Saturday, August 1, 2009

Our Media

When I first received an email yesterday telling me that Michelle Malkin would be a guest on ABC's "This Week with George Stephanopoulos," I thought it was a joke. I assumed it was an example of exaggerating for comedic effect -- as in, "The Sunday morning shows' guest lists tilt to the right so often, one of these days, we'll even see Malkin on."

It turns out, this wasn't a joke.

Here are the scheduled guests for the Sunday public affairs shows and other weekend programs....

This Week hosts Treas. Sec. Tim Geithner and ex-Fed Chair Alan Greenspan. The roundtable is author/columnist Michelle Malkin, Atlanta Journal-Constitution's Cynthia Tucker, Bloomberg's Al Hunt and Wall Street Journal's Jerry Seib.

This is the Malkin of "The Defeatocrats' Cheer." The Malkin of "In Defense of Internment." The Malkin who went after a 12 year old and his family over their support for expanding S-CHIP. This Michelle Malkin.

Malkin has her shtick, and she's a very effective advocate of far-right ideas. But her appearance tomorrow is a reminder that it doesn't matter how right wing a political observer is; if he/she has something provocative to say, he/she will get airtime from major media outlets.

Scott Horton: NYT Punk’d—Twice in One Day

The dog days of the news season are just about to arrive, but the editors at the nation’s newspaper of record already seem to have gone on vacation. This morning’s issue leads with Michael Gordon breathlessly recounting a real scoop: a sensitive memo by a senior military advisor to the Baghdad command who advocates an immediate pull-out of U.S. forces from Iraq. Just one problem—which the Times later had to adjust their account to reflect—the memo was nothing more than the private thoughts of a blogger, Col. Timothy R. Reese, which had already been posted to the rightwing TownHall website, where he is a regular contributor. Although it was pulled from the TownHall site, it was reposted at several other sites, including the invaluable Washington Independent. Reese’s analysis is pretty interesting; it reflects far more serious thought than his recent tirade against healthcare reform, for instance. I agree that the memo is worth a mention and some discussion. What I don’t understand is the editorial judgment underlying making a rightwing blog post the lead news story of the day. Perhaps this should be balanced by giving tomorrow’s lead to a post at the Daily Kos…

Turning the page we find the Times punk’d yet a second time, in the more conventional way. Karl Rove, violating his agreement with the House Judiciary Committee (which I discussed here), gave “exclusive” interviews to the Times and the Washington Post, in a determined effort to spin the bad news about his role in the firing of the U.S. attorneys and his unseen hand in the work of the Justice Department generally. The Post’s piece, by Carrie Johnson, shows an appropriate level of balance and skepticism about Rove’s self-serving and highly misleading claims. Not so the Times. Indeed, the headline tells the whole story: “Rove Says His Role in Prosecutor Firings Was Small.” The problem, of course, is that the evidence the Judiciary Committee has collected, and the investigation by special prosecutor Nora Dannehy, show precisely the opposite. They put Karl Rove squarely in the center of the effort to remove the U.S. attorneys fired in the December 7, 2006 massacre, and they show that the firings were motivated by improper partisan political considerations. Rove was positioned as the enforcer of Republican Party discipline—ensuring that U.S. attorneys implement the party’s electoral program, including voter intimidation and suppression, or be forced to walk the plank.

I furnish some insights into the twin investigations and where they’re headed in “Will She or Won’t She?,”(sub. req’d) a piece appearing tomorrow in the August American Lawyer. Bottom line: the special prosecutor is studying possible indictments, recognizes that she is in essentially uncharted territory, and is still some distance short of a final decision to seek them. Alberto Gonzales, Karl Rove, and New Mexico politicians Pete Domenici and Heather Wilson are names that figure prominently in the probe.

Health Care Saturday: White Flour Edition

Krugman: The invisible program

Matthew Yglesias leads us to a commenter at Marginal Revolution who looks at life expectancy and concludes that “semi-socialized medicine” is good for the young but bad for the old. Tyler Cowen made the same argument in the Times a while back:

On average, European systems are relatively good for the young, who are generally healthy and need treatment for obvious accidents and emergencies, with transparent remedies. European systems are less effective for the elderly, the primary demanders of discretionary medical benefits.

As Yglesias points out, such arguments weirdly miss the fact that older Americans are covered by Medicare. If you say that American health care works well for the elderly, then the part of our system you’re praising is the “socialized” part.

This is part of a broader phenomenon. Everyone’s favorite story about the evils of socialized medicine is the fact that Canadians wait longer for hip replacements. But who pays for hip replacements in the United States? Medicare, in most cases.

So we make fun of people who want to keep the government’s hands off Medicare. But Medicare blindness isn’t just a problem for the rubes.

Greg Sargent:

* HuffPo reports that Obama’s political operation is gearing up its ground game for the health care wars — in the districts of Blue Dog Dems.

* TPM reports the stunning response from the office of Dem Senator Ben Nelson to an ad by outside liberal groups attacking him for slowing health care reform:

“If this is an indication of the politics going into August, then health care reform may be dead by the end of August.”

Shorter Nelson: Criticize me and health care reform is doomed…

* Sam Stein reports that the groups targeting Nelson, Progressive Change Campaign Committee and Democracy for America, have absolutely no intention of letting up.

  • Steve Benen adds:

    Now, it's true that DFA and the PCCC are not Nebraska organizations, but it's worth remembering that the groups' ad features a small businessman, who owns a shop in Ralston, Neb., who supports reform and opposes the delays Nelson has demanded. The ad is not "outside special interest groups telling them what to think"; it's one voice -- that of a Nebraska shop owner -- urging his senator to do the right thing.

    Nelson is up for re-election next year, and it's not surprising that he'd like to avoid any and all criticism. But threatening to kill health care reform because a couple of groups are running a television ad he doesn't like seems rather petty.

    People are allowed to express their political opinions, even if they're critical of Ben Nelson. The ad doesn't make any false claims; it doesn't include any personal attacks; and the criticism itself is a little out of date since we already know the pre-recess deadline won't be met. For that matter, it's my understanding that it wasn't an especially large ad buy anyway.

    So, with so much on the line, and the health and hopes of millions in the balance, perhaps Nelson can drop the threats?

  • Atrios adds: I love it when our elected officials reveal themselves to have the emotional maturity of emotionally stunted 11-year olds. His widdle feelings are more important than people having access to health care.
Waldman (DK): Pull the plug on Senate Finance
Two quick observations on a Nate Silver post:

This is not exactly to suggest that Grassley is bargaining in bad faith. But he has almost no reason to compromise on any points of substance. At best, he's probably somewhat indifferent between a weak health care bill passing and the whole enterprise failing apart; that's a very dangerous person to be negotiating with. The same thing certainly goes for Mike Enzi, who is more conservative than Grassley and hails from a much redder state. Olympia Snowe is different: she is a de facto independent in a very blue state, who might even have some hopes of being on a Presidential ticket someday.

Mike Enzi is not really negotiating in this. He is there as the political officer. The "minder" for Grassley and Snowe. This should be obvious to Baucus. It's obvious to all his colleagues in the Senate, and pretty much everyone else in the world, too.

