lose all sanity defenses.

"Yes, but..." doesn't cut it. Crying socialist, communist, fascist, racist, Hitler, Stalin doesn't cut it.

(Geez, folks, where were you the last eight years? We could have used you. Yet as draconian as the Bush Administration was, even with George Bush scorning the Constitution as "just a goddammed piece of paper," I still know they weren't trying to kill your puppy.)

Actually reading the portion of the bill might be asking too much, but the issue is really quite simple. Most doctors right now meet with their sickest patients to discuss the future openly. Not to make recommendations, just to explain honestly what a patient is facing. (Such options, by the way, include, "You can be kept alive on every pill and medical device known to man as long as humanly possible.") It's the patient's choice. It's the patient's choice if they even want to meet with the doctor! All this bill does - All This Bill Does - is reimburse you for the doctors' bill. For what they're already doing. Reimburse you for what doctors have been doing since the beginning of medicine. Often for free.

That's it. It's about payment reimbursement.

Check it out here. HR 3200, Section 1223. Read it first.

Okay, honestly, I really do get it that there are people who think the government wants to kill old people.

What I don't understand is how deeply, gut-wrenching, twisted-up inside do they have to be to believe it?

How white-ash bleak must one's fury be at having political power for eight years and then losing all of it to ignore reality and believe the government wants to kill old people?

How stomach-churning horrified must one be towards liberalism to believe that liberals, who brought about Social Security, Medicare and civil rights, want to now kill the elderly and needy?

How frozen with angst must a person's life be to believe change means the government wants to kill them?

How terrified in one's soul must someone be towards black people to believe that a black president would want to kill the weakest people in America?

And how willing must a person be to completely stop thinking for themselves to believe without questioning that the United States wants to will senior citizens?

It must be hell inside to be that torn up with vitriolic hatred, hysterical panic, and emptiness to prefer to believe the insane rather than simple reality.

The government is not trying to kill senior citizens. Here, let me give you a hug. It's all okay.

Now, in fairness, some GOP spokesmen who are creating this fear-mongering fall into the above-mentioned categories themselves. But in equal fairness, most know better and are just demagogues trying to relentlessly lie and terrify people for political gain.

Like when resigned-governor Sarah Palin wrote last week how "my baby with Down Syndrome will have to stand in front of Obama's 'death panel.'"

Or like when Newt Gingrich said on Sunday that in this government "there are clearly people in America who believe in establishing euthanasia."

And even Sen. Chuck Grassley (R-IA), who said on Wednesday, "[Y]ou have every right to fear...We should not have a government program that pulls the plug on grandma."

You want to discuss "downright evil," as Ms. Palin called it? Start with these statements. Toss in others from Republican spokesmen just like them.

They know better. (And I'm bending over backwards to presume that Sarah Palin does know better.) But what they are doing is just trying to terrify susceptible people into believing insane things, just to advance a conservative agenda.

(How susceptible? An audience that rants against government-run health care while supporting Medicare makes the demagogue's job oh-so much easier. It's like playing with human silly putty.)

A demagogue who relentlessly repeats an insane lie, that's one thing. But how angst-ridden does a person have to be to truly believe that the U.S. is creating a health bill that will kill our senior citizens?

Even the barnyard animals knew that Chicken Little was nuts, no matter how many times he yelled that the sky was falling.

The government is not creating a bill to kill senior citizens.

You know better.

Source: http://www.huffingtonpost.com/robert-j- ... 58653.html

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Jon Stewart on Glenn Beck's flip-flop on how awesome health care in America is ... too funny! http://www.thedailyshow.com/watch/thu-a ... -operation

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Some nice interviews on Bill Moyers journal this week - on fearmongering, media coverage, and more importantly, what it will take to get meaningful reform legislation passed, and even one on why conservatives should favor certain aspects of reform ... watch the show here: http://www.pbs.org/moyers/journal/08142009/watch3.html

Here's the complete transcript of Moyers' interview with Kathleen Hall Jamieson, Director of the the Annenberg Public Policy Center at the University of Pennsylvania (which runs factcheck.org) and Drew Altman of the Kaiser Family Foundation (which runs Ad Audit, a KFF cite which verifies truth in health care advertising) (Note: there are links to both these cites in other replies that I've posted in this series on health care)

August 14, 2009

BILL MOYERS: Welcome to the JOURNAL.

I'm okay with protest. Sometimes I wish I'd done more of it myself when I was young.

But it's hard to reason with someone who's packing a gun. That's why I found so menacing that photograph of the fellow standing outside President Obama's town hall meeting on health care in New Hampshire this week with a 9mm pistol strapped to his thigh and a sign quoting Thomas Jefferson on watering the tree of liberty with the blood of tyrants and patriots.

Knowing from his MySpace profile that he admires white supremacists, it made me queasy to see that man standing there, pistol at his side. Of course he's exercising his Second Amendment rights under the Constitution and he has a carry permit. But still…

The protesters I admire are those unarmed men and women who put themselves in danger for Civil Rights. And the Suffragettes, marching for the right to vote. And the veterans of the Bonus Army who camped out in Washington after the first World War when the government defaulted on its obligations to them. And those who spoke out against the Vietnam War. I've been haunted for years by the image of the pacifist who doused his clothing in kerosene and burned himself to death beneath Robert McNamara's Pentagon window in 1965, soon after I'd had a meeting in that very office. Some said he was delusional, but his wife said he was expressing "His concern over the great loss of life and human suffering caused by the war in Vietnam." Over the years I came to better understand the deeply moral grounding of his anguished martyrdom.

PROTESTORS: No more Obamacare. Just say no! Just say no!

BILL MOYERS: So you can see, perhaps, why it's hard even to describe as protests what's happening today -- the raucous disruption of town meetings that deny others their right to free speech. The cries of tyranny, the analogies to Hitler on the signs and in postings on the internet. That's not conscience at work; it's the product of colicky, cranky unconscionable anger, fueled by lies.

Here's Newt Gingrich dissembling on health care. Yes, the same Newt Gingrich, once disgraced, now back on the Sunday talk shows like Napoleon returning from Elba.

NEWT GINGRICH: You're asking us to trust turning power over to the government when there clearly are people in America who believe in establishing euthanasia including selective standards.

BILL MOYERS: Remember, this is from the man who told the New York Times in 1994 that he would use opposition to Clinton's health care reform as "…a springboard to win Republican control of the House." That's exactly what he did - and hopes to do again.

Oh, I forgot Sarah Palin, who, like Gingrich, is also vying to speak for the extreme right of their party. She noted on her Facebook page that, quote, "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel'… Such a system is downright evil." She said.

Death panel? We have nothing to fear but fear mongering itself.

Even in the hallowed halls of Congress, the cuckoo flu seems to have reached epidemic proportions:

REP. PAUL BROUN: This program of government option that's being touted as being this panacea, the savior of allowing people to have quality health care at an affordable price, is going to kill people.

BILL MOYERS: Throughout our history, there's a thin line between hot-headed, partisanship and deeply ingrained paranoia. Yet what are we really talking about? Nothing less -- or more -- than trying to do a civilized thing -- stem the exorbitant costs of a health care system that routinely victimizes those without the wherewithal to check into a hospital when they're sick.

How to make sense of all this? I put out an SOS for my two guests. They're just what the doctor ordered.

You'll recognize Kathleen Hall Jamieson instantly -- she's been at this table often, making sense of politics and the press. She is director of the Annenberg Public Policy Center at the University of Pennsylvania, which runs FactCheck.org, a non-partisan research organization that tests the accuracy of our political discourse. Among her many books is my favorite, UNSPUN: FINDING FACTS IN A WORLD OF DISINFORMATION.

Drew Altman is President and CEO of the Henry J. Kaiser Family Foundation, widely respected for its independent research and information on American health care. The foundation runs a superb, impartial website that looks at the health care reform advertising blitz and measures claims against the truth -- check it out via our website at PBS.org.

Welcome to you both. You're just in time.

DREW ALTMAN: Thank you.

KATHLEEN HALL JAMIESON: Thank you.

BILL MOYERS: We're seeing this debate take a really ugly turn. Let's take a look at how ugly.

CROWD: No more Obamacare! No more Obamacare! No more Obamacare!

PROTESTOR MALE: Tell me what page it's on. What page is it on?

REP. JOHN D. DINGELL: It is in the bill.

PROTESTOR MALE: What page?

REP. JOHN D. DINGELL: Go and sit down.

PROTESTOR MALE: You want to talk about conspiracies? I'll tell you about conspiracies!

PROTESTOR MALE: One day God's going to stand before you and he's going to judge you.

CROWD: Kill the bill! Kill the bill! Kill the bill!

PROTESTOR FEMALE: I want to know if it's coming out of my paycheck? Yes or no!

REP. JOHN D. DINGELL: Your employer supports the bill.

PROTESTOR FEMALE: I want an answer to the question!

BILL MOYERS: Kathleen, what's playing out here?

KATHLEEN HALL JAMIESON: People who are angry and frustrated and not necessarily well informed in part driven by people who are on the other side of the reform effort. And it's driving into news evocative visuals that are leading the public, I think, to overgeneralize the extent to which there is principal, reasoned dissent from health care reform.

DREW ALTMAN: It's part of our democracy, but I think it's actually kind of sad because the left, doesn't like this legislation a lot. They're not really enthusiastic about it. They would prefer a single-payer approach with more government. And on the conservative side, they're not crazy about it either. They would like a market approach, people getting vouches or a tax credit and just shop in the marketplace. This is down-the-middle legislation. And yet we see these fears and concerns as if this were a radical approach. It's not a radical approach. It's just a down-the-middle approach.

KATHLEEN HALL JAMIESON: But you're also seeing something else. In your clip you see a woman who says, "Is it coming out of my paycheck?" She's raising a legitimate question. But when people are shouting at each other, the answer doesn't get through. And when you're impugning the integrity of the person who's answering the questions, the member of Congress, that person's response isn't going to be believed if it is able to be articulated and isn't simply shouted down.

And so it's not creating context in which misinformation on both sides can be corrected. And that's the problem. We don't have a deliberative process here taking place in public to inform public opinion.

Instead, we're potentially distorting it.

DREW ALTMAN: But I think what also happens is, the concerns of most Americans, of average Americans, just get lost in this process. This whole debate began because of the real problems and worries that average people are having paying their health care bills. And what we really have here are the strong concerns and fears-- and you don't want to minimize them; it's part of our democracy-- that some people have about this legislation.

But the worries that average people have that we see in our polls about paying their bills get lost. And in instead we're debating other things, fears that people have that really aren't there in the legislation.

BILL MOYERS: How do we decide who these people represent? I mean, are they just a fringe element that are like honey to the cameras of the press? Or is there something else going on that's difficult at this moment to measure?

KATHLEEN HALL JAMIESON: I'm not sure that we should be trying to measure it. I worry about public opinion polls coming into this environment and asking questions that may actually distort our understanding of what the public knows. Unless you start by asking the public in a poll what they know, what the baseline level of knowledge is, it doesn't matter what the public thinks ultimately about a piece of legislation or not because you can be reflecting uninformed public opinion.

But the nature of public opinion it's expressed in "USA Today" in-- at a front-page piece that appeared on Thursday of this week which says "Protests Tilt Views on Health Care Bill." Now that's reflecting the results of a poll that asked about people's response not to the health care bill but to the protests about the health care bill.

But the headline leads you to think it's about the health care bill itself. And it suggests that public opinion is now shifting dramatically away from the Obama health care reform efforts.

BILL MOYERS: So the protests seem to be making some people more sympathetic to the protesters?

KATHLEEN HALL JAMIESON: And potentially the press then picks that up, polls, finds that sympathy, creates a structure that suggests that health care reform initiatives are losing support. Now polls have driven press coverage which says "Obama on the defensive. Obama struggling to explain. Obama trying," when, in fact, the dynamic under that has been created by a news structure that decided to cover this in a certain way, to do polling in a certain way. And those two things played into the process to make it more difficult for the discussion to actually happen about the substance of what's going on.

DREW ALTMAN: So it's exactly right. So we have the protests, the media coverage, especially the 24-hour news cycle, follows the protests and the town meetings. Then the polls poll about the media coverage of the protests. And we create almost an alternative reality about what is occurring out there.

When you look at the real polls about where the public actually is, what you see is there's been a little bit of a tick down in public support and people are getting a little anxious as they follow the media coverage. But still the majority of the American people are for moving forward with this.

And we have seen more people begin to say, "Gee, I'm not so sure that this is good for me and my family," but it's still a small number. It's only 20, 22 percent who say, "I'm a little bit worried about this." And a much bigger number say, "I still think this is good for me and my family." And then you've got a group in the middle who's not so sure. And everyone's fighting for that group on both sides.

KATHLEEN HALL JAMIESON: And imagine if you're trying now as just a person who's sitting in your home and you do all sorts of other things, you have a job, you have children, you know, you have all sorts of concerns. And what you get of this debate is what comes through news. The pictures that you're seeing are-- because the news is focusing on conflict and attack, are a very angry people shouting at representatives.

First, no substantive information. But secondly, what aren't you seeing? Well, you aren't seeing something that actually was featured on the front page of "The New York Times" this week. "Free health care draws thousands. Thousands of people came to the forum in Englewood, California, for free dental care and free medical and vision services." People at protests-- people protesting health care reform shouting at legislators as opposed to people waiting for free health care and dental care--

DREW ALTMAN: Who can't afford it otherwise.

KATHLEEN HALL JAMIESON: Who can't afford it otherwise.

DREW ALTMAN: Right.

KATHLEEN HALL JAMIESON: Now suppose we saw more of these pictures and fewer of those or just a balance of the two. You'd have a completely different sense of what's at play in the debate. Pictures matter. Evocative visuals lead us to generalize to what's important to the framing of the debate, how we should see this discussion. And also they help shape the answers to those public opinion polls. More pictures of people dissenting, more sense that maybe we should hold back a little in our support. More pictures of people in need of care, people just like us who don't have it, greater sense that maybe there's a social concern here. And then the question might I, the insured, at some point be in that situation?

DREW ALTMAN: And you really got to feel bad for just the American people who, from the beginning, have just been trying to answer one question. Will this help me with my health care bills? That's the question they're trying to answer.

And so they're turning on the television and they're seeing a debate about whether this is Russia or it isn't Russia and whether there are death panels and whether it's a government take over of the health care system. And they just want to know "my premiums are going up $1 thousand every five years. And is this going to help me with that 'cause I can't pay my rent or my mortgage? I'm having trouble paying for my food because of my health care bills." That's really the question they want answered.

BILL MOYERS: Some of it depends upon how well the member of Congress handles the protest. I saw one this week in which Senator McCaskill of Missouri did quite well. Take a look.

SEN. CLAIRE MCCASKILL: We will not get a single-payer bill, nationalized health care system out of Congress. It's not even on the table… I don't understand this rudeness. What is this? I don't get it. I honestly don't get it. Do you all think that you are persuading people when you shout out like that? Beg your pardon? You don't trust me.

BILL MOYERS: Some of those protesters, some of the loudest protesters, were advocates of a single-payer nationalized plan that-- which she said is not going to happen. So what do you think about how she handled that?

KATHLEEN HALL JAMIESON: Well, first, there is a way to structure these encounters in which you increase the likelihood that the person who is there to speak for the Congress, in this case Senator McCaskill, actually is able to control the microphone.

And in part in this structure in the rooms of some of these members as they talk to audiences is set up for confrontation because the member is standing there in the same environment, looking face to face with all these individuals. And once you get into that range and cameras come in, you can hear the shouting out at the same moment you hear the member's voice. And as a result, the member doesn't control the environment. She's controlling the environment.

But more importantly, she, across the last week, has held a number of forums in which she's had a chance to explain in depth at longer-- in longer periods than this the substance of the various pieces of legislation and debunk misinformation. That's the way democracy should work. And that the attacks are coming from both the left and the right is an important realization. There's been a tendency in news to feature those that are coming from the right without indicating there's substantial dissatisfaction from some on the left about the fact that this isn't single-payer at the time which those on the right that, yes, it is; it's Canadian style socialized medicine. That is going to produce all sorts of bad outcomes that, in fact, don't occur in Canada or Great Britain, in fact.

DREW ALTMAN: It's revealing that in this clip, the single-payer advocates were so upset with the Senator because it just makes the point that both the folks further on the left and on the far right are equally dissatisfied with this legislation.

I'd like to make just one other point about this bill, which is that they're all doing town meetings. And these town meetings, of course, bring out folks who are most interested in the issue on the right and on the left.

And that leaves the President alone as the national communicator about health reform. And it might have been helpful if some of these members in the Congress who are putting this legislation together also played a role as national explainers of what's going on with health reform because, again, the President is by himself as the national explainer of this issue.

BILL MOYERS: But how do you explain that he has lost control of the message? I mean, he's got the biggest pulpit of all. And yet he's not determining this narrative right now, right? How did he drop the ball?

KATHLEEN HALL JAMIESON: He's lost the message in news. He didn't lose the message in his town hall earlier this week when he spent much of the time in the town hall explaining the legislation and arguing that the status quo is scarier. If we don't change, it's scarier than if we do change.

And he did it in detail and he did it very effectively. News then comes in and plays that town hall as Obama on the defensive, trying to explain his message.

And so what happens is the few who watch the town hall get the whole context. That was an effective town hall for President Obama. He made one serious error when he suggested AARP had certified the legislation, that the legislation would not produce cuts in Medicare, when in fact it has not endorsed any legislation.

That also then is featured in news. But those who watched the whole town hall I think reasonably would have concluded a strong case was made that keeping the status quo, not putting change in place, was scarier. What was going to happen in the future is scarier for those with insurance than it would be if we made the change.

DREW ALTMAN: I think, in addition, what happened is for a time the experts' agenda and the policy makers' agenda on Capitol Hill hijacked the public's agenda.

BILL MOYERS: What do you mean?

DREW ALTMAN: Because the focus became about bending the curve and health information technology and the policy makers' understandable interest in reducing the federal deficit in the future.

And now, as you may have noticed, they brought the discussion back to the concerns of the people, which brought us this debate in the first place. And so the language has changed. It's now about health insurance reform and not about health reform.

BILL MOYERS: Take a look at this montage.

PRESIDENT BARACK OBAMA: And that's why we are going to pass health insurance reform in 2009[…] Now when we pass health care reform, insurance companies will no longer be able to place some arbitrary cap on the amount of coverage you can receive, in a given a year or a lifetime[…] we are closer to achieving health insurance reform than we have ever been[…]every time we come close to passing health insurance reform, the special interests fight back with everything they've got.

BILL MOYERS: Health insurance reform. Not health care reform. What's the strategy behind that?

KATHLEEN HALL JAMIESON: People like their health care. They don't want their health care reform. The problem is one of access and cost. And they mis-framed this debate in 1993, '94 by talking about health care reform. Early in this debate--

BILL MOYERS: The Clintons?

KATHLEEN HALL JAMIESON: Yes. Early in this debate, talked about health care reform brought up all the wrong associations. If it's health insurance reform, then who's potentially the enemy? The insurance industry. Who's rationing care? It's the insurance industry. Who should we be concerned about bringing under control? The insurance industry. They're the ones who stand between you and your doctor.

Obama's coming in to interdict that. He's going to get this under control. It's a very important reframing.

DREW ALTMAN: I think this is really critical because this wasn't the debate drifted for a while and the message drifted for a while. It wasn't defined in terms that average people could understand. So they couldn't answer--

BILL MOYERS: You're including me in that. I'm serious about that.

DREW ALTMAN: And maybe I--

KATHLEEN HALL JAMIESON: I think you're including all of us in that.

BILL MOYERS: Yeah.

DREW ALTMAN: So people just couldn't answer the question, "What does this mean for me and my family?" And so they didn't know what they had to lose if this didn't happen. But more importantly, that left the field open for the critics and the opposition to define it the way they wanted to and even to scare people a little bit that this might be a government takeover of the health care system. Or a bureaucrat might get between you and your doctor.

People couldn't say, "No, I want to fight for this because I know what I'm going to get. I'm going to get some help with my bills." Or "I'm going to get-- the insurance system is going to change. And if I get sick or if I have cancer or heart disease, I'm going to be able to get health insurance and they can't drop me. Or I can change jobs and I'll still have health insurance coverage."

They didn't know what they would get. They didn't know what they might lose if this didn't pass. And that now is changing. In a sense, what happened was the media and the debate focused on the issues which were in contention on Capitol Hill, that they were debating on Capitol Hill, because media coverage follows the controversies instead of the people issues that brought us this debate in the first place.

BILL MOYERS: Let me show you the ad that the liberal group MoveOn.org is running-- taking on the insurance industry in the vein of what-- Obama was saying in Portsmouth, New Hampshire this week. Take a look.

ADVERTISEMENT: They are enormous and powerful. They prey on our weaknesses, trying to separate the healthy from the sick. Their strategy is to confuse and exhaust their victims. And they kill people each year by denying coverage while profiting billions. During shark week, let's take on the real predators: health insurance companies. Call Congress, tell them: don't put insurance profits before health care. Support a real public option.

KATHLEEN HALL JAMIESON: It's an evocative image, the idea that the health insurance industry is a shark about to devour you. But what-- as it plays with you beforehand, it's certainly one that's memorable. I don't think it's fair to suggest that they're killing people. There is a process in place, however, in which if the public option is robust in this health insurance plan, it does dramatically change what they are able to do.

And we could come out of this reform scenario with a world in which things are much better for the insurance industry but don't necessarily accomplish the objectives that President Obama has if the public option is taken down by arguments that it's government takeover or socialized medicine or whatever.

I think the public option is an important piece in cost control and in insuring long term that the insurance industry, which has many positive aspects, but that the insurance industry is as competitive as it ought to be but also to treat people fairly

DREW ALTMAN: You know, one side says it's a government takeover of the health care system. And the other side says, "Well, then you'll just be left at the mercy of the sharks in the health insurance industry." That's messaging. It's standard health reform messaging. Whether there is or isn't a public option in this legislation, it would fundamentally change how private health insurance works in a way that would be better for people. That's the substance of the legislation.

BILL MOYERS: How do you explain the disinformation and the misinformation? You had Representative John Mica this week saying that Obama's plan creates a new cottage industry of death counselors. You've got Sarah Palin, Newt Gingrich talking about euthanasia. What-- how do you account for that? And how does the press break through and the average citizen break through to understand that that's a lie?

KATHLEEN HALL JAMIESON: That's one of those claims generated because a provision in the bill has meant-- a provision of one of the bills has been seriously distorted. But in this case, news organizations have actually done a very good job debunking the claim. If you just simply count up the number of news organizations that have taken that on, gone to the provision, said, "It's not there; here's what this is," you'd say news has done a pretty good job.

Why is there still misinformation out there? Because you have in these news accounts of the town halls people still shouting about death counsels or death panels. And as a result, it's still getting through in news despite news's own debunking of it.

BILL MOYERS: So it's an effective strategy?

KATHLEEN HALL JAMIESON: Any strategy which takes the White House off message and puts the President in the position of having to deny the death panels are in a bill is an effective strategy for the opposition. It takes something which is a tiny, tiny, tiny misleading piece of one piece of potential legislation and blows it up into being, in effect, the intent of the bill, killing grandmother.

DREW ALTMAN: But there's a deeper issue, I think, which is not just debunking the myths and doing the fact checking, which is critically important. But it is how much and how often you cover the town hall meetings and spend time debunking the myths and doing the fact checking because the more you cover it, the more the focus becomes the ads and the town hall meetings. Even if you're fact checking and even if you're providing the facts, you create unease among the American people that there is something wrong here, that there is a debate that there may not actually be about these facts. And that unease grows. And we see that in our polling. We do a tracking poll every month on this. And you can just see that anxiety growing in the American people.

BILL MOYERS: So the fear mongering is working?

DREW ALTMAN: I believe that this will turn, as much as anything, on the media coverage of this. And it has in the past. And the media has a set of important decisions to make not just about getting to the facts as opposed to covering "he said this and she said that," but how much they cover the town hall meetings, how much they cover the ads, as opposed to looking at the legislation and also covering what's in it, what it means for people.

