Saturday, August 15, 2009

Health Care Saturday: Flashing Gums Edition

Scot Lehigh (Boston Globe):
IT’S HARD TO SAY what’s more amusing, the wild-eyed rants at town hall meetings or the conservative attempts to portray those snarling sentiments as genuine mainstream anger about the president’s health care plans.

Some Republicans are gleeful in the hope that the testy town hall encounters will derail Obama’s signature initiative.

Question: Do they really think the country is dopey enough to mistake microwave mobs staging Potemkin Village protests as an accurate expression of true American opinion?

If so, they’re delusional.


But even if you weren’t aware of all that, it would be hard to mistake the hostile town hall encounters for a serious barometer of voter sentiment. Sure, some talk-radio types are insisting they are. Lawmakers know better, however. After all, if these folks really spoke for the country, Democrats wouldn’t control Congress, and Obama would never have been elected.

All we’ve learned here is something we already knew: This nation never has to worry about suffering from a shortage of kooks, cranks, and ideologues.

Just don’t try to tell us they are level-headed, mainstream Americans.

Maddow and Armey will be on Meet the Press this Sunday.
Dick Armey retreats Aug. 14: Rachel Maddow reports on the resignation of Dick Armey from D.C. lobbying firm DLA Piper amid questions about the relationship between the firm and Armey's FreedomWorks group, which has been organizing protests at town halls. Maddow further probes the relationship between PR company Shirley & Banister and conservative activist groups.
Herbert: Hard to Believe!

It was strange to find in this economically stressed, rural region of Vermont, not far from the state capital of Montpelier, a good news story about health care.

Those who live in the area, no matter what their income, can get high-quality primary care, dental care, prescription drug services and mental health assistance at a price they can afford. All they have to do is call or stop by the Health Center at Plainfield, which is part of a national network of centers that are officially (and clumsily) known as Federally Qualified Health Centers.

I was somewhat skeptical when Senator Bernie Sanders, an independent from Vermont, told me that these centers (there are 39 sites of various size in the state) had “essentially solved the problem of primary care” for local residents. Politicians are in the business of making big claims. Most of the time you don’t hold it against them. But you don’t take the claims as gospel, either.

In this case, the senator’s claim seems to be very much on the money. The center at Plainfield is modern and well equipped, spotlessly clean, quiet and efficient. Patients that I spoke with marveled at the friendliness of doctors and staffers and said they never felt intimidated. Appointments are easily made, and if it is necessary to see a physician on the same day, or within 24 hours, that is usually not a problem.

All types of patients are served at the center, from the well off to the impoverished. There is a sliding scale of fees for patients without insurance. They are charged what they can afford. No one is turned away.

“This place is so important,” said Kathleen Hoyne, who was at the center with her 14-year-old son, Daniel. “Neither my husband nor I have health insurance through work.” Daniel, she said, is covered by Vermont’s expanded children’s health insurance program.

There are similar health centers across the country serving primarily low-income patients in areas where medical services are scarce. They are a crucial resource, even in those cases where staffing is difficult or other challenges arise. But there are not enough of them.

What is impressive is how much sense the centers make. They are nonprofit and receive federal support, but they don’t require a ton of taxpayer dollars. By focusing intently on primary care and preventive services, they save tremendous amounts of money.

Given the toxic tone of the current health care debate, it’s interesting to note that the centers actually have significant bipartisan support. (President George W. Bush was a strong advocate.) And the Office of Management and Budget has rated them as among the most efficient and effective users of taxpayer money.

Nearly 10,000 patients are served by the Plainfield center, which is a godsend because there are no other primary care physicians in the vicinity, and very few dentists in private practice will treat poor patients, who usually are covered by Medicaid.

When you look at the number of people who are served by these health centers nationally and then look at the number still in need of the services, you begin to get a sense of the scope of the crisis in health care in the U.S. The centers currently serve about 20 million people and receive approximately $2 billion a year from the federal government. It is estimated that another 40 million people in medically underserved areas, primarily rural areas and inner cities, need the services a health center would provide.

Senator Sanders and Representative James Clyburn, a South Carolina Democrat, are sponsoring legislation (as part of the current push for health care reform) that would quadruple the number of centers across the country over the next five years.

In the areas served by the centers in Vermont, the problem of access to primary care does, in fact, seem to have been solved. The centers not only provide patient care, they offer transportation (often crucial in rural areas), counseling, health education classes and a range of other community services. And still the costs are substantially lower than average for comparable health-related services.

Twenty miles from Plainfield, at the Northern Counties Dental Center at Hardwick, I ran into a stark example of the difference that proper health care (in this case, dental care) can make. Armando Gelineau, a grizzled, toothless old-timer who has spent much of his life coaching boxing, was leaving the center with his granddaughter, a young woman named Morgan Worden.

When Ms. Worden smiled, you couldn’t help but notice that her teeth seemed perfect. “I come here every six months for a checkup and cleaning,” she said. “They’re very friendly.”

Mr. Gelineau laughed, flashing his gums. “They didn’t have that in my day,” he said.
Lying right targets vets Aug. 14: Rachel Maddow talks with Rep. Joe Sestak, D-PA, about the right-wing fear campaign against health care reform turning its sites on U.S. veterans.