Instead of Grassley and Enzi, Baucus should be sitting in a room with Ben Nelson and Mary Landireu -- and maybe Olympia Snowe. Those are the swing votes -- the pressure points -- the people with whom there's actually something to be neogtiated. If Grassley wants to come in and snack on beef jerky and spitball a few ideas, then sure -- door's always open. But I don't know what good he's doing the Democrats by being given so leverage over the process.

Absolutely true, and a very important point. Right now, it's Enzi, Grassley and Snowe why? Because these negotiations are ostensibly a function of the Senate Finance Committee. Enzi, Grassley and Snowe are members of the committee, and Nelson and Landrieu aren't.

But so what? The reality, as everyone up to and including Baucus has acknowledged, is that they're after a bill that can get 60 votes. And not only that, but the Finance Committee product still has to be merged with the HELP product, anyway. So what difference does it make whether that's negotiated with the people who hold those votes, or with their political proxies on the Finance Committee? In fact, common sense would tell you that there is a difference, and that it's presumably always better to be negotiating directly with the other parties you're after rather than some intermediary. So if you're aiming for 60, why not negotiate directly with those few votes out there that can get you to 60?

Nobody had any problem with negotiating the settlement to the stimulus impasse outside of the formal framework established for that purpose. Collins, Snowe and Specter weren't on the conference committee, and Snowe isn't on the Appropriations Committee, either. But everyone knew where the votes were, and the negotiations happened around them, with the results carried to the formal committee structures for approval thereafter. Why we should continue with the charade of carrying on these negotiations in the Finance Committee when everyone on the Finance Committee has their eyes on votes outside of the committee membership, anyway, I have no idea.

And I just have to throw in a third point here, now that I think about it:

So what was Baucus hoping to achieve by negotiating with people who have an incentive to see the process fail? There are two basic cases here. Either the Democrats can muster all 60 votes on their own, and Grassley's vote would be the icing on top of Obama's victory cake and would only serve to improve the Democrats' electoral prospects in 2010 and 2012. Or they can't, in which case Grassley has it within his power to cause the Democrats a huge, potentially back-breaking headache.

Democrats in all likelihood can't muster all 60 votes on their own. The probability that Senator Kennedy will ever be able to return to the Senate and cast a vote is, unfortunately, minimal -- and that's an optimistic assessment. Senator Byrd is only marginally more likely to be able to appear. There are, for all practical purposes, still only 58 Democrats in the Senate.

That means that the 60th vote, if that's what we're shooting for, is going to have to come from a Republican. But the political complication in this is that no Republican wants to be that 60th vote all by themselves. There are still a few of them who might be willing to be the 61st vote, so that no one can be singled out as "the one who did it." The two votes we need to get to 60 are going to want company and cover. So it may turn out to be the case (assuming the ability to hold all 58 Democratic votes) that getting two Republicans is actually harder than getting three. And that means the search should be on for #3. Is it Grassley? Maybe. But since it doesn't matter as regards final passage whether that vote comes from inside or outside the Finance Committee, you should probably be looking at a wider roster.

I wrote the other day that it was time to consider easing Baucus out of the driver's seat on this. It's not that he's "too conservative" for this job. It's that he's not doing it, conservative or not.

It seems that call tapped into a sentiment that was much more widely held than I knew. Since the likelihood of that happening is probably pretty slim (think Lieberman), we might as well start looking for other, frankly simpler, solutions. There's really not much reason to remove Baucus as Finance Committee chair, necessarily. But there's plenty of reason to remove these negotiations from the Finance Committee.

If it's all about getting to 60, get to 60 where the 60 are.

Publius: Least Surprising News of the Day

I'm not sure Max Baucus and staff read Jonathan Cohn, but they should. This comes from his latest report on where things stand on Capitol Hill:

Baucus, as you may know, has been trying to hammer out a deal with a bipartisan group of six members. But on Thursday the most conservative member of the bunch, Republican Mike Enzi of Wyoming, made it clear he didn't think it possible to get legislation ready for the August recess.

By all accounts, Enzi has been under enormous pressure from Republican leadership, which wants no bill at all and sees time as its ally. Whether Enzi was responding to their pressure or simply following his own conscience is anybody's guess.

I, for one, am shocked that Republicans see delay as a tactical device rather than as a time for careful study and deliberation about policy merits. I'm equally shocked to Enzi dragging things out. And here I thought he only cared about Doritos...

The conventional wisdom among many political observers is that Democrats and Republicans should be able to work together to find compromise solutions to pressing problems. Politicians should "put aside their differences." Legislation should be "bipartisan." Effective leaders should be able to "bring people together."

It's worth noting, from time to time, the practical and ideological problems with this approach to problem solving. The parties disagree -- as they should; it's why they exist -- and are more polarized now than at any point in modern political history. Ezra has posted this chart from Nolan McCarty, Keith Poole, and Howard Rosenthal before, but I'm glad he ran it again yesterday. It shows current political polarization is at its highest point since the 19th century:


This political environment obviously makes compromises and "bipartisan" solutions very difficult, since the parties, more so than at any recent point, simply see matters of state in fundamentally different ways. But the polarization among lawmakers in both chambers also, as Ezra noted yesterday, "makes it virtually impossible to govern in a system that is designed to foil majorities and require a constant three-fifths consensus. It's not good if the country is virtually impossible to govern. Problems don't stop mounting while we try and figure things out."

There's been some talk lately about the effort to convince at least some Republicans to support health care reform, the way plenty of Republicans support Social Security and Medicare in previous generations. In those eras, the parties were closer together, and there were center-left GOP lawmakers from across the country who were amenable to outreach.

This period, it should be noted, did not last long. Looking at the chart, we see the parties came much closer together in the wake of the Great Depression, and the polarization remained low for several decades. It created an environment in which bipartisan policymaking was considerably easier.

And that's long gone. To reiterate a point Harold Meyerson emphasized this week: "Nationally, the [modern Republican Party] is dominated by Southern neo-Dixiecrats. In their book 'Off Center,' political scientists Jacob Hacker and Paul Pierson compared congressional Republicans of different eras and concluded that a Republican House member in 2003 with a voting record that placed him at the median of his party was 73 percent more conservative than the median GOP member of the early '70s. Max Baucus, then, isn't negotiating universal coverage with the party of Everett Dirksen, in which many members supported Medicare. He's negotiating it with the party of Barry Goldwater, who was dead set against Medicare. It's a fool's errand that is creating a plan that's a marvel of ineffectuality and self-negation -- a latter-day Missouri Compromise that reconciles opposites at the cost of good policy."

Regarding the leaked strategy memo advising conservative operatives on how to disrupt Dem "town-hall" meetings, sgwhiteinfla suggests:
My advice is that every Democratic member of Congress should get intimately familiar with this memo. And at if they plan on holding a townhall during the break they should employ what I like to call the "8 Mile" strategy. For those who never saw the movie, Eminem's character wins the rap battle at the end by predicting all of the lines of attack that his opponent will use and then he goes in on his opponent. By the time his turn comes Em's opponent is flustered because for one he didn't have any disses left to use and for two because Eminem had ripped him up. So he just hell the microphone and froze.