BILL MOYERS: Well, there's not any legislation yet, as you have--

DREW ALTMAN: Well, we have five bills and we'll--

BILL MOYERS: Yeah.

DREW ALTMAN: --maybe get to two and then to one. But we'll see.

KATHLEEN HALL JAMIESON: And I predict end-of-life voluntary private counseling I bet is not going to be in the final legislation.

BILL MOYERS: Euthanasia?

KATHLEEN HALL JAMIESON: And I bet the word "euthanasia" is not ever going to appear in a piece of legislation.

DREW ALTMAN: Somebody may make a decision that having voluntary counseling just isn't worth it.

BILL MOYERS: I don't know why they included that in the bill.

DREW ALTMAN: It was a Republican…

BILL MOYERS: Yeah, yeah, exactly. Now he's backing away.

KATHLEEN HALL JAMIESON: You know, I know why. The-- everyone who has worked with elderly parents or foresees a point at which they are going to have to be making these kinds of decisions has thought about end-of-life issues.

BILL MOYERS: I had my mother when she was dying, you know? I had to face that. You--

KATHLEEN HALL JAMIESON: Well, and we-- we've all been in this kind of a situation. And we're going to be personally affected by this at some point. And wouldn't you like to have at that point the-- the ability to say that-- that that discussion you'd like to have with your doctor about what the options look like? Do you want to stay on a ventilator under these kinds of circumstances? You know, what kind of heroic means do you want in case, you know, you were in critical life support failure? How much resuscitation do you want? Do you want a do-not-resuscitate order or not?

Do you want that encounter with your physician, when the physician's explaining what that means paid for or not? I can see someone sitting in a room saying, "Why would we want to deny people the opportunity to take advantage of that medical exchange and have it covered?" Why wouldn't you want people to know about hospice, which is a--

DREW ALTMAN: Yeah, they--

KATHLEEN HALL JAMIESON: --a wonderful movement in this country that has done more--

DREW ALTMAN: They genuinely thought it would be helpful.

BILL MOYERS: Yeah, okay.

KATHLEEN HALL JAMIESON: And I don't think they heard the possibility that this well-intentioned and I think completely appropriate move would be translated into killing grandmother. And I'm interested, by the way, in which no one's hypothesizing killing grandfather.

BILL MOYERS: Well, I think there are too many grandfathers in Congress in control of the legislation. I mean, but the truth of the matter is no good deed goes unpunished, right?

DREW ALTMAN: Well, I don't think we anticipated. In the past, these debates were about health care's legendary interest groups and raw politics. But, you know, there is a deep strain in our country. There was a debate once about fluoridation, just fluoridating the water supply. And it became a debate about this being a Communist plot. And I think the people at these town meetings--

BILL MOYERS: Ah, democracy--

DREW ALTMAN: --believe these things. This is our country.

BILL MOYERS: What do you think when you hear protesters standing up at these town hall meetings say, "Keep your cotton-picking government hands off my Medicare?" What's going on there?

KATHLEEN HALL JAMIESON: I love the fact that those people love their Medicare because it provides the basis ultimately for a turn in this argument to explain how similar part of these proposals to their Medicare. It actually is reassuring to me, not that they're misinformed and don't realize that Medicare is government based but that the Medicare model is, in fact, the model under the public option essentially.

DREW ALTMAN: You know, facts are useful here. While this legislation does involve a significant expansion of government financing for coverage for people, it's useful to point out that the lion's share of the coverage is private coverage, which is why many people think the private insurance industry is supporting this legislation and they are because they get more paying customers.

And while there is a debate about the public option in this legislation, one, it isn't clear that a public option will materialize in the final legislation 'cause many people are against it. And the Congressional Budget Office has actually estimated looking at the House bill that if there is a public option under the rules and I won't go through the details of how it will work, potentially by 2019, which is a ways off, maybe nine or ten million people might enroll in that public option. So that could hardly be construed as a government takeover of the health care system.

BILL MOYERS: Yes, Drew, but what people on the left say, liberals and people even further left, say that what this legislation threatens to do is to require citizens to subscribe to insurance under the insurance company. And without a public option, the insurance company has a captive constituent.

DREW ALTMAN: One the reasons for that is in order to do the reforms of the health insurance system, how health insurance works, which everyone benefits from. It's the one part of this legislation that helps everyone. So you can't be turned away if you get cancer or heart disease or if you're sick. You'd have to have a big pool, so you spread the risk that way so that those of us who are healthy are subsidizing those of us who are sick because we, too, may get sick some day. So that's the reason for the requirement that everyone's in.

BILL MOYERS: Is it a legitimate concern that if I'm required by government to have insurance and the only people selling that insurance are insurance companies, then I'm their captive?

DREW ALTMAN: Well, what it really means then is we have to be-- I think this is the next shoe to drop in this debate, once we get past five bills and we can focus on what are the details of health reform, health insurance reform sorry, legislation is, there'll be a set of rules about what are the minimum benefits that need to be provided so people are adequately protected? What's the basic plan that people will get? What are the subsidies that people are going to get? And will the subsidies that people get be adequate so that now they're going to be required to have health insurance coverage, they can actually afford that coverage?

And when we see the details of the legislation, when we get to a House bill and a Senate bill and a final bill, I believe everyone will be focused on that question because something on the order of 30 million people-- it could be more or less depending on the details-- will be in these so-called exchanges buying mostly private health insurance policies and will be able to look at that. And another maybe 11 million people will be getting their coverage through expansions of the Medicaid program. So there'll be a lot of people who are affected by that.

KATHLEEN HALL JAMIESON: But there's one other issue. It's not simply going to be will individuals be able to afford it under a mandate, but will government be able to afford it? Will we collectively, as the taxpayers, be able to afford? And one of the things that is legitimate underlying the protests in these encounters with members of Congress is a concern about the cost. Can the government continue to carry these gigantic deficits? Will the--

BILL MOYERS: A legitimate question.

KATHLEEN HALL JAMIESON: And those are very important questions. And it-- when the CBO has scored--

BILL MOYERS: Congressional Budget Office.

KATHLEEN HALL JAMIESON: --existing legislation, it has suggested that some of the projections were overly optimistic. And as a result, that we may not yet be in a situation in which Obama, President Obama, can deliver on his promise that this will be deficit neutral over ten years. And then it's possible that they get to being deficit neutral over ten years. What about the out years? What about the years beyond ten years?

We're in a situation that we wouldn't have been in were it not for many of the decisions of the Bush administration. But the deficit now is a serious issue with real economic consequences in the long term. And when you hear individuals in these exchanges with members of Congress saying, first, we had the big bailout. Then we had the big stimulus. Then we had cash for clunkers. How are we going to afford that? What are you passing on to my children and grandchildren? And what's it going to cost me as a taxpayer? Those individuals are asking legitimate important questions and as are the Republicans who are concerned about how this is going to be paid for long term. That's helping to restrain the process to increase the likelihood that everybody is going to be honest when they look at the CBO numbers, the final piece of legislation, to see what the effect is on deficit and debt long term.

DREW ALTMAN: And it needs to be said that there are legitimate reasons why conservatives, be they Republicans or blue dog Democrats or any conservative could be against this legislation. It's just not death panels or government takeover, but there are legitimate reasons they could be against it. The policy makers who are putting this together are absolutely committed to doing this in a deficit neutral way.

BILL MOYERS: Meaning?

DREW ALTMAN: Meaning that they will pay for it through a combination of savings measures and new revenues.

BILL MOYERS: It will not contribute to the increased deficit?

KATHLEEN HALL JAMIESON: Over the first ten years.

DREW ALTMAN: But there's a bit of a catch here. First, though, that's the biggest challenge they face. Of all the challenges they face, the toughest one is financing, financing, financing. It is coming up with that list of savings measures and new revenues that really is the toughest nut to crack. And that's what they're working away at.

KATHLEEN HALL JAMIESON: I think that you've got a real problem with cost shifting in this country. It's not as large as the administration has made it out to be. But when people come into hospitals without insurance and they are helped in the process, as they should be, that cost goes somewhere and it comes off into the people who are insured through some mechanism. I think we ought to be concerned about what that does economically in the long term, also what it does to the well being of those who come in without insurance and, as a result, get care later with a worse prognosis.

We ought to be concerned about that because we're moral human beings. But when Obama, President Obama, makes the big argument which says our economic future is dependent on fixing this, if he could make that single case, he could justify putting this through even if he couldn't in the process guarantee deficit neutrality across a period beyond ten years. He hasn't persuasively made the case. But imagine if he could persuade you that we've got another kind of economic meltdown coming because we're not fixing this piece of our own economy. And he makes the case to you, we could forestall that. Or if it were to happen, it wouldn't be as bad if we fixed this. Wouldn't you find that a persuasive argument? I think there's a case to be made, and I think it's a challenge to him to make it.

BILL MOYERS: What will each of you be looking for as Congress comes back into session on this issue?

DREW ALTMAN: I would look for-- I think two things. One, obviously, have they weathered this storm during the recess? Does it unravel or does it move forward still? I'm certain it'll move forward. I'm pretty confident it will move forward. Let me put it that way.

And then secondly, when they put the legislation together, have they found a way to pay for it? And what is the tradeoff between lowering the price tag of paying for it, which they're trying to do, and the benefits people get? And when we look at that, does it still meet the expectations of the American people for the help they're looking for with their health care bills?

KATHLEEN HALL JAMIESON: I'm not looking for what Congress does, but I'm looking for the signals that are sent to the public by groups the public trusts. If the final legislation comes forward and the AARP has actually endorsed it, then you have a powerful signal to seniors that there's nothing here that's going to hurt you.

If a Concord Coalition, which cares a lot about deficits, has said this final legislation has gotten the cost drivers under control and hence long-term costs under control, that in fact this will help address the problem of rising costs, and if the AMA and the nursing associations are also on board, then I think you'll have reassurance that you've got two important groups in the health care equation saying, "We don't think that our relationship with our patients is going to be hurt by that or our ability to do our job." I'm going to look for those four signals that they've got a good piece of legislation. And I think if you've got those four signals, much of the details can fall to the side because you've got a lot of reassurance going out to the public that it's not as scary as the extremes on either side would argue.

BILL MOYERS: Drew Altman, Kathleen Hall Jamieson, thank you for being with me on the Journal.

DREW ALTMAN: Thank you, Bill.

KATHLEEN HALL JAMIESON: You're welcome.

And for conservatives, here's the transcript of Moyers' interview with David Frum, a former special assistant to George W. Bush. Frum is calling on Republicans to come up with their own plan for health care reform and suggests changes that conservatives can support:

August 14, 2009
MAN: I want everybody to be as courteous and as civil to everybody else as possible.

CROWD: We won't go, we won't go! Angry Mob! Angry Mob!

BILL MOYERS: I was looking at the website NewMajority.com the other day and was stopped by the question: What if we win the health care fight? What happens then?

The writer, David Frum, went on to warn his fellow conservatives to be careful what they wish for. David Frum is with me now. He's the Canadian-born journalist who became a speechwriter to President George W. Bush, the first insider to write about that administration. This is his book: THE RIGHT MAN: THE SURPRISE PRESIDENCY OF GEORGE W. BUSH.

Now a resident fellow at the American Enterprise Institute, David Frum edits NewMajority.com, which is "dedicated to the modernization and renewal of the Republican Party and the conservative movement."

His other books include HOW WE GOT HERE: THE 70'S, THE DECADE THAT BROUGHT YOU MODERN LIFE, FOR BETTER OR WORSE, and his most recent, COMEBACK: CONSERVATISM THAT CAN WIN AGAIN. Welcome to the JOURNAL.

DAVID FRUM: Thank you, Bill.

BILL MOYERS: What did you mean conservatives should be careful what they wish for?

DAVID FRUM: Well, let me invite you, just for a minute, to imagine yourself a conservative Republican and looking back on the history of the past decade. And as you look back at it, you know, what was one of the greatest points of vulnerability of the Republican record as they went into the 2008 election cycle? It was the stagnation of wages that occurred between 2000 and 2008.

Basically, the typical American worker was making no more money in the year 2007, before the crisis, than in the year 2000. Why not? It's not that employers weren't paying more for labor. They're paying a lot more for labor, about 25 percent more.

All of that increase in the wage fund was consumed by the cost of benefits. So Republicans went to the country with a very dismal economic record in large part because of the explosion of health care costs. Let me give you another thing to think about from a Republican point of view.

We believe in tax cuts. Conservatives want to lower taxes. Yet the Bush tax cuts are slated to phase out in 2010 and 2011, whatever the Democrats do. It's just automatic. Why was the tax cut written that way? It was the rules of Congress to make sure there wasn't an explosion of the deficit, require the tax cut to be phased out because of the remorseless rise in the cost of programs like Medicare and Medicaid. If those programs don't stop increasing in costs, there will never be another tax cut. And we are going to be faced with government taking an ever-larger share of the nation's economy.

BILL MOYERS: So if the Republicans win this health care fight, by that I think you mean if they just simply defeat whatever the Democrats propose, right?

DAVID FRUM: Republicans-- there are many Republicans who fantasize about a repeat of 1994, when the Clintons' plan was defeated and Republicans went on to win back both houses of Congress, forgetting that 1994 was the end of a very long period, more than 40 years in the case of the House, of Democratic rule, that that was a very weak majority anyway. This is a young and strong Democratic majority. And they also remember 1994.

They're going to pass something. So the question for Republicans is what do you want that to be? You have an interest here, too. You would like to see the rise in health care costs slow. And you would like to see more room in the federal budget for tax cuts in the future. There are some mistakes in the way that President Obama has presented his case that have made him vulnerable.

You know, he's made it very clear why his health care reform will be good for the federal budget. He's not made it so clear why it would be good for the typical person. That's a point of vulnerability. But if the Republicans win, this is not going to be a great victory for individual liberty. It's going to be a victory for the status quo. The people who are angriest in those town halls are people who have an excellent deal on Medicare who are determined to protect it.

You can't blame them. People are very attached to what they have. But understand the message the political system will take if Obama is defeated is not let's have a lot more free market individualism. The message the political system will take is never tamper with Medicare again unless it is to make it more generous. From a conservative point of view, from a Republican point of view, is that a good message?

BILL MOYERS: You mentioned the Bush tax cuts. You were in the White House at the time those were implemented. And they are due to lapse next year. Isn't that lapse a good thing because we need more revenue to pay for the health care system that even you want to reform?

DAVID FRUM: I would like to see those tax cuts continued. Especially the tax cuts on capital gains and on dividends. Those are, I think, really important to the future growth of the American economy. And it is precisely in order to protect, the rising costs of health care have to be restrained. If health care costs continue to grow as they have been growing, there will never be another tax cut ever. And the level of taxation to the economy is bound to rise and rise and rise.

The thing that is so hilariously grimly ironic about this debate, whatever you think of the Obama plan-- and I don't-- well, there isn't an Obama plan.

BILL MOYERS: The five plans on the Hill right now.

DAVID FRUM: The House plan, which I don't much like. Which is the most finished plan we have. When the President talks about it, he talks about that plan using arguments that I think ought to resonate with conservatives and Republicans. He talks about the federal budget. He talks about the cost to employers and to small business. And those are real concerns, even if you reject his solution, which I hope will happen. There are other parts of the Congress, like the Senate Finance Committee, that can produce responses that reply to the valid concerns the President is raising, concerns, by the way, tormented Republican presidents before him.

BILL MOYERS: So what's the plan you would like to see the Republicans put on the table?

DAVID FRUM: Well, let's start by focusing on what do you think is the problem? You can't solve a problem unless you agree on what you're trying to achieve. The Republicans are not the party of equality. They're the party of liberty and they're the party of efficiency.

BILL MOYERS: And liberty leads to inequality.

DAVID FRUM: Liberty leads to inequality just as attempts to reduce equality lead to adoption of liberty. And it is that tradeoff that is why you have two parties so that the country can come to its balance. Especially in this health care debate, we are talking a lot about efficiencies.

Why is the American health system so crazy? Why do Americans spend so much more than anybody else for outcomes that aren't a lot better? Well, we talk about the health market. We don't have a health market. We have 50 state markets.

And although there are many, many insurers, in many states there are only one or two who are active. So what we need to do, first of all, is create a national market. I would like to see the responsibility for regulating health care removed from the states entirely and put in the hands of the federal government.

We don't regulate banking at state level anymore because it doesn't make sense. That should be true with insurance as well. The federal government should set rules. Here are the requirements for what a health plan should look like.

BILL MOYERS: Now you've just lost some of your conservative allies--

DAVID FRUM: But the state--

BILL MOYERS: --because you're calling for more regulation.

DAVID FRUM: No. Different locus. The states regulate it right now. And they regulate it in incredibly detailed ways. They say in some states that infertility must be covered if anything is and other states not. In some cases, if a woman has a mastectomy, the plan must cover reconstructive surgery. In other states, not.

In some cases, there's community rating. Everybody must be charged the same price. In other states, there are different systems. So from an insurer's point of view, they have to write a completely different set of offerings for Maryland from Oregon, from New York, from New Mexico. And the result is that you have these segmented little markets. It's a case for free trade to say let's begin by opening up a national market.

BILL MOYERS: If you eliminate regulation at the level of 50 states, aren't you giving the insurance industry more clout at the national level?

DAVID FRUM: It's a downside risk that you would have much more regulation at the national level. But just think about it. If we had 50 different mileage standards in this country, if we had 50 different sets of rules to describe what could and couldn't go into toothpaste, we would just collapse the national market. The reason almost every product is cheaper and better and more convenient in the United States than it is in other places is because of the size of the national market. No surprise that when the national market is cut up for one product, that is the product that is the most troublesome.

A second immediate thing, if you're self-employed, the way more and more people are-- and you want to go buy a plan, you'll have to play with after-tax dollars. Employers buy with before-tax dollars. If you're a small business, you get a much worse deal than big businesses. We need to regulate, level this field. One of the ideas that originates with the Heritage Foundation that was adopted by Republican Governor Mitt Romney are these health insurance exchanges that allow individuals and small business to buy on more equal terms. Again, that can be nationalized and made-- that's, by the way, in the Obama plan.

BILL MOYERS: Right. Health exchange.

DAVID FRUM: Health exchange. We need to begin to sever the link between employment and insurance. It is just-- it's a holdover irrationality that you get your insurance through the place where you work, that discourages people from leaving. People who get ill, when they're at a job are then indentured because they can't-- so long as they can work at the old company, they are covered under the old plan. If they move, they can't get a new one. And there-- and that is an artifact of the tax code. And we need to correct the elements for the tax code that do that.

Breaking the link between employment and coverage. We have a terrible problem right now with the cost of Medicaid are divided between the federal government and the states. This is a formula, always, for irresponsibility because the people who are not only-- are states spending 50 cent dollars or in some cases less, but worse, when it comes time to cut budgets, a state, especially a state that gets a lot of money from the federal government, says, "If we take dollar out of Medicaid, we buy a dollar's worth of political pain. And yet we only get 40 cents of budgetary benefits." So that makes no sense. And so Medicaid ratchets endlessly upwards with no one really in control of it. We need, I think, to have to locate Medicaid either with the states or with the federal government, not continue to divide them.

BILL MOYERS: What about a public option that would provide a government competition to the health insurers? It would not end private insurance, but it would provide competition, which, of course, conservatives believe in because they believe competition reduces prices.

DAVID FRUM: This is going to be a line in the sand and one of those--

BILL MOYERS: Deal breaker?

DAVID FRUM: No, on which -- a lot of politics is about political muscle. What do you bring to the party? Party A has this view. Party B has that view. And they put their shoulders against each other in rugby style, see who can push the other over the line. For Republicans, it's absolutely unacceptable. For a lot of Democrats, it's secretly unacceptable.

BILL MOYERS: What do you mean?

DAVID FRUM: Well, I think there are a lot of things that Democrats from conservative states pretend to be in favor of to keep in good order with the national party while counting on the Republicans to make it impossible to happen. When they have Democratic majorities, they then quietly defect because they don't believe in it either.

BILL MOYERS: So you're saying a public option is not politically feasible?

DAVID FRUM: No, I'm saying it's not acceptable to conservatives.

BILL MOYERS: What about you?

BILL MOYERS: You've broken with conservatism in this respect.

DAVID FRUM: I am not an unorthodox conservative. I think I'm a calm conservative. Right now I think a lot of -- their blood is up. They want to win this fight.

BILL MOYERS: Is that why we're seeing these protests, these loud, raucous protests?

DAVID FRUM: Well, let's distinguish between the people who are in those halls, who I think are many-- who, as I say, are people who have a good government plan in Medicare and are anxious because they know that President Obama wants to take a lot of money out of Medicare. That's how he's going to finance his plan.

BILL MOYERS: He says not.

DAVID FRUM: No, he acknowledges he's going to take money out. He just says it's going to make no difference. Because they're going to find so many efficiencies. So there are people who are a little skeptical about it. And they're kind of worried. Those are the voices. Now, that's different from what you're hearing on the radio. That's different from what you're going to be seeing in television advertising. Those people have more ideological motives. But what I am concerned about is in the desire to defeat President Obama, the Republicans are going to fossilize a status quo that is more unacceptable to them.

BILL MOYERS: You mean an unworkable health care system.

DAVID FRUM: Right. Because from the point-- Think about this, if you're a Democrat and you're confronted with ever-escalating health care costs and especially ever-escalating health care costs in the public sector, oh, well. You raise taxes to pay for it. It's not the worst thing in the world.

And if health care grows and if government grows with it, you know, you're not as upset by government as Republicans are. If you want to hold the line on the growth of government over the next two decades, this system has to be reformed.

BILL MOYERS: That's what Kathleen Hall Jamieson says. She said that in order to fix the long-term deficits, which are a concern to conservatives, we need to fix health care. Is that what you're saying?

DAVID FRUM: Yeah, if you see President Obama saying, "I volunteer to go into the beehive and put my hand inside the beehive and fix it," good luck, buddy. Better you than us. Like, why aren't Republicans saying, here's some things you can do that we'll like. Here are our red lines. If you do the public option, no. Surtaxes, no. Higher taxes on capital gains, no.

But if you have an idea as to how to slow the growth in Medicare, if you want to do things like this health exchanges, making it easier to afford to make it easier to buy across state lines, well, good luck to you. That sounds pretty good. And if you're prepared to take the political heat, again-- you know, good luck to you.

BILL MOYERS: I'm reminded that you grew up in Canada.

DAVID FRUM: I did.

BILL MOYERS: Couldn't the conservative, a calm conservative make a case for that kind of national insurance plan in this country?

DAVID FRUM: Look, where those plans have grown up, as in Britain, for example, you've seen conservatives make their peace with them, as the British conservatives have done. And once something is integrated into the status quo of your country, it gets conservative. There are I think a lot of reasons not to regard it as a preferable system.

It stifles the possibility of innovation and diversity. It means that ideas that get into the minds of people in Washington are very difficult to get out. And it creates a -- it also creates this tremendous problem where every malfunction in the system becomes the fault of the politicians.

BILL MOYERS: You describe yourself as a calm conservative. But you have certainly aroused those to your right in the Republican Party. You know, talk show hosts like Mark Levin have come after you saying you're kneecapping your own. What about that?

DAVID FRUM: Look, a lot of the conservative movement in this country is conducting itself in a way that is tremendously destructive. Both of the basic constitutional compact of the requirements of good faith and of their own good sense. I mean, when you were going on the air and calling the President of the United States a Nazi as Rush Limbaugh has repeatedly done. When Mark Levin -- you mentioned him -- he said the President of the United States is literally at war with the American people.

And then people begin, unsurprisingly, showing up at rallies with guns. Well, obviously, if the President were-- I mean, folks, if I believed the President of the United States were a Nazi, were planning a Fascist takeover, it would be contemptibly cowardly of me not to do everything in my power, including contemplating violence, to resist such a thing. Every decent person should do that.

That's why you don't say it when it's not true. And I mean, one of the ways that the constitutional system works is with some understanding that the people on the other side have slightly different priorities but they share your constitutional values. They have invested in the same system. The problems they've got are hard problems. And even if you don't like their answers, you have to have some restraint in the way you talk about them, as you would hope they would have about you.

