Thursday, August 13, 2009

Health Care Follies

QOTD, Joe Klein (Time Magazine's Swampland):
Senator Chuck Grassley has announced his membership in the Limbaugh mainstream of the Republican Party on the non-issue of Death Panels. This is the man who is the lead Republican negotiator in the Senate Finance Committee's effort to create a bipartisan health care bill--and he either (a) hasn't the vaguest notion of what's in the bill or (b) he is so intimidated by the ditto-head-brown-shirts that he is trying to fudge a response to keep them happy. Either way, he should be ashamed. And once has to wonder about the fate of the Senate Finance Committee deliberations if this is what the Administration is dealing with.
Yglesias: British Growing Tired of GOP Lies About UK Health Care

It’s too bad that repeated, endless, flagrant dishonesty doesn’t do much of anything to damage a politician’s ability to be taken seriously as a sober-minded centrist deal-maker, or Chuck Grassley would be in a world of pain:

Sen. Edward M. Kennedy would be refused treatment for his brain tumor in England — at least according to one of the allegations lobbed at Britain’s state-funded health-care service recently by critics of President Obama’s proposed health-care reforms. Such claims have irked British health officials, who say they are misleading, exaggerated and sometimes just plain wrong. [...]

One of the most surprising of these was the rumor — given an airing by Senate Finance Committee Chairman Charles E. Grassley (R-Iowa) — that Kennedy, 77, would not receive treatment for his brain tumor if he were in England because he is too old.

“That’s just wrong,” a British Health Department spokesman said. “The NHS in England provides health services on the basis of clinical need, irrespective of age or ability to pay.”

Note that there’s actually a two-fold lie here. First Grassley falsely implies that congressional Democrats are proposing to create an NHS-like system. Second, he lies about how the NHS operates. And he pays no price for it. He’ll still be Max Baucus’s key partner in crafting health care legislation.

Yglesias: The Limited Powers of the Presidency

I think Ezra Klein nails this:

As Dan says, we’ve not yet seen Obama’s negotiating style come into focus. But we will soon. That said, I don’t know how many times a president has to fail to solve this problem before we admit that it’s not a matter of presidential messaging, or toughness, or will, or strategy. FDR, Truman, Nixon, Carter and Clinton all took runs at this prize. All of them failed. And Lyndon Johnson went for Medicare and Medicaid because he was daunted by the challenge of comprehensive health-care reform.

That’s right. I know a lot of people on the left who seem to have voted for Barack Obama because they liked his progressive agenda, then gotten excited when Obama won the election because they liked his progressive agenda, then Obama proposed progressive measures to the congress and they were excited, then it turned out that key congressional players like Collin Peterson and Rick Boucher and Max Baucus were less left-wing than Obama so actually legislative outcomes would be considerably less left-wing than Obama’s campaign proposal. It’s all well and good to be disappointed with this situation but it doesn’t make a ton of sense to me to do what a lot of people seem to be doing and becoming disappointed with Obama.

I recall back during the primary campaign that there was a kind of misguided sentiment out there that the key factor influencing whether or not we could get comprehensive health reform or good energy legislation in 2009 was whether you believed Obama’s story about “bringing people together” or John Edwards’ story about “fighting” or Hillary Clinton’s story about gritty experience and determination. The fact of the matter, though, is that legislating is about who controls the veto points. The difference between a conservative president whose ideas are checked by the 40th most liberal senator (Mark Warner or Mark Begich, it seems) and a progressive president whose ideas are checked by the 60th most liberal senator (Ben Nelson or Olympia Snowe) is pretty enormous. But when comparing two different possible progressive presidents, the fact remains that the veto points are going to be where they’re going to be. On foreign policy and some other matters the president has tons of discretion and it’s a different story. But big-picture domestic legislation in the modern era is controlled by congress.

Not a moment too soon, a $12 million ad campaign kicked off this morning in support of health care reform. While some of the pro-reform ads have been better than others, I happen to like this one.