The first thing these Democrats should do is present the memo and inform the audience of all of the things that are to come. That there will be people yelling, and interrupting and they will also fan out to inflate their numbers. And then they should point out that these people do not want honest debate. They are there for one thing only and that is to deprive the rest of the attendees of the opportunity to learn about health care reform and have their voices heard. And then they can always point out that these people are paid for by the health insurance companies. (whether that is true or not isn't really important) Once they get that out of the way they will have the audience on their side and against the obstructionists. Instead of allowing these people to hijack the townhall, more than likely what will happen is the audience will turn on them and boo them out of the event.

That, to me, should be a no brainer. Why even give them an opportunity to try to derail the discussion? Or for that matter why try to act like they won't be there when its likely that they will. Just punch them in the mouth first and then you win the battle before it gets started.
Yglesias: The Land of the Free

And I thought that in the United States we didn’t ration health care:

An insurance company that initially refused to pay for a liver transplant for a 17-year-old Northridge girl who died in a hospital should face criminal charges and pay civil damages, an attorney for the girl’s family said Friday.

In the real world, it’s not possible to have an insurance program that will pay for just anything. A private insurance plan will try to find reasons to avoid paying for anything that’s expensive. And it’s natural inclination to do this will be checked by the sloppy method of public outrage and lawsuits. A public program, by contrast, could operate according to an explicit budget constraint, with elected officials and the voters who vote for them in a position to make a choice about how much resources they want to dedicate to health care services rather than to other things. In either case, people with the means and inclination could step outside the insurance circle and purchase additional services.

Knisely: Health Care Reform and “Dr. Avarice J. Greed, M.D., P.C.”

I hadn’t decided whether to bring “the design of government” to health care reform, but at the request of Anna D. (“Thanks, Anna!”) and having seen this WaPo article on Dr. Avarice J. Greed, M.D., P.C., and his confreres, and having received a long email from my sister, a retired nurse (see below), I think I’ll give it a shot.

Over the next few posts, I’ll comment on several issues:

1. Supply. The AMA (American Medical Association) closed half the medical schools in America about the turn of the last century. And, ever heard of “barefoot doctors”?

2. Demand. How much of obesity is due to low incomes? The Danes have a saying, “You have to be rich to be thin.” Would encouraging unions reduce obesity more than education? The GINI Index again.

3. System inefficiencies. Two flavors: Opportunities for information sharing and insurance company profits.

4. Medical mal-avarice. See below for starters.

My sister was first in her class in nursing school, and is now retired and raising show quality dogs. So she’s experienced hospital pricing from the inside and vet pricing from the outside. Her observations:

I never had a job in any “company.” Obviously hospitals try to make money, and particularly in Union [SC] they invited the head RN’s to the top staff meetings. Such things as the base room rate being as low as possible-around $105 a day at that time — 1990 — because they said people call around if a procedure is non-emergency, and what they ask is the base rate. So then you just add higher prices for everything else, and I do mean everything.

At that time, a bag of IV fluid cost the hospital $1.00, we charged the patient $10.00. A foley catheter cost us $5.00, the patient paid $57.00. But then of course, they added for 1-1 RN care, etc.

Same basic thing at my previous job in Psych at MUSC, [Medical University of South Carolina, in Charleston] the base room rate was low, but they had at least 5 therapies for each patient, and I mean the group ones like physical therapy, music therapy, this isn’t counting the medical student seeing the patient, the intern, the resident, the MD, the staffing, etc, etc.

But what got me the most was in Union. I worked there about the time Office Max and that type of store opened. Of course they sent catalogs to everyone. I knew the prices we paid in Central Supply for packs of 3 x 5 cards, pens, all sorts of stuff, and of course there are hundreds if not thousands of those things. Some of the prices that hospital paid for office supplies were 10X what Office Max charged. So I went to the head of that department with the catalog in hand, marked, but he said they liked to order everything from one supplier, so paid whatever that supplier charged.

The darn vets are the same now. If I buy a bag of IV fluids from my vets, it is $35.00. They are exactly, and I mean brand, label, everything, the same as we used in Union, and every other job I have had. IV fluids are considered a prescription drug, whereas the tubing and the needles are not. I can get the identical fluids for $3.99 a bag from KV vet but the Vet has to call or fax the prescription in. They do allow for the vet to tell them what you can have in a year, and you can order it however you want. Of course the shipping is fairly high, so I order maybe 12 at a time, which that lasts me usually a year. And I can buy if from a site that is supposed to be for vets, but I have a password, every breeder I know uses it, for $4.99. The same stuff, Propofol, that Michael Jackson used IV, it is on that site.

The lady that is the financial head of my Vets’ 2 offices, told me the same identical thing, they want to order everything from one place. I have a catalog that the medicine for preventing the dog version of Alzheimer’s, called Old Dog Encephalitis, Selegiline, 5 mg twice a day, costs $5.99 for 500 tablets. The first time I had Huey, Andrew’s father, to the vet for confusion, maybe 2 years ago, the vet told me she had read it helped, but had offered it to 3 clients, but the $200 a month caused them not to get it. I had her write down the name and dose, (just so I could remember it) — the dose is the same for people – and when I went to Wal-Mart it was $46.00; I called Pet Care RX, it was $26.00. Then I saw it in a catalog for vets for $5.99 for a huge size. I can order anything from that catalog except for prescriptions. I got a box the size that a pair of high top sneakers would be shipped in, absolutely stuffed with IV tubings, for $4.99 the other day, 100 of them.

Would it not pay a hospital or a busy vets’ office, really 2 offices with 7 vets, one full time person’s pay to check prices and order things from different suppliers? In IV fluids alone they could pay that person a week’s salary a month. They even order packages of sweetener and sugar and instant coffee from the same place!

How do things like this fit into the direction of having a great company? And of course I only see a few things!

And all I’ll add is that (a) if you can pass on all your costs to the patients (customers) AND add a percentage for profit, who cares what things cost? And that (b) when your customers or patients have no idea of your costs, you can charge them whatever you like!

When I worked for DOD, back in the 1960’s, we had both “cost-plus contracts” and “contractor-furnished lunches.” I loved CFLs – can you guess who paid? It was you, the American taxpayer!

Both are now outlawed in DOD – now how about health care? Duh!

Birthers - In The News

It just keeps getting better. Or worse. Or embarrassing. Or frightening.
Best headline ever, from Hunter (DK):

Did Obama's Birth Certificate Kill Vince Foster?

JedL (DK): The birth of a regional rump party

Here's another amazing finding from our poll showing that less than half of Republicans and southerners believe Barack Obama was born in the United States: 7 in 10 Americans who don't believe Barack Obama was born in the U.S. live in the south, which has 30% of the U.S. population. Nearly 6 in 10 are Republicans, who compromise just 22% of the population.

Here's the data in chart form, showing the distribution of people who either said they believed Pres. Obama was born outside the U.S. or that they were unsure:

Where do the birthers come from?

