Monday, August 24, 2009

Health Care Monday: Big Pharma Lieberman Edition

TPM: Great Moments in Michael Steele

This should go over well.

GOP Michael Steele just managed to compare former House leader and Missouri senate candidate Roy Blunt to raw sewage clogging a toilet and then agree that Blunt is a serial philanderer.

Atrios says People Have To Like This Thing
Aside from pleasing the industry players and interest groups and sucky bloggers like me, voters have to like this fucking health care plan. By voters I don't mean nutty Larouchers and Teabaggers and conservatives who would never vote for a Democrat anyway. They'll claim not to like whatever it is. If it sounds and is sucky, Republicans will run against it and retake Congress. And they'll deserve to.
Yglesias: Coming Between Your Doctor and Your Health Care

There’s lots of great stuff in this Ed Pilkington story about the dark side of free market health care (via Tomasky) but my favorite bit was this part:

Eventually his lack of motor control interfered with his work to the degree that he was forced to give up his practice. He fell instantly into a catch 22 that he had earlier seen entrap many of his own patients: no work, no health insurance, no treatment.

He remained uninsured and largely untreated for his progressively severe condition for the following 11 years. Blood tests that could have diagnosed him correctly were not done because he couldn’t afford the $200. Having lost his practice, he lost his mansion on the hill and now lives in a one-bedroom apartment in the suburbs. His Porsches have made way for bangers. Many times this erstwhile pillar of the medical establishment had to go without food in order to pay for basic medicines.

This is the kind of thing that makes it so hard for me to take seriously the idea that we can’t have the government give people health care because it might subject them to “rationing.” Depending on the details, it may or may not be correct to believe that any particular government program is being too stingy. But how does giving people nothing at all resolve that problem?


Avedon: Good morning.
Last night I dreamed I lived in a land where I did not have to buy crummy insurance from fraudulent insurance companies, and yet I had full healthcare coverage. And lo, I awoke under cloudy skies, and it was so.

Oh, but this is England....
Classic Fiore.


Sargent: New Ad Targets Palin’s Facebook Supporters, Tells Them She’s A Liar

Hard to say if this’ll work, but nothing else has killed the death panel lie, so why not try this?

Americans United For Change, the labor-backed White House ally, is attempting a new one: Running an ad on Facebook — one directly targeted to Sarah Palin’s hundreds of thousands of Facebook supporters — telling them Palin has been lying to them.

Starting today, thanks to the wonders of the Internets, hundreds of thousands of Palin supporters will see this image on whatever Facebook page they visit (click to enlarge):

“Send Sarah Palin a message,” the ad says, “tell her to stop lying about `death panels.’” Click through and you get an Americans United For Change page that lists non-partisan debunkings of the death panels and offers a petition that asks her to “please stop lying.”

It seems unlikely that supporters would accuse her of lying. But AUC officials say the ad’s premise is that some of her supporters are not of the hard core fringe and might at least be open to hearing death panel counterarguments. Indeed, the Facebook ad will be further targeted towards Independent and moderate Palin backers.

Palin’s Facebook presence is her whole political operation, the stage from which she’s issued her “death panel” proclamations. The idea is to undermine her on her only platform.


Appel (Daily Dish): The View From Your Sickbed

A mother describes her family's struggle to keep their daughter Sophie insured:

In fall of 2005, we decided to switch from our private, self-employment insurance that we had used for years to Blue Cross. There was a week long gap between the policies - something that we didn't think anything of, because we simply did not know better. Just as our Blue Cross plan was set to start, we received a notice from them stating that they considered Sophie to have a pre-existing pulmonary problem (due to the amount of doctor's visits for pneumonia), and that while they would cover her in general, they wouldn't cover any pulmonary/respiratory issues until she had gone two years without needing medication or problems.

Our reaction: OMG. Actually I believe it was OMFG. All of a sudden, Sophie was without coverage for pulmonary problems. This was absolutely terrifying. What if she got sick?! What if she needed to be hospitalized?! We spent the next couple of months researching every insurance company that we could, begging them to take Sophie. Nope, it wasn't going to happen.

And then our biggest fear came true: Sophie got very, very sick.