It's a 30-second ad, featuring a male narrator who, if I'm not mistaken, appeared in many of the Obama campaign's ads. For those who can't watch clips online, the script reads, "What does health insurance reform mean for you? It means you can't be denied coverage for a pre-existing condition or dropped if you get sick. It means putting health care decisions in the hands of you and your doctor. It means lower costs, a cap on out-of-pocket expenses, tough new rules to cut waste and red tape and a focus on preventing illness before it strikes. So what does health insurance reform really mean? Quality, affordable care you can count on."

It's tricky putting together a 30-second spot that highlights seven different talking points, without making it sound like a laundry list of ideas. This one pulls it off nicely. What's more, notice the target audience: people who already have insurance, but who may be worried about losing it or getting screwed by their insurance company.

Also interesting is the unexpected coalition of groups financing the effort. Mike Allen reported, "The new group, funded largely by the pharmaceutical industry, is called Americans for Stable Quality Care. It includes some odd bedfellows: the American Medical Association, FamiliesUSA, the Federation of American Hospitals, PhRMA and SEIU, the service employees' union."

Their divergent interests notwithstanding, the $12 million investment has the potential to make a significant difference. Allen added, "In a reversal from former President Bill Clinton's 1993-94 health care debacle, the group's campaign is likely to mean that White House supporters keep the upper hand on the airwaves."

Given the landscape, the air support seems to be arriving at the right time.

  • from the comments:

    I'm not sure that such a revolutionary message that seeks to destroy the most profitable medical insurance industry the world has ever known with government-run death squads will be acceptable to the private broadcasters controlling the public airwaves.

    Posted by: qwerty on August 13, 2009
  • Matthew Yglesias adds, on this new coalition:
    The fact of the matter is that the country is likely to pay a price for moving in the direction of health reform that gets buy-in from these kind of interest groups. But that’s a price relative to a theoretical universe in which it’s possible to pass a better plan with PhRMA spending hundreds of millions in negative ads rather than kicking in money to help finance pro-reform ads. In the real world of politics, this looks to me like dealmaking that’s paying off.
Sen. Deather Aug. 12: During a town hall meeting in Iowa, Republican Sen. Charles Grassley said that under the health care overhaul the government would pull "the plug on Grandma." Rachel Maddow talks about his comments with Bob Krause, who is a candidate running against Sen. Grassley.
Sen. Chuck Grassley (R-Iowa) raised a few eyebrows yesterday when he told a group of constituents yesterday that the "death panel" insanity is a legitimate issue. "We should not have a government program that determines if you're going to pull the plug on grandma," Grassley said, no doubt aware of the fact that his comments were patently nonsensical.

But that's not the only thing the conservative Iowan said yesterday.

As he did at two previous town-hall meetings on Wednesday, Senate Finance ranking member Chuck Grassley (R-Iowa) made a point at his third event to tell his constituents that he won't compromise his principles for the sake of getting a health care deal. [...]

"I don't even think it's right for me to call [the Finance discussions] negotiations," Grassley said, inside a steamy community center packed with a standing-room-only crowd of about 350 people. "We're talking."

Got that? The leading Republican negotiator on health care reform doesn't even want to admit that "negotiations" exist. Grassley is willing to concede that he's "talking" to other senators, but according to the Roll Call report, the Iowa Republican "downplayed the ongoing bipartisan Finance Committee talks, saying his decision to stay at the table allows him to keep his constituents and fellow GOP Senators informed."

Grassley added that no matter what the final bill looks like, unless the reform legislation enjoys the broad support of the Republican Party, he'll vote against it.

It's remarkable. The chief Senate health care negotiator in the Republican Party wants his constituents to know that he doesn't even consider himself to be part of "negotiations," and is only there to acquire information. Grassley is also, apparently, negotiating the details of a bill he's likely to vote against.

Democrats, in other words, are trying to strike a deal on health care reform with someone who doesn't support health care reform.

That Grassley has cultivated a reputation for being a sensible moderate isn't just wrong, it's ridiculous.

Think Progress: Fox’s Cameron: Grassley is ‘taking credit for all these town halls.’

On Tuesday, the AP noted that loud protests at town halls have “dominated coverage” of the health care debate during the congressional recess thus far. On Fox News yesterday, Carl Cameron, who was covering Sen. Chuck Grassley’s town halls, reported that the Iowa Republican was “taking credit” for “the August vacation town halls that we’re now in the midst of”:

SMITH: But Grassley’s sort of taking credit for all these town halls, right?