And I think it's just outrageous. It is dangerous. It's dangerous for the whole constitutional system. Now, I'm absolutely prepared to fight with them. And by the way, it's dangerous to conservatives because the effect of the talk of people like Levin and Rush Limbaugh is to kill our cause with voters who are under 65.

You make that man the face and you say let us contrast him to Barack Obama who is maybe too expensive but who seems calm and judicious? That's an ugly comparison.

BILL MOYERS: For this appearance alone, your website, NewMajority.com, is going to be besieged by some of those folks, right?

DAVID FRUM: We have been besieged but this is a fight worth doing. And I have to say I'm thinking of changing our slogan. I'm adapting something from the old Panasonic folks, our new motto's going to be "just slightly ahead of our time." I know the conservatives of this country are not with me on these issues today. But I know equally well they will be with me on these issues in the future. They are just going to learn it, unfortunately, a harder way.

BILL MOYERS: The book is COMEBACK: CONSERVATISM THAT CAN WIN AGAIN. David Frum, thanks for being with me on the JOURNAL.

DAVID FRUM: Thank you.

[roxybeast]

The debate over the public option is beginning to heat up. Republicans say it is dead. Democrats say it must be in the final bill. And the White House is waffling ...

We begin with a video message from our President ... http://www.huffingtonpost.com/2009/08/1 ... 60311.html

Contrasted with this article by the Washington Post indicating that the President's claims that you will be able to keep your coverage does not necessarily square with any of the current legislative proposals ... http://www.washingtonpost.com/wp-dyn/co ... 01887.html

Meanwhile health insurance and pharmaceutical industry lobbyists keep pouring more and more money on legislators to water down the bills ... http://www.latimes.com/news/nationworld ... 6090.story ... and ... http://www.huffingtonpost.com/2009/08/0 ... 53309.html ... and ... http://www.huffingtonpost.com/greg-pala ... 58209.html ... and finally, ... http://swampland.blogs.time.com/2009/08 ... e-indutry/

Result, in addition to secretly giving away the farm to Big Pharma in the current proposals ... the White House is sending mixed messages and waffling on whether or not the public option should be included in the final bill ... consider these articles ... http://www.huffingtonpost.com/2009/08/1 ... 60511.html ... and ... http://www.huffingtonpost.com/2009/08/1 ... 60733.html ... and this one from NPR: http://www.npr.org/templates/story/stor ... h-20090817
... and this article from the Washington Post ... http://www.washingtonpost.com/wp-dyn/co ... 02248.html

Republicans think they've already defeated the public option ... http://voices.washingtonpost.com/capito ... e_for.html

So much so that Wall Street is already celebrating the death of the public option ...
http://www.marketwatch.com/story/prospe ... 2009-08-17

So what might the public option mean to you & how might it work ... Consider this simple explanation (with audio) from NPR ... http://www.npr.org/templates/story/stor ... =106333900

Yet, Pelosi & the Democrats just announced that they are standing firm behind public option ... http://theplumline.whorunsgov.com/healt ... ic-option/

Enter Democratic strategist Howard Dean, who says you can't really reform health care without including a public option ... http://www.huffingtonpost.com/2009/08/1 ... 60851.html ... and a similar story from NPR ... http://www.npr.org/templates/story/stor ... =111947332 ...
and offers reasons why Democrats should vote in favor of public option ... http://www.huffingtonpost.com/2009/08/1 ... 58813.html

Where the votes stand in the house and senate on public option ... perhaps there aren't enough votes NOT to pass the public option ... Consider these articles ... http://www.huffingtonpost.com/2009/08/1 ... 61265.html ... and ... http://www.huffingtonpost.com/jane-hams ... 61073.html

Perhaps the news of the death of the public option are greatly exaggerated ... http://www.huffingtonpost.com/mike-lux/ ... 61462.html

Contrast this really interesting video of interview with GOP Congressman regarding the hypocrisy on health care - if government run programs are evil and socialist, then why not repeal Medicare and Social Security? And if they aren't, then why not extend Medicare to people under 65? ... either oppose socialism or quit being a hypocrit ... http://www.huffingtonpost.com/2009/08/1 ... 60177.html

Meanwhile, the press attacks all the fearmongering (of course, focusing on it, running stories about it & giving nutjobs airtime may only make it worse) ... Consider Katie Couric's recent video remarks ... http://www.huffingtonpost.com/2009/08/1 ... 60190.html

Despite far right wing death panel claims not being true ... see, e.g., http://www.huffingtonpost.com/2009/08/1 ... 60537.html

A new poll shows that 57% of Republicans either believe the false death panel claim or aren't sure whether to believe it ... http://theplumline.whorunsgov.com/repub ... nel-claim/

And Sen. Chuck Grassley now blames the far left for his conduct in stirring up the false death panel claims ... http://www.huffingtonpost.com/2009/08/1 ... 61118.html

There is a substantial risk that this false death panel tactic may ultimately backfire on Republicans ... http://www.huffingtonpost.com/robert-cr ... 60717.html

And the Death Panel lies may cause Republican party death spiral ... http://www.huffingtonpost.com/jeff-schw ... 60732.html

Meanwhile, nuts keep bringing loaded guns AND ASSAULT RIFLES to Presidential events on health care - three times in just this pass week, dozens of idiots ... http://www.huffingtonpost.com/2009/08/1 ... 61279.html (story with video)

So here's a much needed message for the lunatic fringe ... http://www.huffingtonpost.com/lance-sim ... 59915.html

And now, some much needed humor:

Bill Maher video on what death panels might look like ... the new "American Death Panel" game show ...
http://www.huffingtonpost.com/2009/08/1 ... 60617.html

Pictures of the funniest signs being displayed at town hall protests ...
http://www.huffingtonpost.com/2009/08/1 ... 60838.html ... I love the "we have no idea what we're talking about sign!"

Confused yet? So where should the debate go? What really needs to get accomplished? Consider these articles ...

New PR Strategy? White House touting new message on health care ... http://www.huffingtonpost.com/2009/08/1 ... 60989.html

Listen to this really interesting and informative NPR interview with an insurance industry official from Kaiser Permanente who flatly declares that it is almost criminal not to have universal coverage, ... examines the realities of current insurance coverage and costs in America and contrasts with the programs in other countries ... discusses eliminating excessive administrative costs as one method of paying for reform ... and finds there's enough money in the American health care system right now to cover everybody that does not currently have insurance ... http://www.npr.org/templates/story/stor ... =106853465

Consider this ... are mandates (to buy coverage) mandatory? ... http://www.huffingtonpost.com/dean-bake ... 60919.html

Consider some alternative proposals on health care reform ... http://www.huffingtonpost.com/dr-paul-t ... 60698.html

Or taking some of the best of the English system - (although this commentator just flatly declares without support that a single payer system would just not work in America which I am not so eager to quickly write off) - he does offer some useful insight on the English system ... http://www.huffingtonpost.com/zack-coop ... 59966.html

Will the Centrist idea to substitute "public co-ops" for the public option work? First, an examination of what public co-ops are from NPR (with audio) ... http://www.npr.org/templates/story/stor ... =111965719 ... Then consider this article finding that co-ops won't actually lower costs ... http://www.huffingtonpost.com/2009/08/1 ... 61044.html

One problem with co-ops is that they are still negotiating with existing insurance companies or start their own, which is incredibly expensive, so there are plenty of questions about whether this will allow for full coverage of all the underinsured and uninsured, and whether the alleged competition would actually result in cost savings and lower prices since the policies would still be the same ones currently offered by insurers and the co-ops would naturally include high-risk members. The few co-ops that exist now in Washington & Minnesota, for example per NPR, are in the middle of the price range for insurance coverage. In reporting on the moderate co-op proposal, ABC News reported tonight that "a lot of medical experts have said the only way you're going to get true costs savings in insurance is to have some kind of public insurance company competing with the private insurers. One by one they seem to be taking out measures that would save money."

Here's one good reason to get mad about health care reform - let's adopt the rule "no patient left behind" ... http://www.huffingtonpost.com/patrick-m ... 60796.html

Remember Wendell Potter, the former insurance industry executive who gave an insider's perspective in his interview with Bill Moyers (video & transcript in an earlier post) - here's a recent column he wrote that is very enlightening ...
http://www.huffingtonpost.com/wendell-p ... 60816.html

So what can you do? Here's a good article by Columnist Paula Gordon entitled "Deadly Wrong" ...

Death, dying and an abrupt step back from death's door have dominated our summer. Lessons to date: you'd better have fabulous insurance and a lot of it, know the difference between "gravely" and "mortally" ill, and have tenacious advocates looking out for your best interests, on whichever side of The Great Divide those interests may lie. All this would have been sufficient to radically personalize "health care" and America's faux-system for me. Then I had to factor in the ubiquitous craziness generated by a fear-mongering, deluded few, acting against their own best interests and on behalf of Big Insurance's obscene mega-profits, devil take the hindmost. Add a dash of my personal furies exacerbated by Atlanta's ever-filthy air keeping me captive indoors month after month while driving up all kinds of directly correlated but uncaptured and dire health-related costs.

What links all three? Ill-gotten gains and a savage disregard for the health and well-being of all but the most privileged among us.

Personal dramas aside, I cannot leave to chance the urgent need for each and all of us to stand up and be counted. To push back against out-of-control Big Status Quo -- abetted by crony capitalists and corporate philistines who have rolled over to this outrage by blindly yielding to the soaring costs eating our economy alive and actively causing death to those who simply can't pony up the ever-bigger buck. Never has there been a better time to challenge the tortured and degenerate Calvinism that lets the powers that be determine that somehow only a wealthy few are worthy of life's blessings.

These collective interests have now clearly demonstrated the depths and breadth of their ignominy. They will do anything -- anything -- to stop reform of our appalling health insurance industry and their richly-rewarded pals. The enormity of what today's slick and, yes, evil spirits are intent on pulling off -- defying the clear will of the American people to reign in the abuses to our health in the name of their profits -- is beyond breath-taking.

We really are seeing the work of the usual suspects. They run this country whenever we let them. They're the all-too well-known, self-aggrandizing Newts and Palinistas. The scum of TV, cable and Radioland. And as usual, they're aided and abetted by the shameless likes of incendiaries including Grassfire.org, ResistNet and other paranoid extremists. And never give a pass to the GOFERs -- Good Old Fashioned Establishment Republicans (with due apologies to authentic gophers).

Their self-serving ideas have wormed their way into uncritical and poorly educated minds with the intention of turning us against each other -- eating away at the core of our democracy -- while profiteers and fundamentalists of all stripes attack the best interests of the vast majority.

Our long cultural legacy bears a disturbing resemblance to the current and unacceptable condition in the extensive industry allegedly responsible for our health. A difference between today and once upon a time is that the scary and loud extremists are no longer relegated to the margins of society. Now, they've captured significant megaphones, which makes them appear to have credibility. It is "standing" that they have not earned, do not deserve, and for which they must be held accountable.

They own, outright, entire systems of mass distribution, including but not limited to the FoxFauxNews phenomenon. While these reactionaries seem always to have been utterly shameless, now they have intimidated the dainty and faint-of-heart that pass themselves off as our main stream media. No surprise, the latter are owned by giant corporations also vested in the outrageous status quo and generating outsized revenues REGARDLESS of the consequences. Craziness gets covered as news, filth flung defending their masters' profits gets respectfully reported as if it were a legitimate perspective. At least Jon Stewart and Stephen Colbert remind me to laugh at wicked ways and spur me on to act.

The wrong-wing influence in the public arena is no abstraction to me. Every single day, relentlessly, we are bombarded with the thought-grenades these parasites drop. We get rained on by people and organizations intent on the rabid exploitation of our weakest citizens, barraged by the diatribes, drenched with the lies that the reactionaries spew.

Make no mistake. These are demagogues and fear-mongers who would give cockroaches a bad name. The result? My e-inbox, I regret to report, smokes. And the stuff coming in makes killer-tobacco look mild, radio-active fall-out a balm.

Then we see this same stuff popping up in the garbage dished out by shady characters getting rich off this drek. We receive the end-poison on the airwaves that are allegedly public, witness the blogosphere tainted with anti-truths, distortions and bald-faced lies, peppered with nuttiness like "Life and Government Without Taxes!"

These instruments of kleptocracy have a very long track record of running roughshod over our common wealth. They remain fiercely determined to retain or recapture the reigns of power that for decades have allowed them aggressively to undermine our health, restrict our options and the will to act, while cheerfully enriching themselves. And as practically every person in America can testify -- what gets dished up to us is the WORST health care extortion can buy.

The Bigger the Lie the better. These propagandists care not a whit that the vast majority of the rest of us are suffering the results of what Robert Kuttner aptly described as Everything For Sale and more recently Thomas Frank diligently outed in his reportage of the net result of their minions in The Wrecking Crew.

My horror grows ever greater as I follow the dark places that current, extraordinarily well-funded business interests are merrily plumbing, intent on again having their way with us. While rape, pillage and plunder -- the effects of the current industrial-model, profit-based health administration not-system -- are far from new, they do not improve with age. What we are witnessing is what they have done for decades

As a matter of well-documented fact, the United States has a long and dishonorable history of facile and masterful exploitation of our most vulnerable individuals. The susceptible get stirred up, then cuddle up to their worst fears, grow and cherish their fullblown paranoia.

Yes, the rampant mania we're all witnessing under the cover of August "dog-days" does appear to me to be a misanthropic Hobbesian Leviathan on steroids and the farthest side of sanity. But that is hardly the beginning or the end of it. Be ready.

We do well to remember that America has had more than our fair share of lunacy hovering around the endeavors of our better angels. If you can find a history textbook not distorted, tainted and/or sanitized by the Texas Board of Education and other hard-rightists, you'll find the stories of legions of the disaffected and heavy-hearted arriving here from our first moments on. Dissidents, malcontents, criminals (remember I live in Georgia,) religious zealots, latter-born sons powerless in the face of primogenitor and just plain folks desperate enough to try to start all over.

European diseases had emptied much of the continent of earlier peoples; slavery dulled the entire culture to exploitation; we became expert at xenophobia; flourished by taking what we wanted from those who could not defend themselves -- most workers, all women, too many children -- until the Labor and Progressive movements, one mighty persuasive Depression and a long climb out of its depths and into world war effected changes that opened the way for a genuine middle class.

Alas, reactionaries know how potent demonizing The Other is so they created one. Senator Joseph McCarthy and the Dulles brothers delivered on the fear by the bucket-full and an exhausted, distracted post-war America bought it. Whatever your opinion of the Cold War, one thing is indisputable -- it was astronomically profitable to those Eisenhower clearly warned us about.

It took a while for the reactionaries' waterboy from Wisconsin and his terror tactics to be shamed, but even when McCarthy was held modestly accountable, the Senate vote to censure him was opposed by 22 -- TWENTY-TWO -- Senators, Republicans each and all. It is now abundantly well documented how this first "Joe" is the spiritual wet nurse to a certain confused plumber who shares the name, and a snarly host of others including the sycophant Joe who shills for America's second-favorite stimulant on weekday mornings (along with our most-favored drug: adrenalin.) Not coincidentally, numbers for all of them grow along with profits for the entire anti-health industry that continues to buy political favors, indifferent to party labels. Heavily funded "astroturf" groups add to the noise, confusion, disinformation and distortions.

This dark, stark and,yes, sinister 300 years of baggage rebounds every time those of us vested by our Founders with sovereignty let down our guard. We woke up long enough to get Obama to the White House, but that was the beginning, not the end. In spite of the painful current reality foisted on us by out-of-control pseudo-free-marketeers, we're still in the deadly grip of profit-über alles. Shame on us.

It's hardly news that a well-oiled machine is intensely focused on derailing long overdue reforms to our deeply flawed delivery system, a bloated monstrosity that administers over-priced, under-performing services. OF COURSE the "town halls" we are seeing covered by media outlets as if they were genuine news events are fake, the false-fears shouted manufactured.

However, the deluded individuals who've swallowed whole the lies are real enough. The same arrogance and abuse that is now loosed into the public policy sphere is now countenanced in even the most ordinary day-to-day exchanges.

The Republicans' decades-long and shocking destruction of a civil and civic society leaves us with challenges at every turn. Democrats' complicity is one of those challenges.

Challenges, yes. Intractable, no. Hard? You bet. Worth the effort? Absolutely.

To paraphrase the exemplary Bo Lozoff, if we're going to make the drastic changes that decency and democracy require, it will take practice. So in addition to being a "regular" in my Senators' and Representative's in-boxes, voice-mail and offices, I'm taking my own advice to heart in even the little stuff. Example one:

Yesterday afternoon, I returned to my office to a curt, booming and unfamiliar voice, a message from "Dr. Somebody Something". He demanded that I call back. Immediately. Now we gets lots of calls for companies with names similar to ours, so the mistake was no surprise, but his tone was.

Hey, I'm nice. I called back to tell him he'd reached the wrong number. (OK, the devil made me do what came next.) When he answered, I asked for him by name, dropping the "Dr." part. He shot back 'DR. Somebody!' Then he continued, "Who are you? Who are you with?? And what took you so long to return my call???" As politely as I could manage, I repeated, "I believe you have called the wrong number, sir ... who are YOU and who are YOU with?"

Now he shouted at me, "I AM DR. SOMEBODY and I am CEO of SOMEBODY, INC!" I graciously matched him rank-for-rank. I said, again, that I was extending to him a courtesy in returning his erroneous call, and even managed to laugh at the absurdity of it all as he hurtled the best insult he could manage -- he was taking me off his list! -- and slammed down his phone.

I did not "win." But I did feel I'd made my mark for civility. 'Sides. He WAS a "doctor."

This is not how people in a civil -- as in "civilized" and "civilization" -- society govern themselves. It's also not how decent human beings should talk to each other. This IS how the schoolyard bully gets away with abuse. This is how the Aetnas and erroneous collection agencies and the Rush -- Gingrichs prevail. They corrode the private square as surely as they are doing in the public one, advancing the predation of their masters.

We must resist the provocations from Big Insurance and small-time hustlers (including now the arriviste Palin ... trust me, it's the money). We must confront and defeat them, and there's no better or more necessary place than our failed health delivery system.

In the meantime, raw wounds will take healing. It's past time to take back the conversation, on every level, starting with making sure we GET a major overhaul of our health delivery would-be system. And it can happen. That requires immediate attention from us each and all, everyday people choosing to turning down the volume, telling each other the truth, calling people out when the occasions arise, pointing out errors or, as now, lies.

Example number two from my own life. My cousins and I cover a broad political spectrum and several generations. That insures, shall we say, some lively exchanges. AND, across our differences, we quite simply love each other. Over the years, we've actually built some trust. And I dare say, we've learned from each other.

A couple days ago, one cousin forwarded a scorching piece from a garbage-monger intent on denying us all the right to well-being and reform of today's sorry excuse for a system addressing pressing economics and very real heath needs -- getting between me and wellness. I give my cousin credit. His subject line was "????" Another cousin, generally slow to take political bait, is deeply knowledgeable about the entire medical system, from the inside, and she took a very real chance. I could almost hear her inhaling as she took the time to carefully examine the lies and misrepresentions, then offer reasoned, fact-based views in their place.

She carefully demonstrated how and where the misrepresentations and distortions -- and lies -- are costing us. She subject line? "I don't want to start an argument, but..." and she gave us all a chance to learn. Here are excerpts. The page numbers refer to pages of A DRAFT version of the partial reform of our pseudo-system, followed by Republican former Florida Governor "Bob" Martinez's selective perversion of reality. Then my cousin's reality check:

Page 280:
(Martinez) Hospitals will be penalized for what the government deems
preventable re-admissions.
This is already the case with all medicare and private insurance patients now. It protects patients from being kicked out of the hospital because the insurance company or medicare has decreed the number of days for their diagnosis have passed.

Page 298:
(Martinez) Doctors: if you treat a patient during an initial admission
that results in a readmission, you will be penalized by the government.
Same as above. If the doctor is just tired of you or is not making enough money on you he can decide you are ready for discharge. This prevents that. This is an excellent idea and worth the whole bill being passed.

Page 317:
(Martinez) Doctors: you are now prohibited from owning and investing in
health care companies!
Wow. About time. I love it. Doctors really milk the system with this one. I have seen it to many times. Do you want to go to a hospital or nursing home the doctor actually owns? I don't.

Page 318:
(Martinez)
Prohibition on hospital expansion. Hospitals cannot expand
without government approval.
This is now called "certificate of need". It very effectively keeps hospitals from over building. There is absolutely no need for a hospital to spend millions of dollars adding beds that are not needed. You and I would pay for that when we go to the hospital and they have big unnecessary building costs. Again I like this one and always have. Hospitals always want the biggest most expensive equipment even if it is already available in the community. Duplication can be avoided and millions of our dollars saved.

Page 321:
(Martinez) Hospital expansion hinges on "community" input: in other
words, yet another payoff for ACORN.
This does not just apply to ACORN - everyone has input. I have even entered comments when hearings were held on hospital expansion. Hospitals would all move to the rich part of town and leave the middle class and poor and small communities without hospitals, if they could. Everyone working in a hospital would prefer their hospital to be in a nice, rich suburb. Is that where you want all the hospitals? Do you want a hospital in a small town near you or do you want them all in the State Capitol?

Page 335: Government mandates establishment of outcome-based measures:
i.e., rationing.
The VA system bases all their care on outcome based measures. When Vioxx was pulled from the market, it was because the VA system was measuring the outcomes of patients taking this medicine for arthritis. They discovered that not only did the patients have no better outcomes than with Tylenol but that a large portion of them were having Heart Attacks. This outcome based measure saved millions of Americans from taking Vioxx and having heart attacks. All use of chemo therapy drugs is based on outcomes. If one drug is successful and has good outcomes cancer centers tell other cancer centers the outcomes are good. Please do not treat me with a drug or procedure that does not have outcome based evidence behind it.

Page 341:
(Martinez) Government has authority to disqualify Medicare Advantage
Plans, HMOs, etc.
Yea! finally. Some of those guys are crooks and worse.


My cousin's closing comment: "I do not need a Republican, Ex Governor of Florida to translate Health Care for me. He is just simply wrong on some points and lying on others. He covers every 'talking point' given him by the Republicans and the Insurance Lobby. The tactics they are using to scare people, especially the elderly, are a crime."

Now, there was no predicting what any one of the family would say in response, but what came back from the creator of "????" was particularly telling. "THAT's what I needed to know. Thanks! Although it seems we veterans are being used as guinea pigs. Expendable, you know ...."

When the admirable Senator Barbara Boxer was our guest years back, she reminded me that the ship of state is big and bulky and hard to steer. It will take longer than we'd like to get us back on course, especially considering the calamitous eight years we've just endured.

Senator Boxer's doing her part in the Senate -- championing health care industry reform and more -- and inspiring me to do mine. A good way to begin is by not rolling over to bullies, liars and scoundrels as we've been doing since Joe McCarthy, Dick Nixon, then Ronald Reagan and two Bushes insinuated and cheated their way to power.

We can do no less than to get out there and push back if we are to begin to get the kind of health services we've been denied while insurance and HMO executives have taken home disgracefully bloated paychecks.

What we'll get this time is far from perfect. But it IS a huge step in the right direction; it is a start. And given what the "free-market" insurance industry and ancillary bottom feeders have done to us, right now, any measures that genuinely begin to correct today's rotten system head us in the right direction. Support it we must. Now. There's no time to lose if we EVER are to move back from the ethical, economic and human precipice created by the current predatory delivery system.

The status quo? In the incomparable Lawrence Kasden's words, immortalized by Danny Glover in Silverado, "That ain't right."

Source: http://www.huffingtonpost.com/paula-gor ... 61171.html

So what can you do? You can contact one of the Senators on this list that is still undecided about supporting the public option and tell them to vote in favor of it & oppose any bill that does not include it ... http://www.openleft.com/diary/14574/lat ... whip-count ... and ... http://www.fivethirtyeight.com/2009/08/ ... -have.html

Finally, I just love this excellent humorous yet serious piece by columnist Michael Kranz entitled "Who Would Jesus Insure?" ...