Talk about a regional rump party. Jebus!

kos: Hard to believe, but birthers are REALLY that strong

Our poll on the birther movement has gotten a ton of attention this morning. Some of it came from the pollsters at PPP, which tweeted this morning:

RT @pwire Just 42% of GOP think Obama is a citizen... (I am a little skeptical of this finding- may ask on next nat. poll)

Three hours later:

Adding a birther question to our Virginia poll for this weekend

And then a short while ago:

I take back my skepticism about R2K poll- only 79 of first 168 respondents to Va. poll think BHO was born in USA! 56 say no and 33 not sure

That's a breakdown of 47 percent who think Obama was born in US versus 33 percent who don't. Our poll found that in the South, the numbers were 47-23. It looks like PPP's Virginia poll will confirm our own results. I also look forward to their national poll, so we can also compare results.

Greg Sargent:

* Dave Weigel further breaks down that birther poll along racial lines, and makes a striking discovery: The number of southern whites who doubt Barack Obama’s U.S. citizenship might top 70 percent.

* The birther myth is far more widespread among Republicans than the Muslim one, which is a bit surprising, since you’d expect that those who believe Obama faked his citizenship would also believe he faked his religion.

JedL (DK): Eric Cantor: Birtherism is a secret liberal plot

Greg Sargent:

GOP Rep. Eric Cantor says he’s no birther — he has no questions about Obama’s citizenship, his spokesman tells me. But Cantor is placing the blame for the spread of birtherism not on its authors or on those politicians playing along with it, but rather on Chris Matthews, MSNBC, lefty news outlets and bloggers.

So why is Eric Cantor blaming us for birtherism? As Greg points, the answer is simple. He's blaming us because he doesn't have the political courage to blame his own supporters -- most of whom are birthers.

And also too: Eric Cantor should explain how liberals managed to get Fox News, Rush Limbaugh, Sean Hannity, Lou Dobbs, and the rest of the conservative establishment to embrace this loony-tunes conspiracy theory.

True, we're mocking the hell out of his crazy-ass, tin-foil hat wearing, regional rump political party. But honestly, how can you blame us?

BarbinMD (DK): Markos On The Birthers

Following the release today of Daily Kos' Research 2000 poll, Markos hit the airways to talk about the astounding number of Republicans who have joined the delusional birther brigade.

First on The Ed Show with Ed Schultz:

... and then on Countdown, guest-hosted tonight by Richard Wolffe:


How can you tell if a republican is lying? . . .

. . . his lips are moving.
Eric Cantor Rips Chris Matthews, MSNBC, HuffPo, Liberal Bloggers For Inflating Birther Story

GOP Rep. Eric Cantor says he’s no birther — he has no questions about Obama’s citizenship, his spokesman tells me. But Cantor is placing the blame for the spread of birtherism not on its authors or on those politicians playing along with it, but rather on Chris Matthews, MSNBC, lefty news outlets and bloggers.

Asked for Cantor’s views on birtherism, his spokesman, Brad Dayspring, emailed me this:

“Mr. Cantor doesn’t question the President’s citizenship, but he has serious questions about the President’s push for government controlled healthcare, taxes on small business job creators, and a huge energy tax on middle class families. He finds it ironic that those most eager to talk about the President’s citizenship are in fact some of his biggest cheerleaders–whether it’s Chris Matthews or others on MSNBC, the Huffington Post, or camera toting liberal bloggers chasing people through the streets of Washington.”

This is the first time Cantor has publicly declared his disagreement with birtherism. But that aside, this is actually a really interesting response. Cantor would rather pick a base-pleasing fight with those who are trying to knock down birtherism than denounce those who are promoting and playing footsie with the idea that Obama isn’t legitimately our president.

And that’s the number two in the House GOP leadership speaking…

  • Josh finds No Secret Signals in Your Dental Work
    Reading through all the 'birther' emails we're getting, I'm sort of reminded why you just don't want to get into a conversation with LaRouchies, various others cultists or even just the random unkempt middle-aged guy in Central Park screaming about socialism. They've pre-plumbed every rabbit hole.
Think Progress: Right-Wing Harassment Strategy Against Dems Detailed In Memo: ‘Yell,’ ‘Stand Up And Shout Out,’ ‘Rattle Him’

This morning, Politico reported that Democratic members of Congress are increasingly being harassed by “angry, sign-carrying mobs and disruptive behavior” at local town halls. For example, in one incident, right-wing protesters surrounded Rep. Tim Bishop (D-NY) and forced police officers to have to escort him to his car for safety.

This growing phenomenon is often marked by violence and absurdity. Recently, right-wing demonstrators hung Rep. Frank Kratovil (D-MD) in effigy outside of his office. Missing from the reporting of these stories is the fact that much of these protests are coordinated by public relations firms and lobbyists who have a stake in opposing President Obama’s reforms.

The lobbyist-run groups Americans for Prosperity and FreedomWorks, which orchestrated the anti-Obama tea parties earlier this year, are now pursuing an aggressive strategy to create an image of mass public opposition to health care and clean energy reform. A leaked memo from Bob MacGuffie, a volunteer with the FreedomWorks website Tea Party Patriots, details how members should be infiltrating town halls and harassing Democratic members of Congress:

Tea Bagger Memo

– Artificially Inflate Your Numbers: “Spread out in the hall and try to be in the front half. The objective is to put the Rep on the defensive with your questions and follow-up. The Rep should be made to feel that a majority, and if not, a significant portion of at least the audience, opposes the socialist agenda of Washington.”

– Be Disruptive Early And Often: “You need to rock-the-boat early in the Rep’s presentation, Watch for an opportunity to yell out and challenge the Rep’s statements early.”

– Try To “Rattle Him,” Not Have An Intelligent Debate: “The goal is to rattle him, get him off his prepared script and agenda. If he says something outrageous, stand up and shout out and sit right back down. Look for these opportunities before he even takes questions.”

The memo above also resembles the talking points being distributed by FreedomWorks for pushing an anti-health reform assault all summer. Patients United, a front group maintained by Americans for Prosperity, is currently busing people all over the country for more protests against Democratic members. Rep. Pete Sessions (R-TX), chairman of the NRCC, has endorsed the strategy, telling the Politico the days of civil town halls are now “over.”

Meanwhile, AHIP, the trade group and lobbying juggernaut representing the health insurance industry is sending staffers to monitor town halls and other right-wing front groups are stepping up their ad campaign to smear reform efforts. The strategy for defeating reform — recently outlined by an influential lobbyist to the Hill newspaper as “delay” then “kill” — is becoming apparent. By delaying a vote until after the August recess, lobbyists are now seizing upon recess town halls as opportunities to ambush lawmakers and fool them into believing there is wide opposition to reform.

Think Progress: NRCC is luring doctors to oppose reform by pretending to ‘honor’ them.

The Wonk Room has learned that the National Republican Congressional Committee (NRCC) is engaged in a misleading campaign to trick physicians into opposing health care reform. The NRCC has been placing calls and sending “hand-written” faxes to physicians across the country to ostensibly recognize physicians for their “invaluable experience” and ask recipients to call a toll-free number and approve a press release “to honor the achievements of you and other concerned physicians like you.” The missive invites doctors to “represent” their state “as a consultant on Rep. Tom Price’s (R-GA) ‘Physicians’ Council for Responsible Reform,’” but a call to the “Council” suggests that the NRCC’s real goal is to scare physicians and add legitimacy to Republican efforts to stall reform. (Download a copy of the letter HERE.) Listen to the call:

Rather than seeking “critical input” or “guidance” from doctors “who are respected by their peers”, the “Council” warns doctors about the “very real threat of Washington interfering even more with doctor’s efforts to provide the best possible care for their patients” and explains that the physicians on the Council have already agreed to “a free market type thing.”