And I'm ashamed to say that although we knew that she was incredibly ill, we actually considered keeping her home from the doctor's office, as we knew that this would be yet another strike against her getting insurance. Luckily we pulled our heads out of our asses and took her to the doctor anyway, and it's good that we did, because Sophie was so critically ill that she was sent straight from the doctor's office to ICU. She was so sick that we couldn't even wait for an ambulance; they helped me throw our limp, blue daughter into our car, and I drove like hell to get her to the hospital next door.

Let me state that very clearly one more time: we almost didn't take our baby girl, who was in severe respiratory distress, to the doctor because we knew that it would hurt her chances of getting insurance.

I realize that your reality of living in the U.S. and of health insurance is likely very different than this. But I'm going to ask you to sit for a moment and imagine being in our shoes in that situation. Imagine the shame and guilt of almost keeping your child home from the hospital until it was too late, and then imagine the horror of seeing your child naked in ICU, hooked to many different machines. There is no way to describe how this felt.

One night in ICU? $10,000, not covered by insurance.

After this hospitalization, we were approached by a hospital social worker, who suggested we apply for SoonerCare. SoonerCare is Oklahoma's Medicaid program for kids. Luckily I'm a social worker who was working for a non-profit at the time, so we had no problems meeting financial criteria. (Ha ha. A little social work humor there.) SoonerCare does NOT exclude kids for pre-existing conditions, and it covers Sophie's medications and treatment 100%.

Since that horrible October in 2005, Sophie has needed hundreds of thousands of dollars worth of treatments, hospitalizations, surgeries, medications, testing, and interventions in order to stay strong and healthy, and in some instances, to stay alive.

She has required three bronchoscopies, the middle section of her lung removed, extensive genetic testing, cardiology work ups, dozens of x-rays, CT scans, and a two week trip to a pulmonary hospital in Denver. When she's healthy, she requires three steroids, twice a day, and when she's sick she is usually on five steroids, twice daily. She's been diagnosed with right middle lobe syndrome (though not anymore, since she had it removed), a genetic mutation of cystic fibrosis, severe uncontrollable asthma, and severe sinus disease.

Since SoonerCare is the only insurance that will accept Sophie, we have to meet their financial criteria, which means living at or below the poverty level. I have had to quit wonderful jobs because I made too much money to qualify for SoonerCare. At this point I can only work either part-time, or for a very small salary, because we CANNOT afford to lose Sophie's healthcare coverage. It's the most important thing in our lives. We structure every single financial and professional decision we make around staying eligible for SoonerCare.

And while we'll gladly continue to live at the poverty level in order to provide our daughter with the healthcare that keeps her alive, we SHOULDN'T HAVE TO. We would happily pay outrageous premiums and co-pays, and do whatever else it took to get Sophie covered by regular health insurance. But you know what they all tell us?

She has to go two years with no pulmonary medications and no doctor's visits because of respiratory problems before anyone will accept her. Sophie can't go two DAYS without her medications, let alone two years.

John Cole: What He Said

A moment of stunned silence around the Cole household as I agree completely with Ross Douthat:

If the Congressional Democrats can’t get a health care package through, it won’t prove that President Obama is a sellout or an incompetent. It will prove that Congress’s liberal leaders are lousy tacticians, and that its centrist deal-makers are deal-makers first, poll watchers second and loyal Democrats a distant third. And it will prove that the Democratic Party is institutionally incapable of delivering on its most significant promises.

You have to assume that on some level Congress understands this — which is why you also have to assume that some kind of legislation will eventually pass.

If it doesn’t, President Obama will have been defeated. But it’s the party, not the president, that will have failed.

What he said.

speaking of "Dems" . . .
Benen: LIEBERMAN COWERS IN THE FACE OF CRISIS...
The conventional wisdom is that Sen. Joe Lieberman (I) of Connecticut is willing to stand with the Democratic caucus on everything except national security issues. He continues to prove, however, that this isn't true at all.

Yesterday, appearing on CNN, Lieberman said comprehensive health care reform would be nice, but when it comes to coverage to the tens of millions of Americans with no insurance, he'd like to push the issue off -- until some undetermined point in the future.