I attended my local Tea Party yesterday, and it clarified for me, well, nothing I didn't already know, or at least assume, or at least fear.

It was an unusually hot day in downtown San Francisco, and Justin Herman Plaza was swarming with hundreds of mad-as-hell-and-not-going-to-accept-the-results-of-last-fall's-election-anymore wingnut faithful -- not the thousands that KSFO radio host and marquee speaker Brian Sussman would claim on the air a few hours later, but a robust gathering just the same, pumped up on rabble-rousing rhetoric, pimped out in coordinated red shirts and witty placards, and above all pissed off; their very palpable anger, lacking a living, breathing, stammering, backpedaling town hall-cornered Democratic legislator to focus on, floating instead amorphously around the open plaza, looking for an animating principle and finding it in the inevitable Republican focus here in these first days of the Obama Age: the word "NO."

NO to health care reform. NO to "big government." NO to "creeping socialism." NO to this President. NO to gay marriage. NO to new taxes. NO to cap and trade legislation. NO to the Civil Rights Act of 1964. NO to modernity...

Well, okay, maybe only half the crowd would still subscribe to those last two, but as one speaker after another traipsed on-stage and barked their frothing way through the faux-Gipper stations of the faux-libertarian cross, I wandered bewildered around the crowd's periphery, trying numbly to decipher just what exactly it is that everyone was so heated up about. The experience was, let us say, disheartening. You know this already, but it bears repeating: a lot of Americans simply perceive reality much differently than, um, other Americans do. Did you know, for instance, that:

Everyone who joins national health care will be issued a national I.D. card!

or that:

Federal bureaucrats will have perpetual access to our bank accounts!

not to mention that:

Obama's going to herd us all out of our private insurance plans!

Oh, 'herd us,' will he? you mutter under your breath, because by then you've lost your patina of reportorial detachment (which, to be honest, was pretty freaking fragile to begin with) and just start blatantly arguing back: Obama has said plain as day on numerous occasions that anyone who likes their current plan can stay in it as long as they want!

(Incredulous stare.) "You actually believe that?"

Seniors will all have to appear every five years before "death panels" who'll decide whether they live or die!

Come on, that's just a willfully conspiratorial misreading of that one Medicare provision for voluntary end of life counseling --

"Yes, you see?"

-- which they've already removed from the Senate bill anyway!

"Ha! Exactly! Thank you, Governor Palin!"

It's ex-Governaaarrrrggghh...

Because by then you're literally gasping for air and desperate to bolt out onto the Embarcadero, where you imagine a soul-cleansing fog might drift in off the Bay and erase your pained knowledge of the fact that so many sentient human beings actually believe that

Our health care will be rationed, like in England and Canada!

Yeah, great, except that both England and Canada spend less per capita on health care than we do and their citizens have higher life expectancy.

"No they don't."

Oh, yes they do.

"According to whom?"

The World Health Organization.

(Brief pause, then, with absolutist, pre-civil-war finality:) "You have your facts, I have mine."

Sigh.

I mean, come on, buddy -- nobody really "has" facts, do they? Facts exist in their own right, and we just tout them or shout them or flout them, in accordance with the dictates of our personal knowledge base and perceived ideological imperatives. "There was this guy with a sign that said 'No Government-Run Health Care,' and he had to be 75 years old," marveled one corporate type who'd wandered over on his lunch break. "I asked him if he was on Medicare and he said yes." Did you point out the contradiction? "Sure." And? "He just walked away."

Which was so not a surprise, the Medicare recipients who want nothing to do with government-run health care being one of the more amusing right-wing cliches of this long hot August. There were no doubt plenty of them yesterday among a crowd that was predominantly older, overwhelmingly white and, I'd wager, heavily evangelical, a combustive demographic that didn't exactly cotton to the gutsy girl who kept pacing around trying to yell "Health care for everyone!" loudly enough to drown out the repeated death threats and off-topic anti-abortion catcalls that greeted her homemade "Who Would Jesus Insure?" sign. Her question, in fact, was quite a bit more piquant than the ones I was asking. So I switched over.

If Jesus Christ returned to Earth, would he advocate free medical care for the poorest and sickest among us? "Yes, he would," said a pleasant, Jesus-placard-toting man named Dave Ward.

Wouldn't He have endorsed the public option if He'd seen fit to address health care issues specifically in the Sermon on the Mount? "Yes, I agree with that," said the lady with the 'Meet the New Face of Community Organizers' sign.

And, finally, "I think he would be for it," said Bay Area Patriot volunteer Gina White, making it three straight 'Yesses' in my survey of whether Tea Partiers are willing to acknowledge the philosophical contradiction that has marked their movement ever since Reagan seduced both Wall Street and the Bible Belt. "But let me just" -- she tried to continue, and when I rudely cut her off in order to launch into a lengthy condemnation of her conservative perfidy (yes, by then I'd completely lost it), she politely but firmly asked me to listen.

Which I did, and wound up talking at length with a smart, compassionate opponent of (come on, let's own the name already) Obamacare who was willing to embrace progressives' core moral argument for universal coverage while also questioning our specific strategy for achieving it and offering alternative insurance-reform suggestions that would probably require a few hours of diligent net-surfing in order to counter. All of which made me like Gina White in particular quite a lot and Bay Area Patriots in general maybe a teensy tiny little bit, but only further grayed out an essay that I'd imagined would be painted in stark black and white.

Which clarity is, still, for my money, clearly what's called for at this scary historical moment. Every night for the past few weeks I've been sacrificing a half hour of sleep to gulp down another few dozen pages of Rick Perlstein's brilliant Nixonland. There's nothing like a meticulous accounting of the brutal Vietnam-era cracking of our nation's Red/Blue fault line to put our present cultural circumstance in perspective. You think tempers are high in 2009? Try '68, dude. People were setting off bombs, burning down cities, riding around with shotguns looking for fellow citizens to murder. Forty years ago America really must have felt like it was coming apart at the seams. Instead we stitched ourselves up and moved on. As we will again. As we are already.

So, bottom line, let's pass a damn health care bill already. A real one, with a public option, or at least as close as Senators Baucus and Conrad will deign to permit the other three hundred million of us to to enjoy. No, the recalcitrant side of the aisle won't vote for it, and no, we shouldn't care. We should pass the best possible bill via reconciliation and ignore both Republicans' crocodile sobbing about Democratic unilateralism and tee-bagger invective about socialism this, Communism that, and whatever other detritus emerges from those poor bastards' collective post-President-Moron minority-party psychosis. We need to pass the bill and take our lumps if need be, let the fair-and-balanced pundits blather about liberal overreaching and the conservative comeback, even let the GOP pick up a few House seats in fall 2010 if it comes to that. Just please, please, let's pass the damn bill.

Then we'll sit back and watch. "We are being lied to!" yesterday's speakers yelled repeatedly. They're right, of course, but by whom and about what? Let's pass a good bill, pull up an easy chair, pop a cold one and enjoy the spectacle over the next few years as millions of fence-sitting independents suddenly realize that they and their kids have health insurance which they can't lose because of a job change or preexisting condition. How do you figure those politics will play out among swing voters in, say, Ohio and Florida in November 2012?

Yeah, that's what I think, too, which is why so many Republican leaders are calling the emerging bill, mangled by compromise though it will almost certainly be, the end of the world. They're right about that, too -- it's the end of their world, anyway. As for our world, it just turns. The times change, sometimes epochally and swiftly. FDR '32. Reagan '80. Obama Now. The birth pangs of a new age are often painful and bloody, but this latest American evolution, whose genesis we're collectively creating, will live and thrive. And over time, most of us, anyway, will see that it is good.

Source: http://www.huffingtonpost.com/michael-k ... 60331.html

[roxybeast]

Wow, exactly - hit the nail on the head ... asking the insurance industry, there are two real ways to control your costs, public option or rate regulation ... pick one! I love this article, it's so dead on! ,

Mike Lux
An Alternative to the Public Option I Could Live With

The folks who read my blog posts might be surprised to learn that there is an alternative to the public option I could live with (besides single-payer, of course, that being my preferred option from the beginning). I have been an advocate for a very hard line on the public option, as I discussed here yesterday. But there is one other alternative I would feel okay about, and Bob Creamer outlines it today in his great post, Three Reasons Why a Strong Public Option is Likely to Be Part of Health Insurance Reform. Here's the part of Bob's post I'm referring to:

Once everyone is required to buy insurance, the companies can have a field day raising prices and profits using the government to guarantee they are paid -- either through subsidies or the imposition of fines. You can see why, from an insurance company perspective, this would be a great deal. But from the point of view of the taxpayers -- and the insurance ratepayers -- it would be a disaster. It would be like giving the insurance companies a license to take your money -- with no regulation -- all enforced by government edict.

This, of course, is basically what happened with the prescription drug benefit -- Medicare Part D. But there is a big political difference. A huge percentage of the money used to pay the insurance and drug companies in Medicare Part D comes from the taxpayers (or deficits). Most of the money that will go to pay for health insurance in a new system will come from ratepayers -- individuals and companies who will feel the sting of rate increases directly.

What politician in his right mind would pass a law that requires individuals and businesses to buy products from companies who can then charge whatever the traffic will bear -- especially in an industry where premiums have increased three times faster than wages, and profits keep heading skyward even in the worst recession in 60 years? Once government requires you to purchase a product, it has to provide some means to assure that the price is fair.

There are only two real practical solutions to this problem. On the one hand, you could set up a public health insurance option that does not have the same incentives to increase profit or CEO salaries and would compete against the private insurance companies and keep them honest. That is what President Obama has proposed. Or you could regulate health insurance rates.

Now rate regulation is not a crazy idea. It's been done for years in segments of the insurance market at the state level. But if you think the private health insurance industry is fighting tooth and nail to stop a Public option -- wait to see what they would do to stop rate regulation.

So to my esteemed colleagues in the insurance industry, how's this for a compromise: we'll give up the public option but we will regulate health insurance rates instead. We will institute a system of strict price and rate controls, just like utilities have to live with where they weren't deregulated. That would do more to cut health care cost increases than any other thing we could do. So what do you think, guys?

This is the amazing irony of this whole debate, as it was by the way of the last one (1993-94). Insurance companies are happy to support universal coverage, but they are dead set against anything that would either control their prices or provide them any real competition or accountability.

This is why so many of us who know the health care issue are so determined to not give in on demanding a public option. Look, I am a pragmatist and an Obama loyalist. I want this president to be successful, and having fought a searingly painful fight in the Clinton health care war room a generation ago, I want health care form like I would want a drink of cold water in the middle of a hot desert. But without either a public option, or the kind of strong rate regulation Creamer is talking about, health care reform is a nightmare for the public and for the federal budget. It is not "the good" in the sentence "Don't let the perfect be the enemy of the good," it is a plain and simple disaster. That is why I don't agree with another good friend and ally of mine, Paul Begala, in his op-ed comparing health care reform and Social Security. I respect the argument he is making, and if it were another issue less fundamental to whether the whole thing works, I might agree. But keeping the insurance companies honest, as Barack Obama likes to put it, is too central to everything. That's only possible with either tough rate regulation or a public plan, because this co-op thing is a jumbled mess that clearly is a non-starter.

Health care is something everyone has to deal with in their and their families' lives and it is at the heart of our federal deficit problem. If the Democrats don't get it (at least mostly) right, we are done as a governing party in spite of all the other demographic and political advantages we have. It's time to face the music and tame the insurance industry dragon.

On an action note, my good friends Howie Klein, Jane Hamsher, Darcy Burner and the Atkins brothers, along with DFA, have put together an action to thank progressive Democrats for standing firm on the public option. Thank them here, and donate to your favorite one or five here. As you can see below, many of our fellow activists who think this is critical have.

Source: http://www.huffingtonpost.com/mike-lux/ ... 62117.html

But wait, the public option or rate regulation aren't our only choices, are they? What about this co-op thing, it's not the public option? Or is it? Welcome to the circular argument world of co-op supporters:

Jason Linkins
Health Care Co-Op Supporters Don't Know What They're Talking About

So! Have you heard about these HEALTH CARE CO-OPS? If you watched any news at all yesterday, the answer is yes! And as you heard people on the teevee, attempting to explain what a "health care co-op" is, you might have been left with the strong impression that no one really knew what the hell they were talking about. There's a reason for that: no one really knew what the hell they were talking about!

But what does it matter? Because "health care co-ops" have come to be defined politically as representing the "sensible center" of this debate, offering that elusive, intoxicating elixir known as "bipartisanship." In Washington anything that's "bipartisan" is considered to be stuffed full of wondrous Tinkerbell magic and beloved by the political press, regardless of whether it's effective policy or not. And it usually isn't! To political elites, "bipartisanship" is like cleavage, multiplied by Ecstacy.

In the case of co-ops, the discussion has been even more inane than usual because nobody seems able to consistently describe what a "health care co-op" is. This does not dissuade the media, however. They're perfectly happy allowing a bunch of idiots talk about how magical (or how destructive) co-ops are based purely on the totally screwed-up political calculus.

Here, for instance, is that most serious of bipartisan players, Iowa Republican Sen. Charles Grassley, on MSNBC's Morning Meeting!

GRASSLEY: well, first of all, I hope that you understand that there's a lot of co-ops around the country. Just a few of them involved in health care. So there's a lot of experience of 150 years with Americans with co-ops.
Okay, sure! There are a ton of great co-ops! 150 years of co-ops! But we're talking about nationwide health care reform, so I'm a bit nervous to hear that there are only a "few" co-ops "involved in health care." From whence does his faith in co-ops stem? As it turns out, it comes from a lot of examples that don't have anything to do with health care, even remotely! As pretty CNN hologram Jessica Yellin explained to birther fanatic Lou Dobbs, health care co-ops proponent Senator Kent Conrad was specifically inspired by an entirely different kind of co-op:

He believes that the co-ops are a better option because his constituents are familiar with these models because of energy co-ops they have in their communities and he's seen them work. So maybe that's a better way to go.
So, Kent Conrad is under the impression that electricity and health care are distributed in the same manner? That's sort of dubious! Luckily, energy co-ops aren't Conrad's only inspiration! On CNN, Ed Henry explained:

Kent Conrad has been the one pushing it, saying, look, this has worked with rural electrification, it's worked with credit unions and the like and then maybe this could work with health care.
See, it would be useful if someone in the news could maybe point out that rural electrification and credit unions and health care provision are actually entirely different things. Instead, we are presented with this argument: "Apple, ergo orange."

What's really important about the health care co-ops proposal, of course, is that it is NOT the "public option." But what if you're more concerned with utterly demagoguing the issue? Well, you get Ralph Reed, telling Sean Hannity that co-ops are actually rampantly horrible big-government public optionism, in Trojan Horse form:

Sean, the co-op they're talking about will be heavily subsidized by the federal government and initial subsidy of $3 million and that's just the tip of the iceberg because they're always wrong on their projections. Remember the public option, the government run plan masquerading as a co-op will be subsidized with our tax dollars and that will lead to substandard care across the board and be a major problem.

So: the "health care co-op" is actually the "public option?" I feel like we are going in circles here!

Finally, Sanjay Gupta appeared on Anderson Cooper: 360, to at last offer a full explanation of what a co-op is. Remember: Gupta might have been Obama's Surgeon General if it hadn't been for the cripplingly low salary!

First of all, a co-op is not government run. You are talking about a not-for-profit organization that could offer insurance through a health exchange. They could go to the exchange, choose a private insurance company or they could choose insurance coming from a co-op. This is everyone who buys into the program, pays premiums, is essentially on the board as well. They are all sort of members as well as insured people. They figure out what the premiums are going to be, exactly what benefits are going to be offered. They are members as well as people who benefit from the plan.
[...]

If you look at the co-op across the board they have a couple of things going for them. They are not for profit, for example. They have low administration fees, overhead fees. As a result they may be able to have lower premiums -- that would be competitive...I can tell you this, looking at a lot of these historical knowledge of co-ops, unless you get scale -- hundreds of thousands of people participating -- it is hard for a co-op to compete against a private insurance company, which is why the people who are such supporters of the public option are crying foul. They are saying, look, the public option was a national option, it had scale. Hundreds of thousands if not more people. That could compete. Could a co-op even at a regional level compete? It all depends who joins.

So here's what the media knows about co-ops. If they exist, they are effective, unless they are ineffective. They are not socialized, government-run health care, unless they are. They provide an alternative to the public option...unless they don't. Proponents like them because if you ignore the many ways health-care co-ops are entirely unlike "credit unions" and "rural electrification," you can make the case that they are totally like "credit unions" and "rural electrification." And even if the White House follows along with the inane political calculus of "bipartisanship," and substitutes co-ops for the "public option" for the sake of earning Republican votes, chances are no Republicans will vote for it.

Great job, media!

Source: http://www.huffingtonpost.com/2009/08/1 ... 62340.html

What is clear, if anything, is that the co-op alternative is muddying the political waters ... Consider this article from the New York Times: http://www.nytimes.com/2009/08/18/healt ... 8plan.html

There is strong support and there are strong valid reasons to support inclusion of a public option in the health care reform final legislation. Consider this article:

Robert Creamer
Three Reasons Why a Strong Public Option Is Like to Be Part of Health Insurance Reform

Hasty headlines to the contrary, it is very likely that a strong public option will be part of a final health insurance reform bill when it finally passes Congress this fall. There are three reasons:

1). A Public Option is the most elegant and politically viable solution to a major practical problem. Three basic models have been adopted by Western industrial nations to provide universal health care to their populations.

The government can directly employ doctors and hospitals to provide service. That is the system they have in Britain where they spend 40% less per person on health care than in the U.S. and get pretty good reviews from their citizens. It's the same system that we use to provide health care to veterans through the Veterans Administration.

The government can provide heath insurance for everyone as it does in Canada - or as we do in the U.S. with Medicare. Medical practices and hospitals are in private hands, but the health insurance fund is managed by the government. Again, that system seems to work quite well and also does a good job at controlling costs.

The third approach is to require individuals and businesses to purchase insurance and leave it to private insurance companies to provide that coverage. The problem with this approach is that requires some mechanism to control costs. That is particularly true in the United States where insurance companies are one of only two industries (Major League Baseball being the other) that are excepted from the anti-trust laws that are aimed at insuring competitive markets. In fact, most major health insurance markets are dominated by two or three companies so there is no real competition -particularly with respect to price.

Once everyone is required to buy insurance, the companies can have a field day raising prices and profits using the government to guarantee they are paid - either through subsidies or the imposition of fines. You can see why, from an insurance company perspective, this would be a great deal.

But from the point of view of the taxpayers - and the insurance ratepayers - it would be a disaster. It would be like giving the insurance companies a license to take your money - with no regulation - all enforced by government edict.

This, of course, is basically what happened with the prescription drug benefit - Medicare Part D. But there is a big political difference. A huge percentage of the money used to pay the insurance and drug companies in Medicare Part D comes from the taxpayers (or deficits). Most of the money that will go to pay for health insurance in a new system will come from ratepayers - individuals and companies who will feel the sting of rate increases directly.

What politician in his right mind would pass a law that requires individuals and businesses to buy products from companies who can then charge whatever the traffic will bear -- especially in an industry where premiums have increased three times faster than wages, and profits keep heading skyward even in the worst recession in 60 years? Once government requires you to purchase a product, it has to provide some means to guarantee that the price is fair.

There are only two real practical solutions to this problem. On the one hand, you could set up a public health insurance option that does not have the same incentives to increase profit or CEO salaries and would compete against the private insurance companies and keep them honest. That is what President Obama has proposed. Or you could regulate health insurance rates.

Now rate regulation is not a crazy idea. It's been done for years in segments of the insurance market at the state level. But if you think the private health insurance industry is fighting tooth and nail to stop a Public option - wait to see what they would do to stop rate regulation.

A public option has none of the bureaucratic complexity of rate regulation and uses competitive forces to keep rates down. It is simple and elegant.

That's why the President and his top advisors support a public option.

2). The politics of Congress and the White House. There are a couple of political givens:

* Both the White House and Democratic Leadership understand that they must pass health insurance reform. Defeat is simply not an option. Both the Carter and Clinton administrations foundered because they proposed major policy initiatives and failed to achieve them. The effect was to depress overall support for the President and Democratic Party. In 1994 it cost the Democratic Party the control of Congress when large numbers of Democratic Members (mostly moderates) lost their seats in the mid-term elections. These defeats crippled their ability go back to the political well for subsequent big initiatives.

So far this White House is batting 13 for 13 in major initiatives - but health care is by far the biggest of them all. The White House and Democratic Leadership will do whatever is necessary to win. Health care is their signature issue.

* Finance Committee Ranking Member Charles Grassley has made it increasingly clear that he will not support any "bi-partisan" measure that is not endorsed by a majority of Republicans. That means that the likelihood of a "bi-partisan" deal are about zero.

This leaves two other approaches to victory. First is a strategy that works to get all Democrats and a couple of Republicans to vote for cloture, but not necessarily for a final bill. Second is the budget process known as reconciliation under which the bill could pass with just 50 votes (plus the Vice-President). Either of these options will make possible passage of a public option in the Senate.

* There are at least 100 Democrats in the House who would have to be dragged kicking and screaming to vote for health insurance reform that does not include a public option. In fact, it is hard to see how a bill could pass the House without a public option.

3). Inclusion of a public option is necessary to assure a mobilizable base to counterbalance a highly-motivated right wing and make passage of any health insurance reform possible. The public option has become an iconic symbol for Progressives. Without it, many would lose the passion that sends them to town meetings, phone banks and demonstrations. Without a public option to fuel this passion, the forces for reform would likely be overwhelmed by the shock troops of the right wing.

When you put all of these factors together, it is very likely that later this year President Obama will sign a health insurance reform bill into law that will indeed include a strong public option - not simply because the President clearly supports it, but also because of the practical policy and political considerations that make it critically necessary to success.

Source: http://www.huffingtonpost.com/robert-cr ... 61829.html

While the White House waffles, Democrats are beginning to finally hit back hard in support of the public option, while Blue Dogs and some right wingers trying to find a middle ground push for co-ops. Consider these videos & articles:

Rachel Maddow video on White House failure to support public option, she tells it like it really is & you've got to love that about her! http://www.huffingtonpost.com/2009/08/1 ... 61811.html

An interesting contrast between health care in America and England: http://www.huffingtonpost.com/harry-she ... 62144.html ... it seems the English system is not so bad after all. Consider this article from NPR ... http://www.npr.org/blogs/health/2009/08 ... efend.html

While some commentators call for more bi-partisan compromise: http://www.huffingtonpost.com/sandy-mai ... 60534.html ... Although only a handful of Republicans seem interested in genuine reform ... http://www.huffingtonpost.com/2009/08/1 ... 62382.html ...And meanwhile, folks who actually voted for Obama because they actually need better health care wonder what they voted for ... http://www.huffingtonpost.com/2009/08/1 ... 61939.html

Meanwhile, President Obama is stuck calming the elderly's fears and reassuring veterans that he doesn't want to kill them with death panels: http://www.npr.org/templates/story/stor ... h-20090818 ... while his staff waffles on support for a public option ... http://www.washingtonpost.com/wp-dyn/co ... 02248.html

So the Republicans continue to work to chip away at the bill, propose alleged middle ground reforms like co-ops .. consider this article from the Washington Post ... http://www.washingtonpost.com/wp-dyn/co ... 02965.html ... or seek to split the bill into smaller parts (to kill the parts they don't like) ... http://www.huffingtonpost.com/2009/08/1 ... 61928.html

The harsh reality, of course, is that the right actually opposes reform ... Consider this article on Republican leaders expressing unhappiness with the pharmaceutical industry for supporting Obama's reform proposals even to a limited extent ... see, both ... http://www.npr.org/blogs/health/2009/08 ... aidin.html ... and ... http://www.huffingtonpost.com/2009/08/1 ... 61605.html

Their supporters fear government involvement in health care ... well, at least besides the VA & Medicare ... and fear drives opposition ... but what about the fear of not having any insurance or health care? Which is the greatest motivating fear? Interesting discussion ... http://www.huffingtonpost.com/lincoln-m ... 61814.html

The need for meaningful health care reform to control out of control rises in insurance and administrative costs is very real ... Consider this NPR article which estimates that up to $600 billion per year is wasted on fraud: http://www.npr.org/templates/story/stor ... h-20090818

Newsweek weighs in to say that in the battle between Obama supporters & Fox watchers, it seems that the focus has been lost - this health care reform is a basic civil rights issue: http://www.newsweek.com/id/212162http:/ ... /id/212162

While some folks (like the insurance industry) think change is unnecessary and America has the best health care in the world, the huge response to the recent L.A. free health care clinic helps to demonstrate otherwise: http://www.huffingtonpost.com/2009/08/1 ... 62424.html

Finally, senior democrats are fighting back to support the public option ... consider this story from the Washington Post ... http://www.washingtonpost.com/wp-dyn/co ... id=topnews

But there still is one a roadblock to enacting a public option ... well, one roadblocker anyway, and his name is Max Baucus ... and, you've got to love when Donald Sutherland weighs in!