Josh Marshall's Irony Free Zone

Sen. Vitter (R-LA) attacks Sen. Voinovich (R-OH) for straying from conservative values.

Think Progress: NAACP-Forgery Group, Bonner & Associates, Has A Decades-Long History Of Astroturf Tactics

A DC-based consulting firm has been exposed for forging letters in opposition to the American Clean Energy and Security Act. The letters, replete with letterhead and made-up identities, purported to be from Virginian minority organizations including the NAACP. Rep. Tom Periello (D-VA) received multiple letters pressuring him to vote against clean energy reform. According to Daily Progress, Periello staffers discovered that the letters were actually forged by Bonner & Associates. Going through past correspondence regarding ACES, staffers found at least six forged letters purporting to be from Cruciendo Juntos, a nonprofit hispanic group, and the NAACP.

ThinkProgress has acquired the forged letters. See them here:


Bonner & Associates has a long history of shady tactics and big business corporate associations:

Show Me the Money: Founder Jack Bonner bragged in 1994 that the group has no “idealogical or political bent,” the Washington Post noting that “if you’ve got the money and need some ‘regular people’ to flog your issue, Bonner will find them for you.” [8/23/94]

Defrauding the U.S. Government: In 1986, the firm was caught defrauding the U.S. government in order to retain a contract. Bonner & Associates was fraudulently submitting names from phone books, yearbooks, agency employee books, and other sources. The firm claimed to fire the offending employee: “We fired the people we determined were involved in it…what they did was in direct violation of the written policy of the firm.” [New York Times, 12/18/86]

Fighting the Smoking Ban on Behalf of Philip Morris: Bonner & Associates was hired by Philip Morris during the early 90s to build opposition to the workplace smoking ban. A 1994 National Journal piece reports that the firm “was paid about $1.5 million to solicit 7,000 letters to OSHA from small businesses, criticizing the indoor air proposal.” [National Journal, 12/3/94]

Killing Health Care Reforms on Behalf of PhRMA: After the group was hired by PhRMA to kill Maryland legislation that would have affected prescription drug legislation, they faxed dozens of community leaders with a petition that was meant to appear grassroots, “including grammatical errors and a handwritten cover letter.” A community leader that received one of the faxes said, “I wish they would take off the masks. If the drug industry wants to organize people at the grass roots, they should be honest.” [Baltimore Sun, 3/9/02]

In a statement following their most recent offense against Rep. Periello, the company responded, “We immediately fired the person on our staff responsible for the error.” The Bonner firm’s weak dismissal of their breach as “an error” is a laughable attempt to ignore the nefarious nature of the company’s entire strategic philosophy: Astroturfing (that is, misrepresenting corporate-backed policy as a real grassroots movement).

This incident demonstrates the incredible lengths that the vested interests of health care and energy are willing to go through to undermine reform. With Congress going on recess soon, more of these astroturf tactics will undoubtedly occur as corporate backed anti-reform groups gather in Congressional districts throughout the country to obstruct health care and clean energy reform.

Update Bonner & Associates is placing responsibility of the forgery on a lying "temporary employee":
We take our business very seriously. A temporary employee--lied to us--and contrary to our policies sent these letters. We--no one else--we on our own found this out. We immediately fired the person. We then, called those effected, explained what happened and apologized. In the case of the group in the story--we did it in person and by letter.

This should not have happened--we had a bad employee--but through our internal checks, we found the problem, and on our own initiative took the step to notify the affected group.
Update Protestors braved the DC rain today to protest outside of the Bonner & Associates offices. Watch it:
Update NAACP issued this statement:
“The NAACP is appalled that an organization like Bonner and Associates would stoop to these depths to deceive Congress. In this case Bonner and Associates are exploiting the African-American Community to achieve their misdirected goal. These tactics illustrate that discriminatory tactics normally used to deceive voters are now being used to deceive the Congress,” stated Hilary O. Shelton, Director of the NAACP’s Washington Bureau and Senior Vice President for Advocacy.

In which Lou Dobbs aligns himself with all the RW crazies . . .

Sudbay (AmBlog): Media Matters has an ad on CNN about Lou Dobbs and his birther obsession. Lou Dobbs doesn't like it.

Dobbs is giving all kinds of free publicity to Media Matters and its ad campaign about his birther obsession, which will be running on CNN. The ads notes "CNN Has a Lou Dobbs Problem." And, CNN does indeed have a Lou Dobbs problem.

Dobbs doesn't like Media Matters:

This must make all of those fine reporters at CNN cringe. I mean, Lou Dobbs is fast becoming the best known reporter on all of CNN -- and for all the wrong reasons. Nice work, Jon Klein. This is what happens when you give air time to a racist.

  • Sargent: Media Matters Running Ads Attacking Lou Dobbs’ Birther Obsession — On CNN!

    Okay, this is an intriguing new frontier in political media criticism. Media Matters, which has been attacking CNN for not reining in Lou Dobbs’ birther obsession, has now purchased air time to run a TV ad attacking “CNN’s Lou Dobbs problem” — during Dobbs’ show!

    A Media Matters spokesman tells me the group has bought a week of ad time on CNN, MSNBC and Fox News in D.C., New York, and Atlanta, beginning Tuesday. The catch: Media Matters has specifically purchased time to air the ad during Dobbs’ show — putting CNN in the position of either running the spot or nixing it and making this a bigger story.

    Here’s the script of the spot:

    TITLE: CNN’s Dobbs Problem –- 30 Sec.

    Chyron: CNN Has a Lou Dobbs Problem

    Voice Over: CNN’s Lou Dobbs has been promoting the false, right-wing conspiracy that President Obama hasn’t produced a valid U.S. birth certificate.

    Clips: A series of short clips of Dobbs saying “birth certificate”

    Voice Over: CNN President Jon Klein said Dobbs’ obsession was “legitimate.”

    Clips: Another series of short clips of Dobbs saying “birth certificate”

    Voice Over: It’s time for “The Most Trusted Name in News” to live up to its slogan. Let CNN know there’s nothing “legitimate” about racially charged paranoia.

    Chyron: Take action at

    CNN, obviously, hasn’t yet been informed of the ad’s content. It seems that Media Matters’ goal is to get CNN’s competitors to pick up on the story as news, to bait CNN into responding, and to foment internal tensions over Dobbs within the network. Media Matters has been closely documenting the Dobbs/birther story, and this is a real escalation. It’ll be interesting to see how CNN and Dobbs react.


    Update: A statement from Media Matters president Eric Burns earlier this afternoon gives more context:

    “Between the reaction from other media figures and the crashing of Dobbs’ ratings, CNN is making a mockery of its claim to being ‘the most trusted name in news.’ CNN can’t continue to condone Dobbs’ birther coverage and expect to be taken seriously. Jon Klein owes viewers — and his network — more.”