"[W]e're in a recession. People are very worried about their jobs, about the economic future. They've watched us add to the debt of this country.... Let's talk about how to change the way health care is delivered. Let's talk about protecting people from not getting insurance because of preexisting illness. Let's take off the caps on the amount of insurance coverage you can get over the years. Let's pay for preventive services for health from the first dollar. Here's the tough one. We morally, every one of us, would like to cover every American with health insurance. But that's where you spend most of the $1 trillion plus, a little less that is estimated, the estimate said this health care plan will cost.

"And I'm afraid we've got to think about putting a lot of that off until the economy's out of recession. There's no reason we have to do it all now, but we do have to get started. And I think the place to start is cost health delivery reform and insurance market reforms."

In other words, lawmakers can pass popular consumer protections for those who already have insurance. But if you have no coverage, and your family is one serious illness away from financial ruin, Lieberman wants you to be patient. The politicians will get to you eventually. Maybe after premiums continue to soar and the ranks of the uninsured swell even more, the economy will improve and Lieberman will discover his spine.

I kept waiting for Lieberman to explain why the recession necessarily means the tens of millions of Americans with no coverage should have to wait. He didn't. Apparently it has something to do with the deficit, which he misstated by $200 billion, and which doesn't make sense since reform must be deficit neutral anyway.

Lieberman did add, however, that if Senate Democrats tried to pass reform through reconciliation, it would be a "real mistake," for "the system" and "the Obama presidency."

And why would it be a "real mistake" for legislation to pass, simply because a majority of the Senate voted for it? Lieberman didn't say.

Over the weekend, President Obama said, "[I]f we pass health insurance reform, we will look back many years from now and say, this was the moment we summoned what's best in each of us to make life better for all of us.... This was the moment we earned our place alongside the greatest generations. And that is what our generation of Americans is called to do right now."

For some, that call is louder than for others.

  • Atrios on The Last Honest Man In Washington
    Someone wanting to understand how the Villagers think and function could probably learn a lot by studying how they collectively reacted to the primary challenge to Joe Lieberman. The amount of fawning adulation this buffoon of a man received during that time was comical.

Think Progress: Health insurers mobilize 50,000 employees to lobby Congress, defeat the public option.

The LA Times reports that health insurance companies, on the cusp of defeating the threat of a public option and after winning a set of important legislative health reform battles, is “poised to reap a financial windfall” for their efforts. Big insurance companies have outflanked proponents of reform with a flood of lobbyists, advertising, campaign donations, and, it appears, a well-organized strategy of coordinating their employees to contact lawmakers:

– AHIP, the lobbying juggernaut representing the industry, says 50,000 employees have been engaged in writing letters and making phone calls to politicians or attending town hall meetings.

– UnitedHealth, one of the largest insurers, organized a hot-line for employees to be directed to protests and town hall meetings. In Ohio, the number directed people to attend a radical tea party protest, sponsored by religious fundamentalist Dave Daubenmire, outside the office of Rep. Zach Space (D-OH).

Earlier this month, AHIP President Karen Ignagni threatened Democrats by declaring that if lawmakers vilify her industry, “members of Congress will come back to Washington without a strong sense that health care reform is doable.” Investors and analysts now seem confident that health reform won’t cut into the high profits of the insurers, but instead, will actually be a billion dollar “bonzana” for the industry.

Yglesias: Reform is Hard

I’ve got a new Daily Beast column whose theme I would sum up as “Monday-morning quarterbacking is easy, comprehensive health care reform is hard” pushing back on the idea that the Obama administration is running into problems because it’s making mistakes:

What Clinton tried didn’t work, in other words, so Obama’s trying it another way. Now the United States Senate looks reluctant to pass a comprehensive plan, so people think Obama is making mistakes. But looking back at American history, it’s not only Clinton who failed to accomplish comprehensive health-care reform—his effort joined reform charges by FDR, Harry Truman, Richard Nixon, and Jimmy Carter on the ash heap of history. Johnson, arguably the most accomplished legislator in American history, was too scared to try and brought us Medicare and Medicaid instead. It defies plausibility to suggest that president after president after president is blundering or inept. Rather, we should just admit the obvious—people keep trying and failing to reform the health-care system because reform is hard to do. [...]