It must finally be clear to us all that the stumbling block to successful health/disease care reform has been definitively reduced to two words. They're not "public option" or "single payer", they're "Max Baucus".

He was not elected to eliminate the Democratic Majority in the Finance Committee, but that's what he's done. It was not mandated that he exclude a representative expert on single payer from his 15-person advisory board but that's what he did. More than that, he's filled his campaign coffers with millions of dollars of Insurance Company money, for heaven's sake. Fine that he sits there holding the president's suit coat at that town hall meeting, great that he gets identified by the president a bunch of times. Great, because now we can all have a good look at who he is, sitting there squirming in the spotlight.

Enough sitting. It's time Max Baucus stands up and is counted, and if he can't get up on his own then Rahm Emanuel with someone hefty should go grab him by the scruff of his neck, stand him up and shake some sense into him. Standing by the likes of Grassley only counts with the insurance profiteers. It doesn't count with us. Stand up, Max Baucus, stand up for what's right or you'll be sitting down for a long, long time!

Source: http://www.huffingtonpost.com/donald-su ... 62288.html

So what can you do?

Former Labor Secretary Robert Reich is calling for a march on Washington to show support for the public option ... http://www.politico.com/news/stories/0809/26224.html

As a reminder, ... remember, in yesterday's post (see earlier replies), I provided you some resources to identify Senators or Congressmen on the fence and encouraged you to contact them, particularly if they represent you, and demand that they support the inclusion of a public option in the bill. You can make a difference! ,

[roxybeast]

In today's look at the progress of health care reform, we start with the editors of the N.Y. Times, who weighed in to say that if Republicans won't participate in meaningful reform efforts, the President and Democrats have to go it alone, they should proceed by reinstating and passing a vigorous public option:

EDITORIAL
The Public Plan
August 18, 2009

For the sake of a health care deal, President Obama is hinting that he may be willing to drop the idea of a government-run insurance plan to compete with private insurers and hold down premium costs. He should not give up without first getting a strong alternative to achieve the same goals — and so far there is nothing very strong on the political horizon.

All of the current versions of health care reform would create insurance exchanges, where tens of millions of uninsured Americans, people who lack group coverage and workers in small businesses could buy policies from either private insurers or a new government-run program. While a public plan has been demonized by opponents as a big-government takeover of health care, the idea is to increase competition among insurers and give consumers more choices.

One alternative would be to create nonprofit, member-owned cooperatives to compete with private insurers. They are unlikely to have the purchasing power of a government plan. And Republicans are already saying they will oppose cooperatives too.

While the idea of a public plan makes good sense to us, it is not indispensable. It has nothing to do with covering the uninsured. And its ability to reform the hospitals and other providers of medical care to hold down the cost of care (and premiums) is unclear.

But, if done right, a public plan would bring real benefits. It would probably be able to charge lower premiums than many private plans because it would not be profit driven and might be better able to negotiate or demand low prices from hospitals and doctors. It could provide a safe haven for those who distrust private insurers.

It could also save the federal government substantial money. As part of any reform, the government would subsidize insurance purchases for low-income people. Those subsidies in the House version would be based on an average of the premiums in the three lowest-cost plans, and a lower-cost public option would help lower that average.

Unfortunately, as the House legislation has progressed, the proposed public plan has steadily lost its power to impose lower payments on hospitals and doctors — as the government currently does with Medicare — which is critical to maintaining low premiums.

A bill introduced by three committees, which would have paid doctors and hospitals based on Medicare rates, was projected to save $75 billion over 10 years. An amendment forced into the bill by conservative Democrats simply allows the secretary of health and human services to negotiate prices with providers — an approach projected to save $10 billion to $20 billion at most.

If Mr. Obama wants to jettison the now-weakened public plan to dampen overheated opposition, he should say what he will insist on instead.

At a minimum, there should be very strict regulation of all insurers, on and off the exchange, to promote competition and fair prices and substantial subsidies to help low-income people buy insurance. If competition among private plans fails to hold down insurance costs, there should be a provision to introduce a public plan.

We are frankly skeptical that any compromise will be enough to satisfy Republican opponents of health care reform. If the White House and Democratic leaders decide to go it alone, and they may well have to, they should restore a robust public plan. It is the best way to give Americans real choice.

Source: http://www.nytimes.com/2009/08/19/opinion/19wed1.html

So what about the co-op proposal, here's an insightful attempt to explain what it means ... http://egan.blogs.nytimes.com/2009/08/1 ... companion/ ... but as noted in the previous NY Times editorial, it has significant drawbacks in leverage and cost of subsidies to the uninsured and underinsured. And even the author of the piece thinks the Republicans will also strongly oppose the less effective co-ops, claiming they are merely the pubic plan in disguise as is already happening:

For now, Republicans have decided to wage a scorched-earth policy on health reform, a strategy that may restore them to power but won’t do a thing for the majority of Americans concerned about the future. Palin, auditioning for the role of most willfully ignorant politician in America, and Senator Chuck Grassley of Iowa, the grumpy old man who is supposed to be a serious voice for bipartisan legislation, have told whoppers about killing grandma, and have become heroes to their base because of it. They will lie about the co-op model as well. “You can call it a co-op,” said Senator Orrin Hatch of Utah, “which is another way of saying a government plan.” But it’s not, as hikers and farmers in Utah can tell him, or as Mormon-run welfare and retail outlets in Salt Lake City could attest.

Id.

Co-ops are very likely not the answer for many reasons as this next article suggest. They are very likely merely an attempt to co-opt (or de-rail) true reform. Consider this article ... and I love the quote about co-ops being one of the dumbest ideas floated around Capitol Hill in the past 20 years ...

Co-op, Co-opt, Cop-Out: Conjugating Health Reform
R. J. Eskrow

A verb is conjugated according to its context. Healthcare proposals change according to their context, too. Health insurance co-ops have worked very well in certain parts of the country. But when they're used to kill meaningful nationwide reform, "co-ops" become a "co-opting" of the political process by special interests.

I've already expressed my objections to co-ops in this context. Bob Laszewski calls them "the single dumbest idea (he's) heard in the health care debate in twenty years." I think that's harsh - after all, I've heard lots of dumb ideas over the years - but Bob raises some objections I hadn't considered.

Sen. Kent Conrad boasts on his website that his co-op idea is a "a bipartisan, compromise health care reform proposal." But he apparently forgot to get any "bi" support. Sen. Jon Kyl rejected the idea by calling it a "Trojan Horse."

That makes co-ops a "monopartisan" proposal.

Conrad insists there aren't enough votes in the Senate for a public option. He has rejected Obama's deadline for health bill, and has sent mixed signals on whether he'd even vote for a bill that included a public option. He was evasive and perhaps even a little misleading in this exchange with Robert Siegel on National Public Radio:
SIEGEL: How much would it cost to get a network of nonprofit co-ops up and running all around the country?
Sen. CONRAD: We've gone to the best actuaries in the country and they've independently come back with the same answer. They have said about $6 billion to have the insurance reserve requirements met.
Sen. Conrad wasn't asked about "reserve requirements." He was asked how much it would cost. The total cost for creating a national co-op network would include offices, staff, computer systems, overhead, advertising, etc. etc. ... ... plus those billions in reserves. (We can't vet the $6 billion figure without knowing the underlying assumptions the actuaries were given.)
The Medicare organization at CMS already has much of the needed infrastructure in place, so it could do the job at much less cost - that is, if politicians don't bargain away too many of these cost-efficiencies. (Here's a little political shorthand: When it comes to the public option, "level playing field" is a euphemism for "spending a lot of money to provide political cover.")

Sen. Conrad also said this in the NPR interview: "There are large cooperatives all across this country. Land O'Lakes is a $12 billion club functioning all across America. There are rural electric co-ops in 47 states. Ace Hardware is a cooperative."

But healthcare is not a "commodity" like a kilowatt of power or a stick of margarine. Insurance is an amalgamation of predictions backed by financial instruments, and medical delivery is an economy in which the seller (who is frequently the physician) often controls the demand. Ace Hardware and Land O'Lakes may be fine companies, but they aren't working models for a competitive and efficient healthcare system.

Here's the political bottom line: Right now the "centrist" Democrats support a requirement that middle-class Americans obtain health insurance - the so-called "mandate." If they don't also provide a meaningful alternative to costly, for-profit insurance, the backlash against them will be enormous. Co-ops will not be able to provide that alternative.

And those who think Obama hasn't compromised enough on the public option should take note: He's already compromised plenty. He promised during the campaign that "any American (would) have the opportunity to enroll in the new public plan or an approved private plan." Yet only about six million employees will have that opportunity under most proposals being discussed, according to the Congressional Budget Office. (You can read the pdf report here or see Timothy Noah's summarization in this piece for Slate.) Six million employees is far more modest than a plan that's available to "any American," so there's already been plenty of compromise.

The co-op idea is probably dead, so the public option remains the last best hope for meaningful reform. So far the President has remained above the fray, preferring to let others fight it out. He won't have that luxury for much longer. The confrontation between progressive House Democrats and Senate Dems over the public plan option will come to a head soon. It will take a firm Presidential hand to resolve the conflict.

It's going to take leadership to turn co-option into co-operation.

Source: http://www.huffingtonpost.com/rj-eskow/ ... 62919.html

But here's the most interesting question relating to co-ops, if they can save the health care world as Sen. Conrad claims, then why haven't they already done so? There is nothing preventing people from starting health care co-ops now all over, in every part of, America. So if co-ops are the answer, why haven't they spread like wildfire naturally? Consider this article ... http://www.npr.org/templates/story/stor ... =111966287

So what are the Democrats left to do ... Consider this suggestion ...

There are a lot of talking heads out arguing that the "left" shouldn't be so extreme as to risk health care reform by insisting on the public option or the lifting of the absurd ban on negotiating lower drug prices. The reality is exactly the reverse. It is the handful of Blue Dogs and conservative Democrats in the House and Senate that are standing in the way of the majority in favor of a comprehensive plan. The question isn't whether the progressive majority is unreasonably resisting reform to save the public option. The question is whether a small minority of conservative Democrats will sabotage reform simply to stop the public option.

Substantively, passing health care reform without a public plan to compete with the insurance companies makes no sense. As Jonathan Walker details, it would be an insurance company bonanza, as the government requires the uninsured to get health insurance - supplying the companies with millions of young and healthy customers - while eliminating the option of a competing government run plan that, in Obama's words, can "keep the insurance companies honest." For a country that must get health care costs under control, reform without the government plan as an option is irresponsible.

Source/full story: http://www.huffingtonpost.com/robert-l- ... 62666.html

So the Democrats are poised to go it alone on a health reform bill ...
"Given hardening Republican opposition to Congressional health care proposals, Democrats now say they see little chance of the minority’s cooperation in approving any overhaul, and are increasingly focused on drawing support for a final plan from within their own ranks." Source/full story: http://www.nytimes.com/2009/08/19/healt ... epubs.html

The strong show of support in the Democratic party for the public option apparently took the White House by surprise. Consider this article from the Washington Post: http://www.washingtonpost.com/wp-dyn/co ... 03655.html

But when you make inconsistent claims about your support for the Public Option, can you really wonder why you are getting backlash from your own party? Consider this collection of the President's inconsistent comments on his support for the public option by the Washington Post: http://www.washingtonpost.com/wp-dyn/co ... 03652.html

Meanwhile, back on the Hill, Sen. Grassley, having been firmly slapped around for continuing to spread false death panel lies, now accuses Obama and Pelosi of "intellectual dishonesty" http://prescriptions.blogs.nytimes.com/ ... dishonest/

So what's the latest falsehood being circulated by Republicans to try to de-rail meaningful reform? Try this ...

On Fox News' Hannity, GOP consultant Frank Luntz forwarded the false conservative talking point that President Obama plans to cut Medicare benefits, claiming that it "is almost like he's declaring war on Medicare because it's the only way for him to pay for health care," and that it is a "fact" that "[t]hey're talking about lowering the reimbursements for Medicare." In fact, as FactCheck.org noted: "The claim that Obama and Congress are cutting seniors' Medicare benefits to pay for the health care overhaul is outright false."

Source: http://www.huffingtonpost.com/2009/08/1 ... 62867.html

The White House is busily fighting back, engaging in more spin control. The opponents "spin" or lies, however you see them, are so out of control, that President Obama felt compelled to start his own website to "Set the Record Straight" where you can go to get his take on all the claims: http://my.barackobama.com/page/content/settingtherecord

And despite the past few days and doubts of his republican colleagues, Sen Baucus still believes that he can get a bi-partisan bill passed:

"Mr. Baucus still believes that health care legislation is “inevitable” this year, despite a dispiriting few days for those hoping for a bipartisan bill. Two of his Republican partners — Senators Charles E. Grassley of Iowa and Michael B. Enzi of Wyoming — are sounding increasingly doubtful about signing on to any deal. “I’m trying to get a bipartisan bill, other committees weren’t, and that puts the focus on the Finance Committee,” Mr. Baucus said.

Source/full story: http://www.nytimes.com/2009/08/19/us/po ... aucus.html

The President has clearly gotten off message ... Consider these next two articles ... http://www.huffingtonpost.com/robert-re ... 62349.html ... http://www.realclearpolitics.com/articl ... 97941.html ...

Consequently, public support is dropping, in large part due to a lack of clarity as to what exactly is being proposed and the failure to focus on the real reasons why reform is necessary. Consider this article which discusses the latest NBC poll and also includes links to other commentators takes on the debate: http://voices.washingtonpost.com/politi ... 81909.html

Not that the NBC poll is good news for Republicans, who fared even worse ... "If it's any consolation to Democrats, the public doesn't think any better of the GOP when it comes to health care. The NBC poll found that just 21 percent of approved of the way Republicans in Congress are handling health care, while 62 percent disapprove." Id.

However, the NBC poll has received such sharp criticism due to the framing of the questions, that NBC is now planning to conduct a revised poll to try to get a more accurate read on the public's true support of a meaningful public option ... http://www.huffingtonpost.com/2009/08/1 ... 63413.html

But rather than focusing on "bending the curve," controlling costs of reform, however necessary to the final plan, the President would serve himself well by focusing on stories which show the real reason why health reform is necessary ... Consider this commentary in the Nation last month by Christopher Hayes ...

The policy argument the president is making is sound: more government intervention, a public option and broader coverage will reduce costs in the long run. But this causes so much cognitive dissonance that mainstream media figures are incredulous. And that skepticism, along with industry propaganda claiming that a public option will limit choices, is, not surprisingly, showing up in public opinion. ...

So what to do? If there's a silver lining to the fact that Congress will enter its August recess without a bill, it's that the White House and advocates of real reform will have a chance to modify their pitch. If there was ever a time for Obama's vaunted and much-anticipated grassroots army Organizing for America (OFA) to do its thing, it's now. Since it's closer to the actual lived experience of voters, OFA may have superior instincts about what kinds of messages resonate. Recently it undertook an effort to compile stories from people about their experiences with a broken healthcare system, like this one:

I am 36 years old and have Blue Shield HMO health insurance coverage through my employer. In January 2009, I was diagnosed with metastatic (stage 4) breast cancer.... My doctors prescribed a medication that targets and removes the cancer throughout the body like a "smart bomb"; however Blue Shield of California denied coverage of my doctors' recommended treatment. Blue Shield also denied a radiation procedure that would target and remove the two lesions in my brain. In both cases, Blue Shield denied the original requests and subsequent appeals I filed on the grounds that the treatments are not a medical necessity. I have learned that insurance companies will use "medical necessity" as an excuse to not cover treatment when it appears that the patient is "too sick" (read: not worth it).
Stories like this strike me as a whole lot more potent than talk about "bending the curve."

Source/full story: http://www.thenation.com/doc/20090803/hayes

The Democratic backlash over the public option may have actually done the President a favor by pulling the debate back to reality, and by providing him much needed and strong leverage prior to entering more negotiations when Congress returns from it's current recess ... http://blogs.tnr.com/tnr/blogs/the_stas ... -news.aspx

So let's take that advice and get back to the basics, why is health care reform necessary? Dr. Andrew Weil's latest article claims there are three really bad trends in the current health care system in America: (1) Deterioration of Medical Philosophy and Practice, (2) Failure to Provide Health Care for All, and (3) The Growing Influence of Money. See the full article: http://www.huffingtonpost.com/andrew-we ... 61365.html

Admittedly, serious meaningful reform is necessary, but what will it cost? Here's an article directed at beginning to answer that question ... http://www.nytimes.com/2009/08/19/healt ... 9fees.html

The Democrats have now asked the insurance companies to start producing detailed financial records to try to get to that answer as well ... http://www.huffingtonpost.com/2009/08/1 ... 62844.html

So what went wrong? Why is there any difficulty getting wide-scale public support to pass single-payor, or even a public option? I love this next article ...

How the Right and the Left Destroyed the Public Option
by Frank Schaeffer

What's the common denominator linking crummy public transport, military contractors and the public option being taken off the table in the health care reform fight? Why is a single-payer health care provider "unthinkable"? The common denominator is that the United States is in the thralls of a demented cult that combines the idea of privacy and the profit motive into what is, in fact, our civil religion. It's a crap religion.

The Cult

If the "public option" for health-care reform is off the table who's to blame? We all are -- left, right, moderate, progressive, we have glorified the notion of privacy, profit and individual space for so long that we wouldn't know a public option if one bit us in the ass.

A weird convergence of factors has resulted in United States of America being one of the only places on earth where all sense of a public space, let alone public duty, is off the table as a matter of faith. Privacy, ownership and profit are what we are about.

Examples: Roe v. Wade (whatever your view of abortion) was argued on the basis of privacy. The right to own weapons has been carried such a ludicrous point, in terms of private ownership, that we have little mercenary armies marching around in the woods calling themselves militia groups and armed to the teeth with semiautomatic high-powered military-style weapons. Our trains are 50 years behind the rest of the world's because some genius addicted to the cult of profit decided that they aren't infrastructure but just another business.

"Privacy," "choice," "profit" -- these words are the only American religious creed. Hatred and fear of the government has been both a right wing and left wing preoccupation when government seems to be in a position to curb this cult.

What went wrong?

My son commutes every day to Boston from Newburyport, Massachusetts; a train ride that in Switzerland, France, Germany or even England would take 15 to 20 minutes but here drags on for an hour and 10 minutes. Here our trains must be "profitable" to exist so there is no money to update the system. In other places they work, are updated -- and lose money. The gain is an infrastructure that allows for massive wealth creation in other sectors.

Our train system is stuck in the 19th century. Our health-care providers have been taken over by today's equivalent of the robber barons. Even our prisons are being run by private corporations. When my Marine son fought in Afghanistan and Iraq he and the other soldiers and Marines were outnumbered by the private contractors earning 10 times what our soldiers were earning for doing the same jobs and while making hundreds of millions of dollars for a privatized defense establishment.

"Christian" Heretics

What is so curious is that in this religious country of ours the same evangelicals, conservative Roman Catholics and others who are running around saying that we had a "Christian foundation" have forgotten that one of the great contributions of Christianity (going back to the fourth century) was public nonprofit hospitals and hospices. Since when are Christians against vocation? Since when does Christianity teach that profit must trump all other considerations? -- "I'm my brother's keeper, if I get paid"?

Somehow right wing evangelical Christians now seem to believe that Jesus commanded that all hospitals be run by mega corporations for profit. Somehow the right also thinks that it's normal for the state to hand over its duties to private companies for military operations, prisons, health care, public transport and all the rest. The word "infrastructure" seems to have lost its meaning along with the word "community'"as something for the common good. The common space never needs to "turn a profit" because it is the lifeblood that allows private profit. (Every small business owner about to go under because of health care costs knows this, as does my son, who wastes hours each day on a slow train!)

In fact Christianity was the modern root of the whole idea of public spaces for health care, the rule of law, even public transport and safety that started with the idea of the "king's highway." Public space is what made Western civilization possible. A common law, that applied to all, a common sense of sacred duty to others, a common road system protected by the crown and so forth.

Christianity teaches altruism and altruism is not profit-based. Check out New England's Puritan-established villages. What do you think all those "quaint" post card village greens are? Why do you think they were called the "commons"? The greens are the shared grazing land. Public space was the essential ingredient of Puritan life: church, town meeting house and common grazing land, civic work and hospital building, defense and law. And as for privacy, the community was involved in everything we now hold private.

On the secular side, public space to was also paramount. The dynamism of Western civilization, beginning with the Renaissance in Florence and other European cities, was based on an understanding of the value of public works, public space and public projects combined with private initiative. Walk the great piazzas of Italy and you will be enjoying the public spaces created by civic-minded people who were the forefathers of the Europeans who would build high-speed rail systems that work. Private fortunes were made in the context of a public sector that worked. This is no new thing or "socialism." This is what made the West the wealthy West. (The Medici bankers were no socialists and they understood the need for public spaces!)

If it's Not For-Profit it's Evil. Since When?

Now in the USA we have the worst of all possible worlds: a leftist/libertarian addiction to personal private space, in which no one is allowed to tell anyone else what they should do, combined with this weird anti-Christian "Christian" right wing notion that everything -- even trains, the post office, our infrastructure and medicine, and now even a big chunk of the military (via "contractors") -- must be run for a for-profit motive.

The left, the right, the secular community and the religious community have denied the best of their own heritage when it comes to America. The problem of not getting a public option for health-care reform relates to a philosophical shift in our culture wherein everything has to be justified on the basis of profit and/or privacy. Result: there is no concept of public space at all. Result: idiots shout "socialism" about common sense solutions to our problems that -- very ironically -- the Medici princes of Florence and the Puritans would have all agreed needed to be matters of common public space.

Until Americans -- left and right, atheist and believing -- begin to take another look at where this road of absolutist privacy combined with absolutist profit leads we'll be stuck with the health care that's a mess, trains that don't work and for-profit lunacy: deified individualism.

The Solution

The only real solution is to attack the idea that profit and privacy is sacrosanct. Privacy and profit must be once again balanced by common obligation, public space and civic mindedness trumping individual choice.

We need to get back to the idea of civic space, and public works, not just in health-care but in all sectors of our economy. It's not a question of being anti-capitalist; rather, it's a question of rediscovering a more narrowly defined capitalism that thrives because of a thriving public space. For instance, we need a single-payer health care system and we need it now.

Source: http://www.huffingtonpost.com/frank-sch ... 62085.html

Finally, for our "shot" or "moment of zen" today, I leave you with this video of Sen. Barney Frank's keen handling of a crazy protester who was comparing Obama to Nazi Hitler at a recent town hall ... enjoy! http://www.huffingtonpost.com/2009/08/1 ... 62682.html

[roxybeast]

Obama Calls Health Plan a ‘Moral Obligation’
By JEFF ZELENY and CARL HULSE
N.Y. Times - Published: August 19, 2009

WASHINGTON — President Obama sought Wednesday to reframe the health care debate as “a core ethical and moral obligation,” imploring a coalition of religious leaders to help promote the plan to lower costs and expand insurance coverage for all Americans.

“I know there’s been a lot of misinformation in this debate, and there are some folks out there who are frankly bearing false witness,” Mr. Obama told a multidenominational group of pastors, rabbis and other religious leaders who support his goal to remake the nation’s health care system.