Friday, July 31, 2009

Wingnuts: Southern Edition

In my humble opinion, the only writer who could credibly capture today's repuglican party would be Ionescu. It is really quite astonishing.
For most of my life the South has, rightly or wrongly, been perceived as dominating national politics. I'm really glad those days are over.
This trend shows up again and again and again. . .
A new Research 2000 poll conducted for Daily Kos asked respondents a rather straightforward question: "Do you believe that Barack Obama was born in the United States of America or not?" Since the president was born in the U.S., ideally, the results would be around 100%.

They weren't. There was, not surprisingly, a significant partisan gap. Only 4% of Democrats are confused about the president's place of birth. The number is slightly higher among independents, 8% of whom got it wrong. Among Republicans, though, 28% -- more than one in four -- believe President Obama was not born in the United States.

For a crazy, demonstrably false, racist idea, these are discouraging numbers.

But I was especially surprised by the regional breakdowns. In the Northeast, West, and Midwest, the overwhelming majorities realize the president is a native-born American. But notice the South -- only 47% got it right and 30% are unsure.

Outside the South, this madness is gaining very little traction, and remains a fringe conspiracy theory. Within the South, it's practically mainstream.


It's possible that CNN's executives see an upside to the uproar surrounding Lou Dobbs' Birther antics of late. The bad news, as far as the network is concerned, is that one of its leading on-air personalities has become an outrageous and insulting laughing stock, dragging down the CNN brand and name. The good news, perhaps for some of the network brass, is that everyone seems to be talking about one of their leading on-air personalities.

If Dobbs' madness helps bring more viewers to CNN to see what the provocative nut might say next, that might be a tradeoff the network is willing to make -- less integrity and credibility, but more eyeballs for advertisers.

As it turns out, CNN is failing on both counts. Dobbs is not only humiliating himself, according to a report in the New York Observer, he's also driving viewers away.

According to The Observer's analysis of Nielsen data, in recent weeks, as criticism of Mr. Dobbs has continued to go up, his ratings at CNN have continued to go down.

Mr. Dobbs' first began reporting on Obama birth certificate conspiracy theories on the night of Wednesday, July 15. In the roughly two weeks since then, from July 15 through July 28, Mr. Dobbs' 7 p.m. show on CNN has averaged 653,000 total viewers and 157,000 in the 25-54 demo.

By contrast, during the first two weeks of the month (July 1 to July 14) Mr. Dobbs averaged 771,000 total viewers and 218,000 in the 25-54 demo. In other words, Mr. Dobbs' audience has decreased 15 percent in total viewers and 27 percent in the demo since the start of the controversy.... [I]f Mr. Dobbs' affinity for "birthers" is a ratings ploy, it's a pretty ineffective one.

CNN President Jon Klein has been willing to let Dobbs say anything he wants on the air, no matter how wrong, racist, or ridiculous the comments may be. Perhaps the drop in ratings will prompt Klein to reconsider?

Think Progress: Lobbyist Dick Armey’s Pollution Gospel: ‘As An Article Of Faith,’ It Is ‘Pretentious’ To Believe In Global Warming
Former House Majority Leader Dick Armey (R-TX) appeared as a witness for the Republican bicameral hearing on climate change legislation yesterday on Capitol Hill. Along with a cadre of polluter CEOs and Chamber of Commerce officials, Armey played his part leveling an array of attacks on any effort to transition to a clean energy economy.

As the hearing progressed, most of the witnesses spent their time recycling months-old debunked studies. But Armey distinguished himself by invoking a religious argument to back up his smears against what he called “environmental hypochondriacs” filled with “eco-evangelical hysteria.” Armey claimed that in his world view, because God created the heavens and the Earth, it would be “quite pretentious” for people to believe God would permit global warming to even occur:

DICK ARMEY: What I’m suggesting is we have a sort of an eco-evangelical hysteria going on and it leads me to almost wonder if we are becoming a nation of environmental hypochondriacs that are willing to use the power of the state to impose enormous restrictions on the rights and the comforts of, and incomes of individuals who serve essentially a paranoia, a phobia, that has very little fact evidence in fact. Now these are observations that are popular to make because right now its almost taken as an article of faith that this crisis is real. Let me say I take it as an article of faith if the lord God almighty made the heavens and the Earth, and he made them to his satisfaction and it is quite pretentious of we little weaklings here on earth to think that, that we are going to destroy God’s creation. [...]

SEN. ORRIN HATCH: Mr. Armey it’s great to have you here. Great to see you again and we appreciate all you’ve done throughout the years and your work on Capitol Hill. Great job.

Watch it:

Despite Armey’s claims, global warming is very real and has already caused great damage to creation. Indeed, though Armey would like to create a false dichotomy between people who want to stop global warming and people who believe in God, no such gap exists. A Faith and Public Life poll found 63% of Catholics and 50% of white evangelicals want the federal government to do more to address climate change. Pope Benedict XVI has called for a greater focus on the environment, saying “if you want to promote peace, safeguard creation.”

Armey’s use of faith to demonize clean energy reform should come as no surprise. After promoting a polluter agenda for many years in Congress, Armey became a lobbyist for the firm DLA Piper, which represents many interests with a stake against curbing greenhouse gas emissions:

–- DLA Piper represents Sheikh Mohammed Bin Rashid Al Maktoum, Prime Minister of the UAE, on energy related issues such as maintaining the U.S.-UAE relationship where “U.S companies have played major roles in the development of UAE energy resources, which represent about 10 percent of global oil reserves.” [US Department of Justice, accessed 7/30/09]

– DLA Piper recently signed on Colonial Oil as a new client. [Senate Lobbying Disclosures, accessed 7/30/09]

– DLA Piper represents Irving Oil, lobbying directly on clean energy reform legislation. [Senate Lobbying Disclosures, accessed 7/30/09]

After leaving Congress, Armey became the head of Citizens for a Sound Economy, a right-wing front group funded largely by oil companies like ExxonMobil. CSE later morphed into the astroturf organization known as FreedomWorks, which Armey has used to orchestrate the vicious anti-Obama tea party rallies. And, as ThinkProgress has documented, though FreedomWorks purports to fight on behalf of a purely free market ideology, Armey has used FreedomWorks to whip up “grassroots” support for the clients he represents.

Health Care: Nullification & Beef Jerky Edition

Thers asks:
Suppose, arguendo, the minority Senate GOP somehow engineers nuclear war and mass human extermination. At that point, would it be politically feasible to challenge the sacred principle of the filibuster?

Probably not; let's not get crazy, now. This is after all a serious policy blog and demands to be treated as such.
via Daily Kos' pundit wrapup -

Nate Silver:

Instead of Grassley and Enzi, Baucus should be sitting in a room with Ben Nelson and Mary Landireu -- and maybe Olympia Snowe. Those are the swing votes -- the pressure points -- the people with whom there's actually something to be negotiated. If Grassley wants to come in and snack on beef jerky and spitball a few ideas, then sure -- door's always open. But I don't know what good he's doing the Democrats by being given so leverage over the process.

via DemfromCT's Health Care Friday
  • Oh, noes!!! Obama is proposing a government plan!!! That's socialism!! That's un-American!! That's -um- what 30% of the country has now. Gallup sez:

    Nearly 30% of Insured Have Government Plans, Up From '08
    Percentage with employer-provided care fell from 2008 to 2009

  • Speaking of Gallup, one can argue that Frank Newport is misinterpreting these numbers a bit.