ThinkProgress traveled to a town-hall event in Iowa yesterday, getting an up-close look at Sen. Chuck Grassley (R), the ranking member of the Senate Finance Committee and the leading Republican negotiator on health care reform.

One of the senator's constituents noticed that Grassley was carrying a personal copy of Glenn Beck's book, "Common Sense." When the constituent urged the conservative Republican lawmaker to share it with members of Congress, Grassley said:

"Well the reason I brought it is you're supposed to pass it on to other people when you're not reading it."

He later told ThinkProgress that the book, written by Fox News' self-described "rodeo clown," is "something you gotta read a couple times."

Contrast this with what we saw last week, at an event hosted by Rep. Bob Inglis, a very conservative Republican in South Carolina. When the crowd turned ugly, Inglis suggested it'd be a good idea to "turn the TV off" and stop listening to Beck. "Turn that television off when he comes on," the congressman said. "Let me tell you why. You want to know why? He's trading on fear."

Inglis later told a local blogger, "The America that Glenn Beck seems to see is a place where we all should be fearful, thinking that our best days are behind us. It sure does sell soap, but it sure does a disservice to America."

A week later, Chuck Grassley -- an alleged moderate and the man principally responsible for finding a "bipartisan" solution for health care reform -- is promoting Beck's lunacy.

I can only assume that Grassley doesn't want to be part of reform negotiations anymore, and is working on getting himself kicked out of the talks. If he keeps moving further to the right, and Dems eventually decide to cut their losses with this guy, Grassley gets to have it both ways -- he'll tell moderates, "I invested months of time and energy in bipartisan reform negotiations," and he'll tell the right, "I stuck up for conservative principles and Democrats refused to listen."

C&L: There's a reason the Obama-hating crazies are coming out of the woodwork

ABC News had a noteworthy story today on the increasing fears for President Obama's safety because of the plethora of nutcases -- many of them in fact mentally ill -- who are crawling out of the woodwork and threatening Obama and anyone associated with him:

Experts who track hate groups across the U.S. are growing increasingly concerned over violent rhetoric targeted at President Obama, especially as the debate over health care intensifies and a pattern of threats emerges.

The Secret Service is investigating a Maryland man who held a sign reading "Death to Obama" and "Death to Michelle and her two stupid kids" outside a town hall meeting this week. And in New Hampshire, another man stood across the street from a Presidential town hall with his gun on full display.

Los Angeles police officers apprehended a man Thursday after a standoff with him inside a red Volkswagen Bug car in Westwood, CA – the latest disturbing case even though officials said the man had mental problems.

"I don't think these are simply people who are mentally ill or off their rocker," Mark Potok, director of the Intelligence Project at the Southern Poverty Law Center, told ABC News of those behind the threats. "In a very real sense they represent a genuine reaction, a genuine backlash against Obama."

Experts say a sharp growth in so-called militia groups that helped spawn a wave of domestic terrorism in the 1990s – and are now using YouTube, rock music and the Internet to recruit members and spread hate and fear - shouldn't be ignored.

"It's certainly a scary time," said former FBI agent Brad Garrett, now an ABC News consultant. Garrett said the Secret Service "cannot afford to pass on anyone," and he believes "they really do fear that something could happen to [Obama]."

Garrett said statements like one recently made by controversial radio host Rush Limbaugh comparing a logo for the White House plan to a Nazi symbol "legitimizes people who are on the edge to go do something or say something."

Naturally, the right is full-throated whine about people making this very logical connection: Yesterday on his show, Glenn Beck repeated the standard whine that "left is trying to silence me." No; we just want people like Beck to live up to the immense responsibility that comes with having those powerful media megaphones they hold.

Often we hear the excuse that the problem is simply the fact that these people are mentally ill crazies who would be doing something crazy anyway.

This is, of course, a complete cop-out. It ignores, in fact, the cold reality that violence, even by the mentally ill, does not occur in a vacuum. When people become the subject of a relentless campaign of demonization -- especially by the use of grotesque smears that make them out to be monsters and provably false "facts" that have the concrete effect of unhinging people from reality -- it will only be a matter of time before the lethal violence breaks out.

And while the concern for Obama is well-placed -- he is, after all, the focus of all this hatred -- there is only a remote likelihood of anyone actually succeeding in harming him, since he is very well protected indeed. What's far more likely, in fact, is that some innocent bystanders in his vicinity will be harmed -- or, moreover, that the crazies will decide that instead of harming Obama, they will take out their hatred on his supporters.

This was the thinking, after all, of Jim David Adkisson, the Knoxville church shooter. Recall this passage in his manifesto:

This was a symbolic killing. Who I wanted to kill was every Democrat in the Senate & House, the 100 people in Bernard Goldberg's book. I'd like to kill everyone in the mainstream media. But I know those people were inaccessible to me. I couldn't get to the generals & high ranking officers of the Marxist movement so I went after the foot soldiers, the chickenshit liberals that vote in these traitorous people. Someone had to get the ball rolling. I volunteered. I hope others do the same. It's the only way we can rid America of this cancerous pestilence.