As the president returned to the health care debate after two days of silence, the administration encouraged Republicans to take part in the negotiations. Still, Democratic leaders moved ahead with plans to advance a measure next month with or without Republican cooperation.

The White House acknowledged that its handling of the debate had been inconsistent, with Robert Gibbs, the press secretary, saying, “I don’t think anybody here believes we’ve pitched a no-hit game or a perfect game.”

Mr. Obama did not wade into the uproar among Democrats over whether the bill would have a public insurance component, a key point of contention, but rather tried to correct what he said were untruths about the plan.

“You’ve heard that there’s a government takeover of health care. That’s not true,” said Mr. Obama, who went on to call other assertions, like a death panel for the elderly, “an extraordinary lie.”

The members of Congress involved in bipartisan health care talks said they remained determined to try to reach agreement, with Senator Max Baucus, Democrat of Montana and chairman of the Finance Committee, saying that “bipartisan progress continues” even though lawmakers are scattered for recess.

“The Finance Committee is on track to reach a bipartisan agreement on comprehensive health care reform that can pass the Senate,” Mr. Baucus said in a statement.

The six negotiators are scheduled to consult via conference call on Thursday. Plans for them to meet in person over the break have evidently been shelved.

Senator Charles E. Grassley of Iowa, the senior Republican on the panel, said in a statement that no health care plan had yet found the kind of broad support he thought necessary to move ahead.

“That doesn’t mean we should quit,” Mr. Grassley said.

Highly critical statements by Mr. Grassley of Democratic health care proposals — coupled with near blanket rejection by other Republicans — led top Democrats to suspect that no Republicans would be willing to vote for a health care plan.

A spokesman for the Senate majority leader, Harry Reid of Nevada, said the leadership had not reached a decision that Democrats should try to force through a health plan on their own.

The spokesman, Jim Manley, said Democrats would prefer to proceed in a bipartisan way. But the Finance Committee has an informal Sept. 15 deadline for reaching a deal, and Mr. Manley indicated that Democrats would not wait indefinitely.

“Patience is not unlimited, and we are determined to get something done this year by any legislative means necessary,” said Mr. Manley, raising the prospect of using a procedural shortcut that bars filibusters against a health measure.

With Democrats seeing their hopes for a bipartisan deal dim, Republicans sought to make sure that they would not take the blame for any failure.

Representative John A. Boehner of Ohio, the House Republican leader, said Democrats had been pursing health legislation on their own for months, ignoring Republican offers to explore common ground.

Mr. Boehner joined other Republicans in continuing to criticize current proposals, saying they would lead to rationing of care and making other claims that Democrats say are false — an illustration of how far apart Republicans and Democrats are on the issue.

In a late-afternoon telephone call with religious leaders on Wednesday, Mr. Obama cast the difficulty of the health care debate in terms larger than his presidency, comparing it to the creation of Social Security and Medicare.

“These struggles always boil down to a contest between hope and fear,” he said. “That was true in the debate over Social Security, when F.D.R. was accused of being a socialist. That was true when J.F.K. and Lyndon Johnson tried to pass Medicare. And it’s true in this debate today.”

Source: http://www.nytimes.com/2009/08/20/us/po ... obama.html

[roxybeast]

The President finally seems to be honing his message, which should read: "as Americans, we have a moral obligation to ensure that all of us, rich and poor alike, are provided necessary health care. The strength of any nation is it's people, and the strength of any person is their health. Those who believe that we should let people die and get sicker because they are without means, as is happening now and will continue to happen until we pass meaningful reform, are evidence of a sickness that threatens to undermine core American values of love, caring, and compassion. In this battle between the audacity of hope and the audacity of fear, hope will prevail. Lives will be saved. The weak will be made strong. Our nation, our values, and our place in the world will be stronger for it. May God Bless America with good health!"

In drafting the Declaration of Independence, the founders were heavily influenced by the earlier writings of John Locke, believed to be the original source of the language that life, liberty and the pursuit of happiness are inalienable rights. In the same treatise in which Locke wrote those immortal words, he also wrote these:

The state of nature has a law of nature to govern it,
which obliges every one: and reason, which is that law,
teaches all mankind, who will but consult it, that being
equal and independent, no one ought to harm another
in his life, health, liberty, or possessions:
for men being all the workmanship of one omnipotent,
and infinitely wise maker; all the servants of one
sovereign master, sent into the world by his order,
and about his business; they are his property,
whose workmanship they are, made to last
during his, not one another’s pleasure...
Every one...may not, unless it be to do justice
on an offender, take away, or impair the life,
or what tends to the preservation of the life, the liberty,
health, limb, or goods of another.

Source: John Locke, Second Treatise of Government, C. B. Macpherson, ed. (Indianapolis, IN: Hackett, 1980 (orig. 1690)).

Thus, history teaches that the founders, as evidenced by their contemporary writings, viewed "preservation of the health" of "all servants of God" as a moral obligation existing and required because of our relationship with God. Preservation of the health of every citizen.

And if you're thinking, yeah, but he didn't say Government should be involved in carrying out that promise, consider Locke's very next words:

"God hath certainly appointed government to restrain
the partiality and violence of men.
I easily grant, that civil government is the proper remedy
for the inconveniences of the state of nature." Id.

It seems he did. Granting government authority to protect and ensure the health of all of its citizens was seen as a moral obligation by our founding founders. Let us not dishonor their commitment to God.

Obama Calls Health Plan a ‘Moral Obligation’
By JEFF ZELENY and CARL HULSE
N.Y. Times - Published: August 19, 2009

WASHINGTON — President Obama sought Wednesday to reframe the health care debate as “a core ethical and moral obligation,” imploring a coalition of religious leaders to help promote the plan to lower costs and expand insurance coverage for all Americans.

* * *

“These struggles always boil down to a contest between hope and fear,” he said. “That was true in the debate over Social Security, when F.D.R. was accused of being a socialist. That was true when J.F.K. and Lyndon Johnson tried to pass Medicare. And it’s true in this debate today.”

Source/full story: http://www.nytimes.com/2009/08/20/us/po ... obama.html

The President may have finally stumbled upon a winning argument in the health care debate and one upon which our nation was founded.

[roxybeast]

While Bi-Partisanship Dies, the "Medicare Buy-In" Enters the Fray
by Beth Isbell,
Aug. 20, 2009

In the Republican party "The pressure has been really intense to hold ranks and not give Obama a victory," says Charlie Cook, the publisher of The Cook Political Report. "And, ideologically, this health care overhaul has been tough for conservatives to swallow." Source/full story: http://www.npr.org/templates/story/stor ... =112044867

Meanwhile, health industry lobbyists continue to pour millions into the debate: http://www.huffingtonpost.com/2009/08/2 ... 64469.html ... and some of this money is even being spent to claim that they actually support reform. But do they really or is this money just being wasted? Here's an interesting look at that question ... Jason Linkus write: "All of them are extraordinarily tepid in their support of health care reform. These ads seem to like the idea of someone doing something about health care, but none of them are exactly going to the wall for the public option or anything. One wonders: why is this? The answer may be: Because these ads are made by people who want credit for supporting President Barack Obama's health care reform agenda, but don't actually want the reform itself." Source/full story: http://www.huffingtonpost.com/2009/08/2 ... 63457.html .... The NY Times recently took an in-depth look into the advertising war by the health industry fueling this public debate ... http://www.nytimes.com/2009/08/16/healt ... 16ads.html

(Note: Remember to go back and find the links in prior posts on this blog to the factcheck.org and other neutral ad checker links that allow you to immediately check the accuracy of any ad they run! And here's another good article which counters and fact-checks some of the myths currently surrounding the health care debate ... http://www.huffingtonpost.com/2009/08/2 ... 63916.html )

So where do we stand? Here are two interesting roundtable discussions, each featuring five columnists who look at all the issues surrounding reform and the public option from completely different perspectives ... http://roomfordebate.blogs.nytimes.com/ ... alth-plan/ ... and ... http://roomfordebate.blogs.nytimes.com/ ... e-mistake/

So where does the President stand? The President just gave an interview in which he explains where he currently stands on health care reform ...

Obama Interview: "Guarantees" Reform, Still Open To GOP

President Barack Obama guaranteed on Thursday that health care reform will be achieved, and he stuck by the public option as his preferred choice for revamping the insurance market.

In an interview with Philadelphia-based radio talk show host and MSNBC analyst Michael Smerconish, Obama continued to talk about his desire to bring Republican lawmakers on board. He also chastised, ever so slightly, the press and progressives for getting "a little excited" in their suspicions that he was abandoning the public plan. "Our position hasn't changed," he said.

Obama's most powerful moment, however, may have come when he addressed a caller who had supported his 2008 campaign but was concerned that the president's knees were "buckling" when it came to getting health care reform passed.

"I guarantee you," he told the caller, "we are going to get health care reform done. And I know that there are a lot of people out there who have been hand wringing and folks in the press are following every little twist and turn of the legislative process. You know, passing a big bill like this is always messy. FDR was called a socialist when he passed Social Security. JFK and Lyndon Johnson, they were both accused of a government takeover of health care, when they passed Medicare. This is the process we go through because understandably, the American people have a long tradition of being suspicious of government, until the government actually does something that helps them, and then they don't want anybody messing with whatever gets set up. And I'm confident we're going to get it done."

Watch Video of part of the President's interview: http://www.youtube.com/watch?v=9rt8GFUUA-k

Obama and his Democratic allies are making a renewed push to bolster public opinion behind his health care agenda. On Wednesday, Obama hosted a call with religious leaders who backed his proposal. Later on Thursday, he is hosting an open strategy session with his campaign arm - Organizing for America - to discuss the political landscape surrounding the health care debate.

Through it all, he has stuck to a familiar script: health care reform needs to expand coverage, lower costs, and increase competition. A public option, Obama said on Thursday, is the best vehicle for achieving these goals. But no one should be "obligated to go into a public plan."

On Thursday, Obama showed a certain amount of frustration with the GOP, but he did little to indicate he was willing to give up on recruiting bipartisan support.

"As far as negotiations with Republicans, my attitude has always been, let's see if we can get this done with some consensus," he said. "I would love to have more Republicans engaged and involved in this process. I think, early on, a decision was made, by the Republican leadership that said, look, 'let's not give them a victory. Maybe we can have a replay of 1993, '94 when Clinton came in, he failed on health care and then we won in the midterm elections and we got the majority. And I think there are some folks who are taking a page out of that playbook."

"But this shouldn't be a political issue," he added. "This is an issue for the American people. There are a bunch of Republicans out there who have been working very constructively. One of them, [Sen.] Olympia Snowe in Maine, she's been dedicated on this. [Sens.] Chuck Grassley (R-Iowa) and Mike Enzi (R-Wyo.) are others. They've been meeting in the Senate Finance Committee. I want to give them a chance to work through these processes and we're happy to make sensible compromises. What we're not willing to do is give up on the core principle."

Source: http://www.huffingtonpost.com/2009/08/2 ... 64297.html

While the President continues to call for a "bi-partisan solution," many on the left question whether attempts for bi-partisanship are wasted energy. Consider this article ... http://www.huffingtonpost.com/andy-ostr ... 62221.html ... and this collection of articles on the failure of bi-partisanship and whether the Democrats can actually go it alone ... http://nymag.com/daily/intel/2009/08/democrats.html

Can't the Democrats just present the bill as a budget reconciliation matter which only requires 51 votes in the Senate as a means to ensure it's passage? Well, possibly, and that's the threat being thrown around, but there are some drawbacks and reasons why it might not work. Here's an insightful look at Congressional procedural rules ... http://hotair.com/archives/2009/08/19/t ... ciliation/

But we are still left with a complete failure of bipartisanship, consider this incredibly insightful and funny video from Rachel Maddow on why bi-partisanship isn't working and simply won't work. Democrats just need to order the pizza how they really want it ... http://www.huffingtonpost.com/2009/08/2 ... 64570.html

In a new poll, 77% of Americans feel it is important to have a "choice" between a government-run health care insurance option (i.e. a public option) and private coverage ... http://www.huffingtonpost.com/2009/08/2 ... 64375.html

And perhaps the tide is starting to turn ... more pro-reform supporters are beginning to appear and outnumber opponents at town hall meetings ... http://www.huffingtonpost.com/2009/08/1 ... 62425.html

So Democratic leaders are beginning to stand firm behind the public option ... http://www.bloomberg.com/apps/news?pid= ... YFpPCWavpI .... Howard Dean even directly challenged the President ... http://www.washingtonpost.com/wp-dyn/co ... 01773.html

So what is the public option, this 5 minute video presentation does a nice job of simply explaining what a public option will mean for you ... http://www.youtube.com/watch?v=R2aV6uJGkP0

Some Democrats in Congress even sent the following message to reassure progressives: "The fact is this is no time for progressives to get cynical about the president," said Keith Ellison (D-Minn). "If you raise your voice and you let the president know how strongly you feel about the public option, I think the president will do the right thing because he has been consistent about it all along." Source/full story: http://www.huffingtonpost.com/2009/08/2 ... 64253.html

Meanwhile, Europeans and Canadians are wondering why this issue is so difficult for Americans when other leading democracies resolved it in favor of providing public health care long ago. Here's an insider's perspective ... http://www.huffingtonpost.com/robert-da ... 62170.html

So what is the problem? In short, perhaps it's the sales pitch. In his article "The PolicySpeak Disaster for Health Care," George Lakoff, a USC Professor of Linguistics & Cognitive Sciences, discusses why and how the President has gotten off message, and proposes what he things might be a more effective and winning message:

Howard Dean was right when he said that you can't get health care reform without a public alternative to the insurance companies. Institutions matter. The list of what needs reform makes sense under one conceptual umbrella. It is a public alternative that unifies the long list of needed reforms: coverage for the uninsured, cost control, no preconditions, no denial of care, keeping care when you change jobs or get sick, equal treatment for women, exorbitant deductibles, no lifetime caps, and on and on. It's a long list. But one idea, properly articulated, takes care of the list: An American Plan guarantees affordable care for all Americans. Simple. But not for policy wonks.

The policymakers focus on the list, not the unifying idea. So Obama's and Axelrod's statements last Sunday were just the lists without the unifying institution. And without a powerful institution, the insurance companies will just whittle away at enforcement of any such list, and a future Republican administration will just get rid of the regulators, reassigning them or eliminating their jobs.

* * *

What Now?

It is not too late. The statistic I've heard is that over 80% of citizens want a public plan, but the right wing's framing has been overwhelming public debate, taking advantage of the right's communication system and framing prowess.

The administration has dug itself (and the country) into a hole. At the very least, the old mistakes can be avoided, a clear and powerful narrative is still available and true, and some powerful, memorable, and accurate language should be substituted for PolicySpeak, or at least added and repeated by spokespeople nationwide.

The narrative is simple:

Insurance company plans have failed to care for our people. They profit from denying care. Americans care about one another. An American plan is both the moral and practical alternative to provide care for our people.

The insurance companies are doing their worst, spreading lies in an attempt to maintain their profits and keep Americans from getting the care they so desperately need. You, our citizens, must be the heroes. Stand up, and speak up, for an American plan.

Language

As for language, the term "public option" is boring. Yes, it is public, and yes, it is an option, but it does not get to the moral and inspiring idea. Call it the American Plan, because that's what it really is.

The American Plan. Health care is a patriotic issue. It is what your countrymen are engaged in because Americans care about each other. The right wing understands this well. It's got conservative veterans at Town Hall meeting shouting things like, "I fought for this country in Vietnam, and I'm fight for it here." Progressives should be stressing the patriotic nature of having our nation guaranteeing care for our people.

A Health Care Emergency. Americans are suffering and dying because of the failure of insurance company health care. 50 million have no insurance at all, and millions of those who do are denied necessary care or lose their insurance. We can't wait any longer. It's an emergency. We have to act now to end the suffering and death.

Doctor-Patient care. This is what the public plan is really about. Call it that. You have said it, buried in PolicySpeak. Use the slogan. Repeat it. Have every spokesperson repeat it.

Coverage is not care. You think you're insured. You very well may not be, because insurance companies make money by denying you care.

Deny you care... Use the words. That's what all the paperwork and administrative costs of insurance companies are about - denying you care if they can.

Insurance company profit-based plans. The bottom line is the bottom line for insurance companies. Say it.

Private Taxation. Insurance companies have the power to tax and they tax the public mightily. When 20% - 30% of payments do not go to health care, but to denying care and profiting from it, that constitutes a tax on the 96% of voters that have health care. But the tax does not go to benefit those who are taxed; it benefits managers and investors. And the people taxed have no representation. Insurance company health care is a huge example of taxation without representation. And you can't vote out the people who have taxed you. The American Plan offers an alternative to private taxation.

Is it time for progressive tea parties at insurance company offices?

Doctors care; insurance companies don't. A public plan aims to put care back into the hands of doctors.

Insurance company bureaucrats. Obama mentions them, but there is no consistent uproar about them. The term needs to come into common parlance.

Insurance companies ration care. Say it and ask the right questions: Have you ever had to wait more than a week for an authorization? Have you ever had an authorization turned down? Have you had to wait months to see a specialist? Does you primary care physician have to rush you through? Have your out-of-pocket costs gone up? Ask these questions. You know the answers. It's because insurance companies have been rationing care. Say it.

Insurance companies are inefficient and wasteful. A large chunk of your health care dollar is not going for health care when you buy from insurance companies.

Insurance companies govern your lives. They have more power over you than even governments have. They make life and death decisions. And they are accountable only to profit, not to citizens.

The health care failure is an insurance company failure. Why keep a failing system? Augment it. Give an alternative.

Source/full story: http://www.huffingtonpost.com/george-la ... 64043.html

Democrats and those on the left strongly believe that a public option is the only way to truly ensure accountability. Consider this article:

The Public Option? It's About Accountability
by Dan Froomkin

Are you really confident, for instance, that the insurance industry will work hard to control health care costs? Our health insurance chieftains have been talking about that for decades. But rather than do it, they seem perfectly happy taking a big cut of an ever-bigger pie - and focusing their cost-cutting energies on denying coverage to people when they need it. This seems to work for them. Changing the rules under which they operate may have some modest impact on their behavior, but not nearly as much as looking over their shoulder and seeing a government-run program bending the cost curve, lowering rates, and improving service.

The presence of an alternative - a choice - is critical. It's also about as American as apple pie. The insurance companies themselves understand this very well. The industry-backed PR firms that are bankrolling and inciting ostensibly "grass roots" protests understand this. That's why they encourage talking points about a "government takeover" of health care, rather than anything based in reality. They know full well that a public insurance option - that, initially, relatively few people could even avail themselves of - doesn't lead to doctors working for the government or committee of bureaucrats deciding who lives and dies.

* * *

Let's be blunt. The public option - emphasis on the word "option" -- is a way to hold the insurance companies accountable should they (entirely unexpectedly, of course) fail to live up to their promises, ignore the rules, and keep doing things the way they have for the past several decades.

By contrast, the core of the argument against the public option is nothing more than a sort of whiny plaint of "Leave the insurance companies alone!"

But it's a well-funded plaint. The public option is a grave threat to the regime of obscene profit-making that has left the industry with plenty of cash to now throw in the public option's way.

The growing "opposition" to the public plan is a direct result of that money. This is - remember - exactly how money works in Washington. It buys congressmen. It buys message. It generates publicity. It even makes presidents flinch.

Source/full story: http://www.huffingtonpost.com/2009/08/2 ... 64397.html

Why is reform important, columnist Mike Lux offers some insight in his column today entitled "The Heart of the Matter":

When the President talks about needing to keep the insurance companies honest, we know he is right because we see it, up close and personal, in our own lives. When the President and other Democrats take on the insurance industry, we cheer them on because we know of what they speak. This is what drives us. We are not putting everything we have into this fight because of our thrill at the possibility that the deficit might go down, or that doctors might order fewer test results patients don't need. ...

This isn't symbolic for us, something we are doing just because the right-wing attacked the public option. We want real accountability, real competition, a real check on the insurance industry. So to all you insiders who find yourselves utterly mystified about why we care about a public plan, this is it: we want a check on insurance industry power, pure and simple. We want, as President Obama does, something to keep them honest. Tell us, if not a public option, what will accomplish that? How are you going to make that promise happen?

I can think of some ways that would help. Rate regulation, for one, as Bob Creamer and I suggested the other day. Repealing McCarran-Ferguson, the law exempting insurance companies from anti-trust laws, would help. Making it easier and faster to file class-action consumer lawsuits against insurance companies, that would also be a powerful check on insurers.

But you know what the funny thing is: these insiders panicking because they don't currently have the votes in the Senate, and attacking the very people who have kept the President's plan in the game all these months, they aren't talking about any ideas that would actually accomplish the President's goal of keeping the insurance companies honest. Maybe I would feel a little better about the co-op proposal if I'd seen any actual details on it, but not even the leading advocate for it in the Senate, Kent Conrad, has spelled out anything that would make analysts think it could remotely provide the check we are looking for on the insurance industry.

Source/full story: http://www.huffingtonpost.com/mike-lux/ ... 64254.html

And the conservative chant in unison, "but we can't let government interfere with our health care! It will lead to rationing & socialism!" ... well, frankly NO, according to this US war veteran who give us an insider's look at government run health care we provide our veterans: http://www.huffingtonpost.com/jon-soltz ... 64098.html

And the conservatives chant in unison, "but it will cost too much!", but will it really? I love this next article which takes an in-depth view of that question from a doctor's perspective ...

Fiscal Conservatism and Health Care Reform: a Bipartisan No-Brainer?
by John Geyman, Professor Emeritus of Family Medicine at the University of Washington School of Medicine

We are told by supporters of health care reform bills in the Democrat-controlled Congress that they will save us money in the long run and contain skyrocketing health care costs. But the CBO has projected that the most comprehensive proposal yet, America's Affordable Health Choices Act of 2009 (H.R.3200 in the House), will add to the federal deficit by $239 billion over 10 years. So the Administration and most Democrats find themselves on the defensive over these costs as Republicans have a field day in proclaiming the risks of even higher deficits than we already are facing. As Rep. John Boehner (R-OH and Republican leader in the House of Representatives) says:

"Americans want a better plan to lower costs and improve the quality of health care. --It's not just about health care, it's also about out-of-control government spending that's piling debt on our kids and grandkids"

That gives the fiscally conservative Blue Dog Democrats, in the middle of the battle over health care reform, powerful clout in cutting costs of the various bills working their way through Congress.

Increasing red ink haunts future projections for federal and state budgets for years to come, whether we are considering Medicare, Medicare, or the public's capacity to afford rising health care costs. The proposals currently in Congressional committees all call for expansion of Medicaid, which beleaguered states are already pushing back on. In past years, states have shared the costs of Medicaid with the federal government about equally. Now, 48 of the 50 states are having such budget shortfalls that the federal share of Medicaid's expansion is likely to be 93 percent. (Nichols, J. Dire states. The Nation. 289:5, August 17-24, 2009:3-4) The annual costs of Medicaid are now $340 billion, and the CBO projects them to increase to $430 over the next ten years. (Krauss, C. Trickle-down costs: states fear the bills in health care overhaul. New York Times. August 7, 2009: B1)

So how is the political battle actually playing out? If fiscal conservatism were the dominant factor in the debate, we should have a bill coming out of Congress that will be deficit-neutral at worse, and actually save money at best. But none of the bills we are yet hearing about will accomplish either of those goals. H.R. 3200 will cost about $1 trillion more over ten years. And as we saw in the last post (link to blog # 26), it won't result in containment of either insurance or health care costs. The only proposal in Congress that could meet goals of fiscal conservatives (of either party) is the Conyers bill in the House (H.R. 676), a single-payer Medicare-for-All bill. But so far it has been kept off the table by supposedly fiscal conservatives in both the Senate and House, even including the Obama Administration.