    The wariness with which the public approaches the possible effects of healthcare reform on their personal situations is evident from results showing that more Americans say healthcare would worsen their medical care and reduce their access to healthcare, than say it would have the contrasting, positive effects. These "net negative" results contrast with the net positive perceptions Americans have about the likely impact of healthcare reform on the U.S. more generally -- albeit one that is quite muted.

    My interp is that the "no change" is truly neutral, and it's the "gets worse" number that matters... and that's only 34% - the usual number for the conservative base that hates anything the Democrats propose. If "no change" + "improves" is 55-60%, that's rather good. After all, if it doesn't hurt me and helps you, why not? The key is to track the 34% "worsen" over time.

C&L: Jay Rockefeller explains the fallacy of Conrad's "co-ops" in President Baucus' health care bill: "It's unacceptable"

Hold back the jello. Jay Rockefeller was on this morning with Andrea Mitchell and complained about the Kent Conrad "co-op" plan which he said was basically unworkable. He then went on The Ed show and hit it even harder. Jay is a supporter of the public option and was pissed that the co-op proposal was inserted in the Baucus bill since it was never even talked about during the general election. Isn't it nice that Baucus has killed the public option just to work with Republicans? Conservatives don't even have to win elections to get what they want. That's some deal they have.

Ed: It's not going to work. There's really no successful model out there to support the basis of signing on to a co-op. Would you sign on to a co-op or is that unacceptable?

Rockefeller: That's unacceptable and I can almost prove it. We've been in touch with all the folks that oversee, represent all the co-ops in the country on all subjects and they point out that there are probably less than twenty health co-ops in the country. There are only two that really work that well. One in Puget Sound, one in Minnesota, except for those two, they are all unlicensed. All present health co-ops are all unlicensed, they're unregulated. Nobody knows anything about them, nobody has any control over them and nobody has ever said, which is stunning to me, no government organization or private organization has ever done a study to what effect they might have in terms of bringing down the insurance prices.

They are untested, they are unlicensed, they are unregulated, they are unstudied. Why would we even think about putting them in as a control on this massive insurance industry instead of the public option?

There aren't any co-ops throughout much of the country, but to appease the conservative Dems we're supposed to throw six billion dollars around and hope that the states will try to make them workable. Is this insane? Watch the whole clip, but you get the idea from this one statement. Kent Conrad's big proposal is a complete sham, but President Baucus is trying to cram that down the throats of the country, which will render all health-care reform useless. All hail bipartisanship!

Everyone expected this to be a very busy week for the health care reform campaign(s), and it has been. Whether we're any closer to actual progress is far less clear.

Let's start with the Senate, where a center-right Gang of Six were supposed to finish their negotiations and produce a "bipartisan" bill before the recess. Now, negotiators say, that's not going to happen -- and even if it did, the resulting legislation may be so awful, other Democrats on the Senate Finance Committee may not be able to stomach it anyway.

At the same time, the NYT reports today that the Republican leadership has told its members -- including those in Finance Committee negotiations -- that delaying the process as long as possible is a necessity. Why? Because GOP leaders have apparently decided that they shouldn't "let Democrats head to their home states for the August recess boasting of any progress." Indeed, those same leaders have warned Chuck Grassley that if he helps Dems pass a reform bill, they may punish him by blocking him from becoming the ranking member on the Judiciary Committee next year.

Democrats, in other words, are trying to strike a reform compromise with lawmakers who want neither reform nor compromise. That is, for lack of a better word, insane.

As for the House, the compromise that brought some Blue Dogs on board with reform will apparently help get a bill out of Waxman's House Energy and Commerce Committee, but it's outraged dozens of House liberals, who insist that they can no longer support the legislation now that conservative Democrats have weakened it. At last count, 57 House Progressives say they are prepared to vote against the bill on the floor.

It creates a very difficult dynamic -- keep this week's changes, lose liberal votes, and watch health care reform die just inches from the finish line. Or, get rid of this week's changes, lose the Blue Dogs, and watch health care reform die just inches from the finish line.

Jonathan Cohn says just about all of the relevant players fighting for reform seem, at this point, "more than a little bit concerned."

...Democrats still haven't agreed among themselves on the most challenging issue in reform: how to pay for it. There's no shortage of viable ideas on that front. Senator John Kerry's proposal to tax health benefits by taxing insurers, rather than the insured, offers some hope for a broadly acceptable compromise. But the Democrats aren't there yet.

Will they get there soon? And get there in time? It's the question not just about financing, but about reform as a whole.

Stay tuned.


Opponents of health care reform successfully pushed for a series of delays with the hope that conservatives could kill the effort over the August recess. Supporters of reform are preparing to make sure that doesn't happen. DCCC Chairman Chris Van Hollen (Md.) told Chris Cillizza, "We are not going to allow supporters of the status quo to swift-boat health care reform in August."

The message doesn't seem especially complicated: tie reform opponents to the unpopular insurance industry. Greg Sargent obtained a copy of a script a liberal group will use to target GOP lawmakers over the break:

"The insurance industry makes more than $15 billion a year in profits. Now that money is going to fight health care reform. In Washington, opponents of health care reform are spending more than a million dollars a day, just on lobbying alone. On top of that, the insurance companies give millions to the politicians who support them.

"Congressman Roy Blunt has taken more than half a million dollars from the insurance industry. No wonder he's against reform that will lower costs, give us more choices, and keep the insurance companies honest. Meanwhile we are left paying more than three times what members of Congress pay for good health care. It seems that Roy Blunt is against anything that will hurt the insurance companies' bottom line. Call Roy Blunt and tell him to side with us, not the insurance companies."

Similarly, Brian Beutler reports on a strategy memo distributed to members of the House Democratic caucus, which emphasizes the importance of holding insurance companies accountable. The memo argues:

Remove them from between you and your doctor. No discrimination for pre-existing conditions. No dropping your coverage because you get sick. No more job or life decisions made based on loss of coverage. No need to change doctors or plans. No co-pays for preventive care. No excessive out-of-pocket expenses, deductibles, or co-pays. No yearly or lifetime cost caps on what insurance companies cover.

It's the consumer-focused message embraced by the White House, coupled with the insurance-industry criticism that, I imagine, polls well.

Democrats are reportedly calling their effort "Health Care ER" -- ER for "emergency response" -- that will include radio ads, online activism, and traditional grassroots activities, though it's unclear how much money is behind the recess campaign.

It's obviously intended to, at a minimum, match the right's efforts. With a little luck and effective messaging, reform advocates might even end up in a better position after the recess than before it.

Sudbay: It's been a fundraising frenzy for the Blue Dogs

No wonder Blue Dog Rep. Herseth Sandlin was so ecstatic when the Blue Dogs delayed passage of health insurance reform. The delay bought the Blue Dogs another couple months of obscene fundraising. The Blue Dogs have been sucking up money from the industries impacted by the legislation:

The roiling debate about health-care reform has been a boon to the political fortunes of Ross and 51 other members of the Blue Dog Coalition, who have become key brokers in shaping legislation in the House. Objections from the group resulted in a compromise bill announced this week that includes higher payments for rural providers and softens a public insurance option that industry groups object to. The deal also would allow states to set up nonprofit cooperatives to offer coverage, a Republican-generated idea that insurers favor as an alternative to a public insurance option.