In most countries, laws are passed by a unicameral legislature elected to express, more or less, the will of a majority of the population. Under Obama, the House of Representatives—which basically fits the bill—has already passed what would, if it were to become law, be the single most important piece of environmental legislation in the history of the world. They’re also poised to pass a universal health-care bill that’s already cleared all three relevant committees and almost certainly has majority support. But the House leadership, sensibly, doesn’t want to ask potentially vulnerable members to cast another tough vote unless the Senate is prepared to act.

But of course the Senate is rarely prepared to act on anything! None of which is to say that Obama is perfect or the White House strategy has been flawless. But it’s to make the point that pinning all your hopes and dreams for substantive policy change on finding the smartest awesomest president ever doesn’t make much sense—American politics contains a lot of veto points, and systematic change requires action across all those veto points.

Benen: HATCH GETS A SECOND BITE AT THE APPLE....

Last week, Sen. Orrin Hatch (R-Utah) appeared on ABC's "This Week," and raised a number of arguments that proved Hatch doesn't understand health care reform. He argued, for example, that reform would force "up to 119 million people into Medicaid," which isn't even remotely accurate. He added that members of an Independent Medicare Advisory Council will determine "what kind of health care you're going to have," which is just crazy.

Seven days later, "Meet the Press" decided to reward Hatch for his performance by having him address health care again. This time, he argued that the Congressional Budget Office concluded that "tens of millions of people" would lose their private insurance, go with the public option, and "destroy the private health industry."

David Gregory, to his credit, had his facts straight and intervened. "Well, wait a minute, Senator Hatch, that's not right. The Congressional Budget Office did not say that.... The CBO said that, in fact, those enrolled in private insurance plans would go up by three million, and they estimate that about 10 million people, only 10 million people go into a public plan. 'Tens of millions,' that's different than 10 million."

Hatch, undeterred by reality, responded, "Well, that's plenty. Others are saying up to 119 million people."

The "119 million" number is the same bogus claim Hatch repeated last week, which is still completely wrong.

And that's what brings me back to the thought I always have when I see interviews like these. Hatch appeared on "This Week" and made claims about health care reform that weren't true. Seven days later, he appeared on "Meet the Press" and made claims about health care reform that weren't true, some of which were debunked on the air during last week's appearance.

Will Hatch's misstatements of fact discourage producers from booking him again in the future? Of course not; that isn't how the game is played. It's why Hatch doesn't feel the need to tell the truth -- the falsehoods serve his agenda, and he'll get invited back onto the air whether he's honest or not.


Benen: WHEN POLITICIANS ARE AFRAID TO TELL THE TRUTH...

I've never sought public office, so I can't relate to how difficult it must be to deal with sincere-but-ridiculous questions. Barney Frank offers an example of one style of response, but not everyone can pull it off as well as he does.

But at least Frank didn't pander to nonsense. A couple of weeks ago, Sen. Chuck Grassley (R) of Iowa hosted a town-hall event and was asked "death panels." Instead of explaining reality, Grassley knowingly misled his audience, telling constituents, "[Y]ou have every right to fear.... We should not have a government program that determines if you're going to pull the plug on grandma."

It was one of Grassley's lowest points of late -- Time's Joe Klein called the comments "sheer idiocy" -- which the conservative senator has struggled to explain. Yesterday, on "Face the Nation," Grassley conceded he knew the "death panel" claim wasn't true, but wasn't comfortable telling his constituents the facts.

"I said that because -- two reasons. Number one, I was responding to a question at my town meetings. I let my constituents set the agenda. A person that asked me that question was reading from language that they got off of the Internet. It scared my constituents. And the specific language I used was language that the president had used at Portsmouth, and I thought that it was -- if he used the language , then if I responded exactly the same way, that I had an opposite concern about not using end-of-life counseling for saving money, then I was answering -- [...]

"You would get into the issue of saving money, and put these three things together and you are scaring a lot of people when I know the Pelosi bill doesn't intend to do that, but that's where it leads people to."

Grassley, in other words, is comfortable letting confused constituents stay confused because they're "scared." Because right-wing lies have caused widespread confusion, he added, the provision "ought to be dropped."

But that's crazy. The sensible solution is to have Americans' elected leaders tell them the truth and alleviate their unfounded fears, not let panic-stricken, gullible people "set the agenda" and kill common-sense measures that up until recently enjoyed broad bipartisan support.