So why this incredible disconnect among our elected representatives shaping the future of one-sixth of our economy and future health care of all 310 million of us? The answer, of course, is all about money, corporate power and influence. For industrial stakeholders in our for-profit health care system, our costs are their income, CEO compensation and returns to investors. It really does come down to Wall Street vs. Main Street. More than 3,000 lobbyists (a 6:1 ratio to members of Congress) have descended on Washington, D.C. to lobby for stakeholder interests among industry and providers. They range from the insurance, drug, medical device, and medical equipment industries to hospitals, nursing homes and professional groups within organized medicine. In each case their agenda is to preserve and grow their revenues under the cloak of "reform".

Absent from the negotiating table is the public interest. Instead of long-term containment of health care costs for patients and their families, employers and taxpayers, the battle is being fought to extend future profits of the medical-industrial complex. Corporate money and lobbying clout ($1.4 million a day) is focused on limiting the interference of government in the health care market and avoiding price controls while calling for increased government subsidies (of private insurance through employer and individual mandates and of public programs such as Medicare and Medicaid). And at the same time, supposed fiscal conservatives are distorting the debate through their disinformation campaign against a "government takeover", "socialized medicine" and threats to "choice" -- a blatantly cynical and dishonest approach.

If the public interest is to be served by any health care reform to be enacted this year, we need an informed public to rise up and force our legislators to do the right things to actually rein in the costs of health insurance and care. A weak and small public option won't do the job. Here are some of the things that will:

• Force a favorable vote on the floor of the House this Fall on H.R. 676, the United States National Health Insurance Act, a single-payer bill for all Americans; an amendment to H.R. 3200 will be introduced by Rep. Anthony Weiner (D-N.Y.) in September that would replace the private insurance industry with such a program.
• Require Congress to enact an independent federal agency for Comparative Effectiveness Research, with authority to guide coverage and reimbursement policies.
• If a single-payer program is not possible this year (as it will inevitably be!), hold members of Congress accountable for their votes on efforts to eliminate
overpayments to private Medicare plans (not over years, but now); require that all insurance plans cover a high percentage of benefit costs; allow a public option to vigorously compete with private insurers, including setting its premiums well below private premiums and capping premium increases; and allow the government to negotiate the prices of drugs and medical devices.

When the Congress re-convenes this Fall, we the public will have an opportunity to force our legislators to be accountable to us. We need to get H.R. 676 on the table, scored by the CBO on its merits, and brought to votes in Congress on the basis of its real provisions, not the disinformation and scare tactics of self-serving stakeholders in the open market of health care.

Fiscal conservatism could and should bring together a landslide vote by
Republicans and Democrats, including the Blue Dogs, to pass H.R. 676, the only fiscally conservative option before us. The battle IS over money, but it's OUR money, including that of future generations of Americans, that should take priority over the special interests that profit from our higher costs.

John Geyman, M.D. is the author of The Cancer Generation and Do Not Resuscitate: Why the Health Insurance Industry is Dying, and How We Must Replace It, 2008.

Source: http://www.huffingtonpost.com/john-geym ... 63619.html

As an alternative to a public option, one plan that is gaining strong support is a "medicare buy-in" that would eventually and gradually lower the age for enrollment and leave patients with full choice in selecting doctors and health care providers ... Dr. Marcia Angell, M.D., former editor of the New England Journal of Medicine, explains ...

'Public Option' a Shadow of Its Original Intent - Dr. Marcia Angell Advises Optional Medicare Buy-In
by Michelle Swenson

Dr. Marcia Angell, former editor of the New England Journal of Medicine, senior lecturer in social medicine at Harvard Medical School and author (The Truth About the Drug Companies: How They Deceive Us and What to Do About It), suggests a simple, less costly alternative to building a health care "public option" from scratch. Instead, permit individuals to buy into Medicare, a known quantity with low overhead costs close to 3%, with high rate of public support - polls show higher favorability ratings among those covered by Medicare than those covered by private insurances.

"The public would be happy with Medicare for all. Polls have shown that the public loves Medicare," observes Dr. Angel.

"Public option" remains an amorphous term that is variously defined and deconstructed by different stakeholders, like a Rorscharch Test. Truthfully, the concept of "public option" as currently written in proposed bills is a faint imitation of its original intent, writes Kip Sullivan of Minnesota Physicians for a National Health Program, who evaluated the "public option" features of the current House and Senate Democratic proposals, and concluded that they lack most of the criteria laid out by Jacob Hacker who originally defined the concept. Hacker envisioned a public program closely resembling Medicare, with a large enrollment of the non-elderly population. The Lewin Group's 2001 evaluation of Hacker's "Health Care for America Plan" affirmed reduced overhead and premium costs, and predicted that a lesser number - 2 million - would remain uninsured.

Nevertheless, of the following 5 original criteria that Hacker and the Lewin Group specified as critical to the success of the "public option," only one is met by current House bills.

Hacker's Original Five Criteria of a Health Care Public Option:
• The Public Option had to be pre-populated with tens of millions of people, that is, it had to begin like Medicare did representing a large pool of people the day it commenced operations (Hacker proposed shifting all or most uninsured people as well as Medicaid and SCHIP enrollees into his public program);

• Subsidies to individuals to buy insurance would be substantial, and only Public Option enrollees could get subsidies (people who chose to buy insurance from insurance companies could not get subsidies);

• The Public Option and its subsidies had to be available to all nonelderly Americans (not just the uninsured and employees of small employers);

• The Public Option had to be given authority to use Medicare''s provider reimbursement rates; and

• The insurance industry had to be required to offer the same minimum level of benefits the Public Option had to offer.

Concluded Sullivan, the only one of Hacker's five original criteria met by current Democrats' proposed bills is the latter one, requiring the insurance industry to cover the same benefits the "public option" must cover. None of the other four criteria are met.

By marginalizing the single-payer model from the outset, Democrats have already backed away from making the best case for health care reform as means to economic recovery. Too many have tended to fold in the face of Republican/corporate distortions, willing to abandon even the principles of a strong public option.

The likelihood is that the influence of the insurance industry would distort the "public option" into "a dumping ground for the sickest while they cream off the young and healthy for themselves," observes Dr. Angell.

Even if skittish lawmakers insist on incremental change, Angell suggests that the age of eligibility for Medicare can be gradually lowered by decade, e.g., to 55, then later, to 45, etc.

Dr. Angell notes that the Medicare prescription drug benefit has been a bonanza for the pharmaceutical industry and should be changed to provide for negotiation of bulk drug rates. Provider reimbursements need to be improved and costly subsidies to private plans eliminated. Currently, the fee schedule "preferentially rewards highly paid specialists for very expensive tests and procedures. For the system to work, it would have to be a nonprofit delivery system," she says.

But changes can be made over time, as Thom Hartmann writes in an open letter to President Obama. For now, Democrats should permit individual enrollment in Medicare, and call it the public option. The Medicare billing structure is in place and Medicare recipients have full free choice of providers, in contrast to private plans that limit choice to in-plan providers.

Democrats, bypass the narrow prescriptions of the "Gang of Six" and the distortions and distractions purveyed by partisans. Implement a system that is known and favored by many as your "public option" -permit Medicare buy-in.

Source: http://www.huffingtonpost.com/michele-s ... 63651.html

So what can you do to support meaningful health care reform? You can write or call your Congressional representatives in your district and state, you can contribute to causes effectively supporting real reform, attend town halls and voice your support for the public option & real reform, you can participate in the march on Washington to support the public option proposed by former Labor Secretary Robert Reich, all of which has been discussed in prior posts (so see the earlier posts for more info), ... and, you can fill out this internet petition letting President Obama know that the public option is not optional: http://act.credoaction.com/campaign/publicoption_bo/

Finally, we close with this great article by Ben Wyskida outlining five things you can do about health care, in ascending order of difficulty and commitment ... and while I'd love to just include/quote the whole story here ... it contains links & video clips that you really should check out ... so please go to the original story & do so! http://www.huffingtonpost.com/ben-wyski ... 62534.html

And in our daily "slap" ... Rachel Maddow tells it like it really is: http://www.youtube.com/watch?v=Z144CnlNyrk

[roxybeast]

Pelosi Promises Floor Vote a Vote on Single-Payor System ...

What About a Single-Payer System?
by Steffie Woolhandler,
she is a professor of medicine at Harvard Medical School, a primary-care doctor and co-founder of Physicians for a National Health Program.

“The Health Insurers Have Already Won” reads the cover story in Business Week’s Aug. 6 issue. That’s the short answer to why the public option option is off the table as well as to why the new bill will use an individual mandate to force the uninsured to buy private insurance. Or, more fundamentally, why Congress didn’t pursue the single-payer, Medicare-for-all approach used in other developed nations.

The problem lies with the strength of the private insurers.
The public option was never single payer. Certainly, the option would have cut into private insurers’ profits (that’s why they killed it). But their profits — about $10 billion — are a fraction of what they waste on marketing (to attract the healthy); de-marketing (to avoid the sick); billing their ever-shifting roster of enrollees; fighting with providers over bills; and lobbying politicians. Doctors and hospitals spend billions more on paperwork, none of which the public option would save.

In contrast, single payer would eliminate private insurance, saving nearly $400 billion annually on insurance and provider paperwork, enough to cover the uninsured and plug the gaps in coverage for those with insurance.

In 2007, 62 percent of U.S. bankruptcies occurred in the wake of medical illness, and 77 percent of those in medical bankruptcy had health insurance (usually private insurance) when they first got sick.

Private health insurance is a defective consumer product, and Congress has no business forcing uninsured Americans to buy it.

In order to get the bill out of committee, Speaker Nancy Pelosi promised single-payer supporters, led by Representative Anthony Weiner of New York a floor vote in the fall. This is a tremendous victory for single-payer supporters like my group, the 16,000-member Physicians for a National Health Program. Members of Congress, many of whom say they personally support single payer, must now go on record on the eve of the 2010 electoral cycle. Constituents take note!

Source: http://roomfordebate.blogs.nytimes.com/ ... alth-plan/

[roxybeast]

The Daily Show: This is too funny! Love the health care town hall "snaps!" ... http://www.thedailyshow.com/watch/wed-a ... hall-snaps

and this one's pretty good too - is Fox becoming ... er ... Liberal?
http://www.thedailyshow.com/watch/wed-a ... w-liberals

And finally, here's the tragic level to which the right has fallen ... shouting "Hiel Hitler!" at a jew trying to discuss why national health care has proven to be a good thing in Israel. OMG, where's Barney Frank when you need him! http://www.youtube.com/watch?v=GVS4Zgjm ... r_embedded

[roxybeast]

Republicans Oppose, Democrats Split, Polls Confused, & Liberals Angry
by Beth Isbell
Aug. 21, 2009

The Republicans unanimously oppose the health care reform bills pending in the House. Sen. Jon Kyl (R-Ariz) told Fox that there is no Republican support, not a single vote, for the pending health care reform legislation in the House. See the full story, with video of his interview on Fox: http://www.huffingtonpost.com/2009/08/2 ... 64951.html

And in the Senate, Republicans in the key Senate Finance Committee refuse to even put the public option on the table:

The Senate Finance Committee will not include a public option in its health care bill, one of the key Republican negotiators said on Friday -- to which the White House responded, with a shrug: "That's democracy." Sen. Olympia Snowe, (R-Maine), told MSNBC that the proposal to offer consumers a government-run alternative to private insurance providers would not be endorsed by the "Gang of Six". It is that group of three Democratic and Republican Senators on the Finance Committee that has been vested by the White House with the task of reaching a bipartisan compromise. "We have not had the public option on the table," Snowe said. "It's been co-ops and addressing affordability and availability of plans through the exchange and that's -- those are the challenges we're wrestling with -- to ensure that there are affordable, basic plans to offer Americans." Source/full story: http://www.huffingtonpost.com/2009/08/2 ... 65354.html

While Obama still insists that health care reform legislation will pass ... http://www.nytimes.com/2009/08/21/healt ... obama.html
and that the President still favors a plan including a public option ... "Look, on the public option, the President has said over and over again that his goal here is to offer some more choices to bring costs down and to have more competition," [Deputy Press Secretary Bill] Burton added. "The best way to do that he thinks is through the public option. If there's a better idea, he's certainly willing to listen to it. But you know we're still talking with folks on both sides of the aisle." Source/full story: http://www.huffingtonpost.com/2009/08/2 ... 65354.html

Democratic support in the Senate for reform proposals is badly split between those championing co-ops and those insisting on a public option ... Consider these two articles:

Former Democratic National Committee Chair Terry McAuliffe is demanding his party take a stand on health care legislation that the president and many others aren't willing to take: Pass a bill with a public option for insurance coverage or don't pass anything at all. [He] described a bill without a public plan as a "failure." "If we don't have the public option, we are wasting our time," McAuliffe told the Huffington Post. "To chalk something up and get something that is not the right thing to do is morally wrong... To pass something just so you can go home and go into election saying we passed something is not why lawmakers are sent to Washington."

* * *

"Right now, [Democrats] have the House, the Senate, and the White House," McAuliffe said. "I'm not a believer that we should get something done, chalk it up as a victory, and move on. That is, to me, the worst argument. If we are going to do it, do it right. And if we don't do it right now it is never going to happen. ... The president of the United States ran on this issue. It is the moral thing to do. So let's do this."

"A bill without a public option is not necessary and it is ultimately counterproductive," he added. "If we do it incrementally and don't cover those 46 million people we are trying to put a Band-Aid on a gigantic sore that is out there festering....

"I think what the White House ought to do is stand up," McAuliffe said. "Put everybody on the record. Where do you stand? Do you want to cover these 46 million Americans or not? I think we ought to have a head count. Let the American public know where people stand on this issue. Because without the public option forget all the rest... To get in and fight for a win that doesn't accomplish and care for the people who most need it in this country to me is not a win. It is a failure. You can sugarcoat it. You can put any icing on it that you want. To me it is failure."

Source/full story: http://www.huffingtonpost.com/2009/08/2 ... 65307.html

And, in contrast ...

Budget Buster: Kent Conrad's Long Opposition To The Public Option
by Sam Stein & Ryan Grimm
Huffington Post, Aug. 21, 2009

Though he has refused to take a public position on the matter, in private meetings with colleagues and staff dating back to the beginning of the year, Conrad has repeatedly expressed his opposition to a public option, four top Democratic aides who've sat in meetings with him told the Huffington Post.

Conrad, they say, sees the public option as a dangerous expansion of federal responsibility for health care spending. "His position seems based on ideology more than practicality," said one of the aides.

Without fundamental changes to the health care system, Conrad sees the public option as unable to reduce the cost of health care. The argument by proponents of the public option that a government-run alternative within the insurance market would drive that fundamental change and help push health costs lower apparently doesn't hold any water with him.

Instead, he has presented a vague proposal to create health insurance cooperatives as an alternative.

But if it were up to Conrad, the Senate wouldn't be talking co-ops, public option or health care reform in 2009 at all, the aides say. The focus on health care runs afoul of his singular and career-long devotion to cutting the federal deficit.

* * *

When the White House put out its health care proposal with a five-year timeline, Conrad insisted on using a ten-year frame. That's why we're talking about a $1 trillion price tag rather than a $500 billion one. The real-world difference is negligible -- the two scenarios are the same -- but the trillion dollar figure increases the political focus on costs.

At a July 16th Budget Committee hearing, he argued against expanding health care coverage if it raised the debt, emphasizing that "[w]ithout fundamental changes in the organization and delivery of care, expanding health insurance coverage will worsen the nation's long-term budget outlook."

* * *

Beyond ideology or pragmatism, however, the North Dakota Democrat has a pocketful of other reasons to oppose a public option. Despite being from a state where campaigns cost a relative pittance, Conrad has found himself the recipient of largess from a host of private actors with interests in the health care debate. Over the course of his career he has received more than $828,000 from insurance companies, $610,000 from health professionals, and $255,000 from Pharmaceutical and health product companies, according to the Center for Responsive Politics.

In 2009 alone, Conrad has watched industry cash pour in at a high rate, according to a review of FEC filings. His Political Action Committee, DAKPAC, received a $2,500 donation from the American Medical Association; $2,000 donations from the pharmaceutical companies Merck & Company and Eli Lilly; as well as $1,000 donations from Johnson & Johnson, Blue Cross and Blue Shield, American Hospital Association, AstroZeneca, Abbott Laboratories, Boehringer Ingelheim, and the Federation of American Hospitals.

Meanwhile, a slew of prominent industry lobbyists have been donating to Conrad's leadership PAC as well.

• David Castagnetti, of the firm Mehlman Vogel Castagnetti, donated $1,000 to the Senator's PAC. Castagnetti and his firm have been paid $877,500 to lobby on behalf of America's Health Insurance Plans, including $250,000 in 2009 alone. He has also earned $825,000 ($180,000 in 2009) to lobby on behalf of PhRMA.
• Charles Brain, of Capitol Hill Strategies, donated $1,000 to Conrad's PAC. Both he and his firm have been paid $1.4 million to lobby on behalf of PhRMA.
• John Jonas, of the firm Patton Boggs, gave $1,000 to Conrad's PAC. He and his firm have been paid $280,000 to lobby on behalf of American Healthcare Association in 2009, as well as $280,000 by BristolMyers Squibb for lobbying this year alone.
• Brian Griffin, a lobbyist for the Duberstein Group, made a $1,000 donation to Conrad's PAC. He and his firm have earned $300,000 to lobby on behalf of AHIP in 2009, as well as $960,000 overall.
• Michael Levy, a lobbyist for the firm Brownstein, Hyatt, Farber and Schreck, donated $500 to Conrad's PAC. He and his firm have lobbied on behalf of a host of insurance and pharmaceutical companies including United Health Group, for which it was paid $110,000 in 2009.

The money from these private interests is coming in at rates greater than past cycles, even though he isn't up for re-election until 2012.

* * *

At a July 16th hearing, he prompted testimony from Congressional Budget Office chief Doug Elmendorf that mirrors his own concerns.

Conrad had already gotten a letter from Elmendorf in which the director said that the reform proposals he had seen so far -- because of their subsidies for coverage -- would increase the federal responsibility for health care provision.

"I am going to really put you on the spot because we are in the middle of this health care debate, but it is critically important that we get this right," Conrad said in his opening question to Elmendorf. "Everyone has said, virtually everyone, that bending the cost curve over time is critically important and one of the key goals of this entire effort. From what you have seen from the products of the committees that have reported, do you see a successful effort being mounted to bend the long-term cost curve?"

"No, Mr. Chairman," said Elmendorf. "In the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs."

Elmendorf's answer was ignored savings that Democrats insist will come from large parts of the bill, but a media uproar over the testimony erupted anyway, just as Conrad knew it would. The Finance Committee continued to drag its feet, and emboldened Blue Dogs in the House clamped on to the bill hard. Conrad would tell reporters later that day that he knew the essence of what Elmendorf's answer would be and wanted it out there for public exposure.

* * *

Indeed, although the push for co-ops is tied to the effort to get bipartisan support for the bill, that's a prospect that aides see as less likely by the day.

When the debate shifts to one between Democrats, the co-op proposal will meet stiff opposition. Advocates of the public approach didn't meet Conrad's proposal kindly. Senator Chuck Schumer, (D-N.Y.) initially said the idea didn't "come close to satisfying anyone who wants a public plan." ... But the more competitive [co-ops] become, the more the insurance industry, conservative Democrats and the Republican Party object to them as a "Trojan horse" that will destroy private insurance.

Source/full story: http://www.huffingtonpost.com/2009/08/2 ... 64123.html

Meanwhile, town halls are full of angry conservatives and right wing nutjobs declaring that Obama is Hitler and Reform is Socialism. While I don't necessarily agree with every idea in this next article which suggests 6 steps the President can take to improve the sales pitch, I do like #4 which suggests that he make a surprise appearance at one of these opposition rallies where protesters are holding up Obama is Hitler signs and confront them. Get it on camera. The image would be striking. It might even change public opinion. Would the image be effective in shutting down these wackos? No, but it just might convince independents and undecided and even some moderate Republicans to shift their support behind real reform and against fear. See, http://www.huffingtonpost.com/rob-warmo ... 61588.html

And the mega-rich Republican mayor of New York City to try to claim in an radio interview earlier today that Pharmaceutical companies and their CEOs don't make much money:

Bloomberg: Pharmaceutical Companies, CEOs Don't Make Much Money
by Sara Kugler
Huffington Post, Aug. 21, 2009

NEW YORK — Billionaire Mayor Michael Bloomberg defended multibillion-dollar pharmaceutical companies and their chief executives on Friday, declaring that they "don't make a lot of money" and shouldn't be scapegoats in the health care debate.

The mayor – and wealthiest person in New York City with a fortune estimated at $16.5 billion – made the comments on his radio show Friday during a discussion about health care.

"You know, last time I checked, pharmaceutical companies don't make a lot of money, their executives don't make a lot of money – not that they couldn't be better," Bloomberg said.

Pharmaceutical CEOs are known to make millions, with generous salaries, stock options and other perks.

Abbott Laboratories Inc. Chairman and Chief Executive Miles White's compensation was $25.3 million in 2008. The North Chicago, Ill.-based company saw profit rising 35 percent to $4.88 billion.

Merck & Co.'s chief executive, Richard T. Clark, received a $17.3 million compensation package for 2008. The company's profit more than doubled to $7.8 billion.

The mayor, a Republican-turned-independent who already has spent more than $36 million on his re-election campaign this year, often battles criticism that he is out of touch with regular people. He built his fortune after founding the financial information company that bears his name.

Earlier this year he declared "we love the rich people" while arguing against raising taxes on the wealthy, and said recently that President Barack Obama, who earns $400,000 a year and has made millions from book sales, "doesn't get paid that much" and is "on a budget" like millions of Americans.

Portraying Bloomberg as out of touch is a tactic often used by the Democratic frontrunner in the race, City Comptroller William Thompson Jr.

Thompson's campaign said in a statement Friday that Bloomberg "needs a dose of reality."

"Once again, Mike proves that he just doesn't get it," the statement said.

It was clear that Bloomberg or one of his aides realized his gaffe while he was still on the air Friday.

The mayor, who has sought to cast himself as a financial and business expert, came back from a break and said he had looked up the pay of some pharmaceutical executives.

"Some of them are making a decent amount, more than a decent amount of money," he said.

Either way, Bloomberg said, it doesn't solve anything to beat up on pharmaceutical companies while trying to come up with health care solutions.

Source: http://www.huffingtonpost.com/2009/08/2 ... 65247.html

All of which is leaving those who support meaningful reform to which includes either single-payor or a real public option to wonder ...

(1) Is ...

The Republican Party Is Turning Into A Cult
by Johann Hari

Something strange has happened in America in the nine months since Barack Obama was elected. It has best been summarized by the comedian Bill Maher: "The Democrats have moved to the right, and the Republicans have moved to a mental hospital."

The election of Obama -- a center-left black man -- as a successor to George W. Bush has scrambled the core American right's view of their country. In their gut, they saw the US as a white-skinned, right-wing nation forever shaped like Sarah Palin. When this image was repudiated by a majority of Americans in a massive landslide, it simply didn't compute. How could this have happened? How could the cry of "Drill, baby, drill" have been beaten by a supposedly big government black guy? So a streak that has always been there in the American right's world-view -- to deny reality, and argue against a demonic phantasm of their own creation -- has swollen. Now it is all they can see.

Since Obama's rise, the US right has been skipping frantically from one fantasy to another, like a person in the throes of a mental breakdown. It started when they claimed he was a secret Muslim, and -- at the same time -- that he was a member of a black nationalist church that hated white people. Then, once these arguments were rejected and Obama won, they began to argue he was born in Kenya and secretly smuggled into the United States as a baby, and the Hawaiian authorities conspired to fake his US birth certificate. So he is ineligible to rule and the office of President should pass to... the Republican runner-up, John McCain.

These aren't fringe phenomena: a Research 2000 poll found that a majority of Republicans and Southerners say Obama wasn't born in the US, or aren't sure. A steady steam of Republican congressmen have been jabbering that Obama has "questions to answer." No amount of hard evidence -- here's his birth certificate, here's a picture of his mother heavily pregnant in Hawaii, here's the announcement of his birth in the local Hawaiian paper -- can pierce this conviction.