CAMERON: Yeah, that’s right. Well, he’s the top Republican on the Senate Finance Committee, the one of five committees yet to pass a bill. And he says all of the delay caused by his collaboration and willingness to negotiate slowed this process and there by created the August vacation town halls that we’re now in the midst of. The idea being all of the voices of dissent wouldn’t have been heard had he not been part of the negotiating process.

Watch it:


It's easy to mock the insane rhetoric about "death panels," but let's not forget that right-wing activists, by screaming about an imaginary threat, are getting exactly what they want.

Tucked inside a sweeping House bill to overhaul the health system is a provision that would require Medicare to pay physicians to counsel patients once every five years. During those sessions, doctors could discuss how patients can plan for such end-of-life decisions as setting up a living will, obtaining hospice care or establishing a proxy to make their health decisions when they are unable to do so. [...]

[G]rowing complaints over the provision are leading key lawmakers to conclude that the health overhaul should leave out any end-of-life counseling provisions. A group in the Senate Finance Committee that is attempting to craft Congress's only bipartisan health bill has decided to exclude such a measure, Senate aides said this week. [emphasis added]

Up until very recently, this provision was a common-sense idea that enjoyed bipartisan support. It would help seniors and their families plan for end-of-life care; it would help guide physicians and doctors; it would help save taxpayers money; and it would help honor patients' wishes. Even insurance companies are fine with it.

But after a right-wing temper tantrum, based on confusion and lies, lawmakers are prepared to dump the idea altogether.

Who wins? Unhinged activists, who are effectively being told that they'll get their way if they scream loud enough. Who loses? Everyone else.

It reminds me of kids who give the bully their lunch money thinking, "Well, if I give him the lunch money today, maybe he'll leave me alone tomorrow." I don't think that ever works.

And here's the real kicker: it won't make any difference. Lawmakers can take the measure out of the bill, and right-wing critics will continue to equate reform with the Nazi Holocaust, because a) they're unconcerned with reality; and b) they'll assume the measure is still there anyway.

Sargent: Group “Warning” Elderly About Dangers Of Health Care Reform Tried To Privatize Social Security

Elderly people who are frightened by a conservative group’s ads warning them that health care reform could lead to their extermination at the hands of government bureaucrats might want to keep this in mind: The same group invested huge money in the push to privatize their Social Security.

The 60 Plus Association — which is running a national ad warning that health care reform would mean bureaucrats would decide whether old folks are “worth the cost” — has already gotten attention for some of its previous right wing advocacy.

But little to no attention has been paid to the group’s efforts to privatize Social Security, the effort which could arguably do the most to discredit it among the seniors that are the primary target of the group’s lurid health care scaremongering right now.

A Democrat points me to this piece from National Journal’s archives that show the 60 Plus Association spending big bucks on the Social Security privatization push as far back as 2001. The group’s president, Jim Martin, was one of an exclusive group of top level anti-Social Security right wingers that included Grover Norquist, and Martin that year bankrolled the privatization push to the tune of more than $1 million.

In 2005, when George W. Bush’s privatization push started to gather steam, the group hailed Bush and the Republican Party’s “leadership” on the issue, describing itself as a “strong proponent for personal retirement accounts.”

The talking point writes itself: Seniors, every time you hear ads “warning” you about the “dangers” of health care reform, supposedly for your own good, keep in mind that these ads were bankrolled by the same forces that spent huge money trying to protect you from your own Social Security.

Think Progress: Report: Fox News gives opponents of health care reform a 6-to-1 advantage.

As ThinkProgress has previously noted, Fox News regularly attacks efforts to reform the health care system. Now, a new report by Media Matters shows that “opponents of health care reform outnumber supporters by 6-to-1 margin” on Fox News. The report examined the coverage on August 11 and 12:

Opponents of reform outnumber supporters on Fox News

Mediaite’s Steve Krakauer noted yesterday that Fox’s coverage of congressional town halls during the August recess has been “clearly unfair.” Krakauer writes that Fox’s coverage “is entirely one-sided and has been during this entire summer.”

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