As for Grassley's claim that he used "exactly" the same language as President Obama -- "pull the plug on grandma" -- the Iowa senator again has it backwards. The president was mocking the "death panel" nonsense, explaining what wouldn't happen. Grassley's town-hall answer made it sound as if the bogus claim had merit.

Paul Krugman concluded, "We talk a lot about ideology, we talk a lot about the influence of moneyed interests, and all that is relevant. But we should not ignore the sheer personal cowardice of many politicians. Here we have Grassley saying, in effect, that he was afraid to tell a constituent that she was wrong -- then trying to blame President Obama for his failure to tell the truth."

Yglesias: Steele Promises Government Will Never Get Between Seniors and Their Medicare

Michael Steele offering some nonsense in rare form. The venue, naturally, is the op-ed pages of the Washington Post whose editors once again display the casual contempt for the truth and for their readers that is the hallmark of their approach to journalism:

Second, we need to prohibit government from getting between seniors and their doctors. The government-run health-care experiment that Obama and the Democrats propose will give seniors less power to control their own medical decisions and create government boards that would decide what treatments would or would not be funded. Republicans oppose any new government entity overruling a doctor’s decision about how to treat his or her patient.

The crux of the matter here is that absent government getting between seniors and their doctors and offering to pay the doctors’ bills most seniors would be unable to afford the level of medical care they need. That’s why liberals created Medicare in 1965. Conservatives opposed this “government-run health-care experiment” at the time and derided it as likely to lead to socialism. Here’s Ronald Reagan laying out the case against Medicare.

But obviously once the government says it will pay for medical care the question arises of how much it should pay and for what. Currently that decision is in the hands of congress, which is not well-suited to making technical judgments about appropriate reimbursement rates for medical procedures. The Obama administration has proposed outsourcing the bulk of the decision-making to an expert body, known as IMAC, that would naturally still be subject to being overruled by congress. The idea is to prevent lobbyist-driven overpayments, not to deny care to seniors. And it would save the government some money over the long run. Which, you would think, conservatives would be happy about. Especially when you consider that conservatives don’t think Medicare should exist in the first place! But instead of being happy, we’ve got this campaign of deception, fearmongering, and opportunism.

So congratulations to Fred Hiatt for landing such a buzzworthy piece of nonsense for his publication and I hope the right-wing enjoys the giant tax hikes we’ll be enacting down the road once they show the political world that any attempt to trim Medicare spending, no matter how modest, will be savaged by opportunists on the other side.

  • Steve Benen adds: A.L. wrote nine words this morning that literally made me laugh: "GOP now promising to protect seniors' Medicare from Dems."

    As silly as that sounds, this is the point we've reached. In the 1960s, Republicans opposed the creation of Medicare. In the 1990s, Republicans shut down the federal government because a Democratic president wouldn't tolerate proposed GOP cuts to Medicare. In 2008, the Republican presidential ticket ran on a platform of cutting Medicare.

    And in 2009, Republican National Committee Chairman Michael Steele has the chutzpah to write a Washington Post op-ed, accusing Democrats of trying to undermine Medicare.

    ...

    Steele says Medicare faces long-term shortfalls, but he opposes efforts to address them. He condemns boards that could deny Medicare financing for some treatments, but fails to note that such boards already exist and have for years.

    If one sifts through the nonsense, looking for something substantive, what we're left with is Steele's uninformed opposition to the creation of an Independent Medicare Advisory Council (IMAC). The idea is to have appointed IMAC members -- physicians and medical experts, appointed by the White House and confirmed by the Senate -- who would have some added authority to help control what Medicare pays doctors and hospitals. The panel would probably help lower costs more effectively than Congress, which isn't especially good at these technical, medicinal, and scientific questions.

    The idea was originally proposed by conservatives, embraced by Democrats, and would serve as part of a larger effort to save money and take political considerations out of the process.

    And now Michael Steele wants seniors to think big bad Democrats are trying to undermine Medicare.

    What an embarrassment.

    Update: Steele personally endorsed the prospect of Medicare cuts during his unsuccessful 2006 Senate campaign.

    Second Update: Media Matters fact-checks Steele's piece, point by point.

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