This trend has reached its apotheosis this summer with the Republican Party claiming en masse that Obama wants to set up "death panels" to euthanize the old and disabled. Yes: Sarah Palin really has claimed -- with a straight face -- that Barack Obama wants to kill her baby.

You have to admire the audacity of the right. Here's what's actually happening. The US is the only major industrialized country that does not provide regular healthcare to all its citizens. Instead, they are required to provide for themselves -- and just under 50 million people can't afford the insurance. As a result, 18,000 US citizens die every year needlessly, because they can't access the care they require. That's equivalent to six 9/11s, every year, year on year. Yet the Republicans have accused the Democrats who are trying to stop all this death by extending healthcare of being "killers" -- and they have successfully managed to put them on the defensive.

The Republicans want to defend the existing system, not least because they are given massive sums of money by the private medical firms who benefit from the deadly status quo. But they can't do so honestly: some 70 percent of Americans say it is "immoral" to retain a medical system that doesn't cover all citizens. So they have to invent lies to make any life-saving extension of healthcare sound depraved.

A few months ago, a recent board member for several private health corporations called Betsy McCaughey noticed a clause in the proposed healthcare legislation that would pay for old people to see a doctor and write a living will. They could stipulate when (if at all) they would like to be withdrawn. It's totally voluntary. Many people want it: I know I wouldn't want to be kept alive for a few extra months if I was only going to be in agony and unable to speak. But McCaughey started the rumor that this was a form of euthanasia, where old people would be forced to agree to death. This was then stretched somehow to include the disabled. It was flatly untrue -- but the right had their talking point, Palin declared the system "downright evil", and they were off.

It's been amazingly successful. Now, every conversation about healthcare has to begin with a Democrat explaining at great length that, no, they are not in favor of killing the elderly -- while Republicans get away with defending a status quo that kills 18,000 people a year. The hypocrisy was startling: when Sarah Palin was Governor of Alaska, she encouraged citizens there to take out living wills. Almost all the Republicans leading the charge against "death panels" have voted for living wills in the past. But the lie has done its work: a confetti of distractions has been thrown up, and support is leaking away from the plan that would save lives.

These claims have become so detached from reality that they often seem like black comedy. The right-wing magazine US Investors' Daily claimed that if Steven Hawking had been British, he would have been allowed to die at birth by its "socialist" healthcare system. Hawking responded with a polite cough that he is British, and "I wouldn't be here without the NHS." Frank Laffer, the right-wing economist lauded by David Cameron, claimed on CNN that it would be a disaster if the government got its hands on Medicare, the program providing healthcare for the elderly, paid for entirely by... the government.

This tendency to simply deny inconvenient facts and invent a fantasy-world isn't new; it's only becoming more heightened. It ran through the Bush years like a dash of bourbon in water. When it became clear Saddam Hussein had no Weapons of Mass Destruction, the US right simply claimed they had been shipped to Syria. When the scientific evidence for man-made global warming became unanswerable, they claimed, as one Republican congressman put it, that it was "the greatest hoax in human history", and all the world's climatologists were "liars". The American media then presents itself as an umpire between "the rival sides", as if they both had evidence behind them.

It's a shame, because there are some areas in which a conservative philosophy -- reminding us of the limits of grand human schemes, and advising caution -- could be a useful corrective. But that's not these what so-called "conservatives" are providing: instead, they are pumping up a hysterical fantasy, that is only a thin skin covering raw economic interests and base prejudices.

For many of the people at the top, this is mere cynical manipulation: one of Bush's former advisors, David Kuo, has said the President and Karl Rove would mock evangelicals as "nuts" as soon as they left the Oval Office. But the ordinary Republican base believe it. They are being cruelly manipulated into opposing their own interests through false fears and invented demons. Last week, one of the Republicans sent to disrupt a healthcare town hall started a fight and was injured -- and then complained he had no health insurance. I didn't laugh; I wanted to weep.

Indeed, if you spend any time with American right-wingers -- as I have, reporting undercover on events like the National Review cruise and the Christian Coalition Solidarity Tour of Israel -- you soon find that your arguments don't center on philosophy. You have to concentrate on correcting basic factual errors about the real world.

They insist Europe has fallen to Islam, since Muslims immigrants are becoming a majority and are imposing sharia law. In reality, Muslims make up 3 percent of the population of Europe, and most of them oppose sharia law. They insist Franklin Roosevelt caused the Great Depression, and should have cut government spending. In reality, whenever he did cut spending -- as he tried periodically throughout the 1930s -- the economy began to tank. But explain this patiently -- with a thousand sources -- and they simply shriek that you are lying, and they know "in their heart" what is true. They insist gay marriage would cause the institution of the family to collapse. In reality, where it has already been introduced in Europe, heterosexual families continue just as before. On the list goes: evolution is a lie, a blastocyst is akin to a baby, torture produces actionable intelligence...

How do they train themselves to be so impervious to reality? It begins, I suspect, with religion. They are taught from a young age that it is good to have "faith" -- which is, by definition, a belief without any evidence to back it up. You don't have "faith" Australia exists, or fire burns: you have evidence. You only need "faith" to believe the untrue or unprovable. Indeed, they are taught that faith is the highest aspiration and most noble cause. Is it any surprise this then percolates into their political views? Faith-based thinking spreads and contaminates the rational.

Up to now, Obama has not responded well to this onslaught of unreason. He has tried to conciliate the elite economic interests, and joke about the fanatical fringe they are stirring up. He has shamefully assured the pharmaceutical companies that an expanded healthcare system will not use the power of government as a purchaser to bargain down drug prices, while wryly saying that he "doesn't want to kill Grandma." Rather than challenging these hard interests and bizarre fantasies aggressively, he has tried to flatter and soothe them. His healthcare plan is weaker and harder to explain as a result.

But this kind of mania can't be co-opted: it can only by over-ruled. Sometimes in politics you will have enemies, and they must be democratically defeated. The political system cannot be gummed up by a need to reach out to the maddest people with the maddest fears. There is no way to expand healthcare without angering Big Pharma and the Republicaloons. So be it. As Arianna Huffington put it, "It is as though, at the height of the civil rights movement, you thought you had to bring together Martin Luther King and George Wallace and make them agree. It's not how change happens."

However strange it seems, the Republican Party really is spinning off into a bizarro-cult who believe Barack Obama is a baby-killer plotting to build death panels for the grannies of America. Their new slogan should be -- shrill, baby, shrill.

Source: http://www.huffingtonpost.com/johann-ha ... 62594.html

And for further amusement, here's an interesting interview from NPR with an insurance company executive regarding rising costs and profits in the insurance industry ... and her interesting spin on how they really want reform & why they are spending so much money on lobbying. Yeah, right, ... and, she sounds like she doesn't really believe it either. Listen for yourself:
http://www.npr.org/templates/story/stor ... =112094043


Or wonder ... (2) Does the Public Actually Get It? And If Not, Why Not? ...

Do the People Really Understand Health Care Reform?
by Lance Simmens

It is often difficult when one is close to a problem to step back and envision how that problem looks to those who do not perceive to be ensnared in the problem. It is similarly difficult to realize the complexity of large issues when there are competing issues that seem far more pressing and immediate and affect one directly. No one will argue that we as individuals both consciously and subconsciously perform triage on issues and prioritize them, dealing with the most serious first and the least serious last.

What makes the current cacophony of voices that substitutes for dialogue on health care reform so frustrating is that in each of the instances identified above there is a disconnect among a large proportion of the population as to the seriousness of the issue as it affects them. A large number of the electorate fail to realize that the problem affects them in a very direct way regardless of how close they perceive themselves to be involved with it and has a huge ripple effect on aspects of their lives that they feel are unconnected.

Make no mistake about it, this is a complicated and complex issue, but no more so than climate change and to his everlasting credit Al Gore has educated millions and millions of people worldwide about the importance of this largely scientific phenomenon to their personal lives. Sometimes we need to simplify in ways that seem elementary. Let me attempt to do so in a way that may help the public to become further engaged in an issue that is of tremendous long-term importance not only to them personally but to the society as a whole. I would like to ask a series of questions that need to be answered in the clearest way possible so as to craft a message that may strike the appropriate chord. And remember, as important as it is to ask the right questions, it is every bit as important to shape the answers in a clear, concise, and understandable form.

First, is there a need for health care reform? Why? And specifically, what is it in the current system that needs to be reformed? Incredibly, there appears to be confusion as to whether or not the current system is indeed in need of reform. I know to many of us it appears we have crossed that bridge long ago, but evidently not. Hence, officials and others can begin their arguments with the premise that this is the finest health care system in the world, so why fix what ain't broken?

Second, what are the best ways to fix our health care system? How exactly would that affect me directly? What would change for me if we put this fix into place?

Third, can we control health care costs that are spiraling out of control by fixing the system? How will this occur? What does it mean for me, both as an individual and as a contributing (read tax-paying) member of society?

Fourth, what exactly are the goals of the current health care system? Should we institute a better set of goals? What are the actual outcomes of the current system? Can we effect a better set of outcomes? How will these outcomes affect me as an individual?

Fifth, please outline everything, I mean everything, in terms of what it means to me. I need to know exactly how my life will change and why it will be better. If it is better for me, it must be better for everyone.

Now if all this sounds like it is a little me-centered, it is. And unfortunately, that is the only language we Americans seem to be able to relate to, at least those who are currently spewing the ill-informed spittle that is being voiced and covered at these town hall meetings or that is being propagated by the conservative opposition forces.

I fear that sometimes we give the populace far too much credit for being well-versed on the issues. For instance, single-payer system, public option, co-ops, even though they may seem to be evident on their respective faces, far too many seem confused, and who among us would feel comfortable explaining the differences in ways that would not force average people's eyes to glaze over?

Keep it simple stupid (KISS) would be well employed here. We must first show unequivocally that the patient, in this case our health care system, is very ill. Strange thing, when people are seriously ill they care little about how they get better, only that that is the ultimate outcome. It seems to me that far too few people are either aware or accepting that the patient is ill, seriously ill. Thus, this must be our first and most prominent task.

Given the time table for action it does not appear to be too late to employ such a simplification strategy. Given our failure to succeed in reforming the health care system it seems imperative that we take the time to lay the proper foundation for this debate and in many instances we need to fill in the cracks of the current foundation, one that is permeated with misinformation and deception.

The opposition forces are strong, but the forces for change are stronger. We must arm these forces for change with arguments and rationales that are understandable and persuasive. My guess is that if understood and conveyed correctly, they will be persuasive.

Source: http://www.huffingtonpost.com/lance-sim ... 63491.html

Or (3) Just Plain Angry ... Consider these next two articles ...

At Last Liberals Get Angry
by Bob Burnett
Huffington Post, Aug. 21, 2009

Then came health care reform -- the number one Liberal domestic issue. During the Democratic primaries, we understood that Barack Obama did not believe a single-payer system -- an extension of Medicare to cover all Americans -- was a viable option. Ever the optimists, Liberals backed away from our preferred solution, believing that we could get many of the advantages of a single-payer system if Americans were guaranteed access to a public option, a non-profit, insurance plan competing with those offered by health insurance companies.

Liberals believe an acceptable health care plan must have four components:

Provide affordable, quality health care for all Americans
Guarantee choice of doctors and health plans
Cause no increase in the Federal deficit
Reduce health care costs
Theoretically, the President's proposal would accomplish all four.

Liberals have focused on the Obama solution for cost reduction: a Health Insurance Exchange that would offer citizens health care options, plans that offer a few different packages. The President promised: "One of these options needs to be a public option that will give people a broader range of choices and inject competition into the health care market [to] force waste out of the system and keep the insurance companies honest."

* * *

Liberals correctly interpreted these remarks to mean the Obama Administration was backing away from the public option, abandoning the best hope of reducing health care costs. And then a miracle happened. Liberals got angry.

For eight and a half years, Liberals have been patient and well behaved. We've been good citizens and steadfastly supported a government that often appeared to not care about us. Liberals have patiently listened to the opposition, even when their arguments seemed irrational. We've tried to negotiate with those opposed to health care reform, even when they shook their heads, stamped their feet, held their breath until their faces turned blue, and refused to consider any change to the existing dysfunctional system.

At long last Liberals have had enough. We're not going to compromise on the public option. We're mad as hell, and we're not going to take this anymore.

Source/full story: http://www.huffingtonpost.com/bob-burne ... 64928.html

And this one ...

Obama's Trust Problem
by Paul Krugman

According to news reports, the Obama administration — which seemed, over the weekend, to be backing away from the “public option” for health insurance — is shocked and surprised at the furious reaction from progressives.

Well, I’m shocked and surprised at their shock and surprise.

A backlash in the progressive base — which pushed President Obama over the top in the Democratic primary and played a major role in his general election victory — has been building for months. The fight over the public option involves real policy substance, but it’s also a proxy for broader questions about the president’s priorities and overall approach.

The idea of letting individuals buy insurance from a government-run plan was introduced in 2007 by Jacob Hacker of Yale, was picked up by John Edwards during the Democratic primary, and became part of the original Obama health care plan.

One purpose of the public option is to save money. Experience with Medicare suggests that a government-run plan would have lower costs than private insurers; in addition, it would introduce more competition and keep premiums down.

And let’s be clear: the supposed alternative, nonprofit co-ops, is a sham. That’s not just my opinion; it’s what the market says: stocks of health insurance companies soared on news that the Gang of Six senators trying to negotiate a bipartisan approach to health reform were dropping the public plan. Clearly, investors believe that co-ops would offer little real competition to private insurers.

Also, and importantly, the public option offered a way to reconcile differing views among Democrats. Until the idea of the public option came along, a significant faction within the party rejected anything short of true single-payer, Medicare-for-all reform, viewing anything less as perpetuating the flaws of our current system. The public option, which would force insurance companies to prove their usefulness or fade away, settled some of those qualms.

That said, it’s possible to have universal coverage without a public option — several European nations do it — and some who want a public option might be willing to forgo it if they had confidence in the overall health care strategy. Unfortunately, the president’s behavior in office has undermined that confidence.

On the issue of health care itself, the inspiring figure progressives thought they had elected comes across, far too often, as a dry technocrat who talks of “bending the curve” but has only recently begun to make the moral case for reform. Mr. Obama’s explanations of his plan have gotten clearer, but he still seems unable to settle on a simple, pithy formula; his speeches and op-eds still read as if they were written by a committee.

Meanwhile, on such fraught questions as torture and indefinite detention, the president has dismayed progressives with his reluctance to challenge or change Bush administration policy.

And then there’s the matter of the banks.

I don’t know if administration officials realize just how much damage they’ve done themselves with their kid-gloves treatment of the financial industry, just how badly the spectacle of government supported institutions paying giant bonuses is playing. But I’ve had many conversations with people who voted for Mr. Obama, yet dismiss the stimulus as a total waste of money. When I press them, it turns out that they’re really angry about the bailouts rather than the stimulus — but that’s a distinction lost on most voters.

So there’s a growing sense among progressives that they have, as my colleague Frank Rich suggests, been punked. And that’s why the mixed signals on the public option created such an uproar.

Now, politics is the art of the possible. Mr. Obama was never going to get everything his supporters wanted.

But there’s a point at which realism shades over into weakness, and progressives increasingly feel that the administration is on the wrong side of that line. It seems as if there is nothing Republicans can do that will draw an administration rebuke: Senator Charles E. Grassley feeds the death panel smear, warning that reform will “pull the plug on grandma,” and two days later the White House declares that it’s still committed to working with him.

It’s hard to avoid the sense that Mr. Obama has wasted months trying to appease people who can’t be appeased, and who take every concession as a sign that he can be rolled.

Indeed, no sooner were there reports that the administration might accept co-ops as an alternative to the public option than G.O.P. leaders announced that co-ops, too, were unacceptable.

So progressives are now in revolt. Mr. Obama took their trust for granted, and in the process lost it. And now he needs to win it back.

Source: NY Times - http://www.nytimes.com/2009/08/21/opini ... ugman.html

So what do the recent public opinion polls show?

"A new poll from Rasmussen shows that Americans want a public option, and support for reform collapses without it. Just 34% of voters nationwide support the health care reform plan proposed by President Obama and congressional Democrats if the so-called "public option" is removed. The latest Rasmussen Reports national telephone survey shows that 57% oppose the plan if it doesn't include a government-run health insurance plan to compete with private insurers."
Source/full story: http://www.huffingtonpost.com/2009/08/1 ... 63030.html

Without Public Option, Enthusiasm for Health Care Reform, Especially Among Democrats, Collapses
Poll by Rasmussen Reports

Just 34% of voters nationwide support the health care reform plan proposed by President Obama and congressional Democrats if the so-called “public option” is removed. The latest Rasmussen Reports national telephone survey shows that 57% oppose the plan if it doesn't include a government-run health insurance plan to compete with private insurers. Last week, Rasmussen Reports tracking found that support for the Congressional plan was at 42%. While the tracking question did not specifically mention the public option, it referred to the bill proposed by the president and congressional Democrats now working its way through Congress. All of the congressional committees that had passed reform legislation included a government health insurance plan. Therefore, it is reasonable to compare those results with the current polling to measure the potential impact of dropping the public option.

The most dramatic impact is a sharp decline in enthusiastic support. Without the public option, only nine percent (9%) Strongly support the legislation. The earlier poll found 26% Strongly in favor of it.
That enthusiasm gap is especially significant since the percentage of those opposed to the legislation has consistently been higher. Last week’s poll found 44% Strongly opposed to the reform legislation. If the public option is dropped, 37% remain Strongly opposed.
The other dramatic shift can be found in the partisan dynamics.

Without the public option, just 50% of Democrats support the legislation. That’s down from 69% support measured a week ago. But here the enthusiasm gap is especially strong. A week ago, polling found that 44% of Democrats Strongly favored the reform plan. Without the public option, just 12% of Democrats Strongly support it.
Minus the government insurance option, 68% of Republicans remain opposed to the plan, down from 79%. As for those not affiliated with either major party, 70% are opposed if the public option is dropped. That’s up from 62% in the previous survey.

These results suggest that the president has difficult choices ahead. A solid majority of unaffiliated voters are opposed to passing health care reform legislation with or without the public option. However, failure to pass a plan of any kind could create additional difficulties for the president, and a plan without the public option does not have the enthusiastic support of his base. This helps explain why, according to the New York Times, senior Democrats are considering going it alone on the reform plan without trying to get any Republican support for it.

Other recent Rasmussen Reports polling highlights the underlying political challenges. Thirty-two percent (32%) of voters favor a single-payer health care system. These voters make up a heavy majority of those who favor passage of health care reform. They view the current legislation as a baby step along the way to a single-payer system. Most Americans oppose a single-payer system and are seeking reassurance that the current plan will not head in that direction.

Overall, when it comes to health care decisions, 51% fear the government more than private insurance companies while 41% hold the opposite view. Most Americans support the concept of reform, but cost control is seen as the most important aspect of reform. Also, voters simply don’t believe the legislation will deliver the benefits that its advocates claim. Few believe it will increase patient choice or make health care affordable. In fact, most voters believe the passage of the current health care reform effort will lead to higher costs and lower quality of care.

The health care reform debate has helped push Obama’s job approval ratings in the Rasmussen Reports daily Presidential Tracking Poll to new lows.

Source: http://www.rasmussenreports.com/public_ ... _collapses

A new ABC News/Washington Post poll shows that support for President Obama's health-care reform may be fading, particularly among seniors and independents. However, their new poll also shows while support for a public option/government health plan has slipped some, it is currently holding on at about 51-52% for v. 45-46% opposed, but that overall opposition to the current legislation is reversed by about the same margin. While 56% think the ability to get insurance will improve, 40% or less think what is actually covered will get worse. Souce/full story: http://www.washingtonpost.com/wp-dyn/co ... 00239.html

Yet, another poll this week showed 77% of Americans feel it is important to have a "choice" between a government-run health care insurance option (i.e. a public option) and private coverage ...

New Poll: 77 Percent Support "Choice" Of Public Option
by Sam Stein
Huffington Post, Aug. 20, 2009

More than three out of every four Americans feel it is important to have a "choice" between a government-run health care insurance option and private coverage, according to a public opinion poll released on Thursday.

A new study by SurveyUSA puts support for a public option at a robust 77 percent, one percentage point higher than where it stood in June.

But the numbers tell another story, as well.

Earlier in the week, after pollsters for NBC dropped the word "choice" from their question on a public option, they found that only 43 percent of the public were in favor of "creating a public health care plan administered by the federal government that would compete directly with private health insurance companies."

Opponents of the president's agenda jumped on the findings as evidence that backing for the public option was dropping. Proponents responded by arguing that NBC's tinkering with the language of the question (which it had also done in its July survey) had contributed to the drop in favorability for a public plan.

SurveyUSA's poll, which was commissioned by the progressive group MoveOn.org, a proponent of the public plan, gives credence to those critiques. While arguments about what type of language best describe the public option persist --"choice" is considered a trigger word that everyone naturally supports -- it seems clear that the framing of the provision goes a long way toward determining its popularity.

In asking its question SurveyUSA used the same exact words that NBC/Wall Street Journal had used when conducting its June 2009 survey. That one that found 76 percent approval for the public option: "In any health care proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government and a private plan for their health insurance--extremely important, quite important, not that important, or not at all important?"

To ensure that its respondent pool was composed of people from similar demographics and political mindsets, SurveyUSA asked respondents a question pulled directly from NBC's August survey. The results were nearly identical.

Read a description of the president's health care plan, 51 percent of Survey USA respondents said they "favored" the approach, while 43 percent opposed it. In the NBC poll, 53 percent of respondents said they favored the president's plan, 43 percent said they opposed it.

Source: http://www.huffingtonpost.com/2009/08/2 ... 64375.html

So what is really going on here? What does this new polling data actually mean?

First, it means that the people doing the polling are not asking the right questions or are asking their questions inartfully. These are complex issues and people on both sides have complex views. Polls are designed to answer a yes or no question, but the way the question is worded and the "implied" premises of the question often greatly skew the result. Second, the polls indicate overwhelming (77%) of true reform which includes a meaningful public option alternative to private insurance. And they show that a full third of the American public would even favor the more drastic option of a national health care single payor system (similar to how health care is handled in Canada, England or France). Third, they show that Republicans and conservatives strongly oppose reform, but not all of them. Fourth, they show that even Progressives and Liberals have serious concerns that all of the pending legislation has effectively been gutted and will not lead to meaningful reform. Fifth, they show that not only are Republicans and conservatives concerned about cost, that so are many Progressives and Liberals, largely for the same reason - the bailouts. While this only helps to galvanize Republican and conservative opposition, Progressives & Liberals just see this issue as far too important to let the governments prior investments in the economy, even if we believe that some of those bail-out investments were unwise, to let these concerns de-rail the best chance to secure meaningful reform of the health care system ... well, ever.

The best course, per the polling data, would be to push for single-payor as leverage to end up with a meaningful public option that actually delivers high quality care with your choice of doctors and providers, substantial reduction of administrative costs and endless red-tape, and provides job-to-job portable universal coverage for those without, not enough, or with pre-existing conditions. That is what the best data suggests the majority of voters want. Mr. President, make it happen.

After finishing this piece and now sitting back & reading it, this thought occurred to me: the President should simply tell Republicans that they have until the end of recess to present their version of a meaningful reform bill or Democrats are going to pass single-payor. Then just sit back & watch Republicans implode as they fail to come up with any viable alternative acceptable to the majority of voters.

And finally, in our daily "slap" ... Jon Stewart interviews the originator of the Death Panel lies ... full story with video of complete interview (at the bottom of the page), but Stewart warns "one should only view it in the company of someone capable of navigating you through a 'bad trip.'": http://www.huffingtonpost.com/2009/08/2 ... 64970.html

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Beth Isbell also maintains a blog which includes a collection of helpful resources and articles to understanding health care reform:
http://www.studioeight.tv/phpbb/viewtopic.php?t=16924

[roxybeast]

Bill Moyers Journal ... Critical Condition, a documentary putting the face on the 47 million uninsured in America - the stories of how three American families struggle without insurance ... shocking! Watch: http://www.pbs.org/moyers/journal/08212009/watch.html