At the same time, the group has set a record pace for fundraising this year through its political action committee, surpassing other congressional leadership PACs in collecting more than $1.1 million through June. More than half the money came from the health-care, insurance and financial services industries, marking a notable surge in donations from those sectors compared with earlier years, according to an analysis by the Center for Public Integrity.

A look at career contribution patterns also shows that typical Blue Dogs receive significantly more money -- about 25 percent -- from the health-care and insurance sectors than other Democrats, putting them closer to Republicans in attracting industry support.
Is anyone surprised? This hasn't been about policy for the Blue Dogs. They've made craven political calculations that are filling up their campaign coffers.

Krugman: Health Care Realities

At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”

It’s a funny story — but it illustrates the extent to which health reform must climb a wall of misinformation. It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.

And that government involvement is the only reason our system works at all.

The key thing you need to know about health care is that it depends crucially on insurance. You don’t know when or whether you’ll need treatment — but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential.

Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend.

And in their efforts to avoid “medical losses,” the industry term for paying medical bills, insurers spend much of the money taken in through premiums not on medical treatment, but on “underwriting” — screening out people likely to make insurance claims. In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care.

Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.

Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.

Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.

And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.

So here’s the bottom line: if you currently have decent health insurance, thank the government. It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays.

Which brings us to the current debate over reform.

Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.

Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That’s not radical; it’s as American as, well, Medicare.
Yglesias: The Fire Department: A Public Option

Tina Dupuy had a nice item in the Huffington Post yesterday noting that urban firefighting in the United States was once a private for-profit industry. Then around the middle of the nineteenth century, cities began to decide that this system was too haphazard, corruption-prone, and unfair and thus began the dread big-government takeover of firefighting:

Yet if we had to have the “conversation” about the firefighting industry today, we’d have socialism-phobic South Carolina Sen. Jim DeMint on the TV every chance he could get saying things like, “Do you want a government bureaucrat between you and the safety of your home?”

Rep. John Boehner of Ohio would hold press conferences and ask, “Do you want your firefighting to be like going to the DMV? Do you want Uncle Sam to come breaking down your door every time some Washington fat cat says there’s a fire?”

It’s a good point. Anyone who’s honest about it is ultimately going to have to admit that direct public-sector provision of services is something that can be done in a quite high-quality way. Obviously, low-quality service is also possible. The fact of the matter regarding the DMV is that even though people find DMV lines important, people also just don’t care about it very much. No lifelong Democrat has ever crossed party lines to vote for a Republican gubernatorial candidates because he’s fed up with the low-quality of the DMV and excited about injecting some new blood into the stodgy motor vehicles bureaucracy.

By contrast, people do care about crime and Rudy Giuliani was able to get elected in super-Democratic New York City. Any mayor with a lick of sense at least attempts to provide a crime control agency that performs well. I think the evidence from the UK is that NHS quality is a constant subject of political debate and politicians are forever attempting to achieve better performance. This, I take it, is the reason why the NHS is so successful at delivering cost-effective treatment outcomes. A very low budget by world standards is why its outcomes don’t look great in absolute terms.

Meanwhile, in the United States it is worth keeping in mind that public provision of health care services isn’t on the table. And we don’t need to guess what public provision of health insurance might look like; Medicare is a very large and not-at-all obscure government program. It’s not perfect, I’m not even sure I’d say it’s great, but it measures up quite well in terms of both cost and quality relative to the private sector.

If Americans are lucky, later this year, health care reform proponents will overcome conservative opposition, institutional obstinacy, procedural morass, and internal Democratic division and pass a landmark piece of legislation.

And if that happens, they'll soon after find that far-right policymakers in some states hope to block reform before it's implemented. Indeed, they're already laying the groundwork. Take Florida, for example, where nearly 4 million people currently have no health care coverage.

Earlier this week, Florida State Senator Carey Baker (R) and State Representative Scott Plakon (R) introduced a state Constitutional amendment that, if adopted, would prevent Floridians from enrolling in any federal health care legislation. [...]

"We believe this unprecedented power-grab by President Obama and Congress is clearly not in the best interests of the citizens of Florida," Baker and Plakon said in a joint statement. Baker, who is a Republican candidate for Commissioner of Agriculture and Consumer Services, participated in the right-wing tea parties on July 4. Both he and Plakon are sponsors of a "sovereignty" memorial, a measure meant to serve "as a notice and a demand to the Federal Government ... to cease and desist, effective immediately, from issuing mandates that are beyond the scope of [their] constitutionally delegated powers."

Their amendment to ban health care would need approval by a three-fifths vote in both the House and Senate. If passed by the legislature, Florida voters would vote on the constitutional amendment on Election Day 2010.

Texas, meanwhile, has one of the nation's highest rates of uninsured residents -- roughly one in four Texans go without coverage. Its Republican governor, Rick Perry, recently said he's "willing and ready" to block reform from taking shape in his state, calling it "encroachment." What's more, Republican lawmakers in Arizona have approved a ballot measure that would, if approved, allow the state to override a federal health care law that includes individual or employer mandates.

The legality of these right-wing efforts is dubious. I imagine far-right policymakers in various states didn't like Social Security or Medicare when they became law, either, but they're still national programs, doing an enormous amount of good.

But it's nevertheless interesting, since a) the fight with conservatives can continue long after reform passes (if it passes); and b) these efforts are a reminder of just how far off the ideological cliff some elements of the GOP have gone.

Yglesias: Health Insurance Industry’s Strategic Bribery

In Scarface Tony Montana expresses his view that “In this country, you gotta make the money first. Then when you get the money, you get the power.” And of course there’s something to that. But as Ryan Powers demonstrates with this chart, it also works to get the power first. Then when you get the power, you get the money:


The business of influence and access peddling in Washington is often thinly veiled in pseudo-respectable claims that industry groups donate to candidates who they believe are predisposed to agree with their public policy priorities. But I think it is more accurate to say that industries donate to individuals who they perceive as predisposed to being bought. Indeed, if the health insurance industry really based its contribution decisions on who they thought would be more likely sympathize with their desire to keep the health care system as it is, they would do well to always direct a majority of their cash to GOP candidates. But they don’t. [...]

This is hardly a novel point on my part. But I think it’s important to keep in mind as we watch individuals who campaigned on and for the Obama agenda work to block or water down that agenda in the House. While I have not looked at the data, I expect there would be similar trends in the Senate.

Right on. This is why the very same members likely to be concerned that expanding coverage to the poor is too expensive also tend to be the same members who oppose saving money through the introduction of a robust public option embedded in a strong health insurance exchange. There are some visions of “health care reform” that are compatible with the interests of insurers, and the job of on-the-take Democrats is to try to steer legislation into that harbor.

Meanwhile on another level this kind of dynamic just embeds large advantages for incumbent candidates. A public financing scheme would be good for the country and good for progressive politics, but not necessarily good for potentially vulnerable left-of-center incumbent elected officials, so it’s hard to get anyone jazzed about the idea.