The right-wing crazies popping up almost daily, thanks to right-wing fearmongers, are very real cause for concern about Obama's safety. But we should also be concerned about our own.

Friday, August 14, 2009

Our Media: What digby said Edition

digby: Missing The Point, Big Time
As I as read all the blaring headlines about Karl Rove's involvement in the US Attorney cases, I can't help but be reminded of Glenn Greenwald's interview with Chuck Todd, political director for NBC News in which he brought it up as an example of how silly we little purists (those who view the system from 30,000 feet) are for insisting that the rule of law applies to politics just as it applies to the rest of us:
Chuck Todd: Look at the US attorney thing. What did we find out during this whole US attorney scandal? There was no doubt the White House, the previous White House was trying to play politics with US attorney selections. That has been proven. Except what did we also find out - it was perfectly legal. Now, this is a case of where you're mixing the politics and, and look, President Obama now is nominating US attorneys, some of whom are political favors.

GG: Well, what was perfectly legal, to fire prosecutors who either prosecuted Republicans or refused to prosecute Democrats? It turned out it was legal?

CT: Unfortunately, it turned out it was perfectly legal.

GG: Who said that? Who said that?

CT: Because they serve at the pleasure of the president.

GG: There's lawsuits--

CT: They serve at the pleasure of the president.

GG: Chuck. First of all, the question of whether or not crimes were committed in the US attorneys case is still a pending matter before several federal courts.

CT: And I believe it should be investigated--

GG: There are laws in place that say, it is a crime to obstruct prosecutions for political reasons. If Karl Rove is in the White House directing that prosecutors who prosecute Republicans, or who refuse to prosecute Democrats, be fired, that is a crime. That's not--

CT: Wait, now you conflating what I said. What I'm saying is that the aspect that he could just, the White House could just fire US attorneys at will - that was perfectly legal.

GG: But the question is whether the--

CT: The question is whether they fired them at a time when it actually, that is what is being investigated and should be investigated.

GG: And if there are crimes that were committed, they should be prosecuted?

CT: And I think - and this is something see more from the legal community - this issue of US attorneys being political appointees, is probably something that needs to be taken up, because I think it's fraught with peril, and fraught with the potential for abuse.
I think it's pretty clear that he didn't realize that the issue in the scandal wasn't whether the president had the right to fire US Attorneys but whether the White House used the Department of Justice for political purposes. In fact, I think it's clear he really didn't know the difference. To Todd the whole controversy was about cronyism. How can someone in his position misunderstand something so fundamental?

He must be very confused by all the hoopla in the papers. After all, it was all perfectly legal. What's the problem?
digby: And That's The Way It Is

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Someone asked me the other day what I would tell a recent immigrant to read and watch in order to understand American politics. I told them they should probably read the NY Times, various magazines, blogs and online publications, but if they don't have the time or inclination to do all that, the most efficient way to understand American political culture is to watch Stewart and Colbert. An investment of an hour a day (less with DVR) and you probably come out knowing far more than Chuck Todd in just a couple of weeks.

Bigfooting Healthcare

Last night, on the teevee, I saw a 60 second, fact-free ad distorting the health care proposals beyond recognition, designed to scare the beejeesus out of the elderly. I was fuming. Immediately after that ad, I saw an ad from the AARP, telling us that people were out to scare the elderly with lies. Good. Which leads to this morning's QOTD from the New York Times :

But as Congress developed its legislation this summer, critics seized on provisions requiring Medicare financing for “end of life” consultations, bringing the debate to a peak. To David Brock, a former conservative journalist who once impugned the Clintons but now runs a group that monitors and defends against attacks on liberals, the uproar is a reminder of what has changed — the creation of groups like his — and what has not.

“In the 90s, every misrepresentation under the sun was made about the Clinton plan and there was no real capacity to push back,” he said. “Now, there is that capacity.”

Rachel remembers Terry Schiavo and coins the delicious phrase: bigfooting end of life decisions.
Making painful decisions Aug. 13: Rachel Maddow is joined by George Felos, the former attorney for Michael Schiavo, about the difficulty families face in dealing with end-of-life decisions.

The NYTimes commits journalism. No false balance, no buried lede.
JIM RUTENBERG and JACKIE CALMES - False ‘Death Panel’ Rumor Has Some Familiar Roots

WASHINGTON — The stubborn yet false rumor that President Obama’s health care proposals would create government-sponsored “death panels” to decide which patients were worthy of living seemed to arise from nowhere in recent weeks.

Advanced even this week by Republican stalwarts including the party’s last vice-presidential nominee, Sarah Palin, and Charles E. Grassley, the veteran Iowa senator, the nature of the assertion nonetheless seemed reminiscent of the modern-day viral Internet campaigns that dogged Mr. Obama last year, falsely calling him a Muslim and questioning his nationality.

But the rumor — which has come up at Congressional town-hall-style meetings this week in spite of an avalanche of reports laying out why it was false — was not born of anonymous e-mailers, partisan bloggers or stealthy cyberconspiracy theorists.

Rather, it has a far more mainstream provenance, openly emanating months ago from many of the same pundits and conservative media outlets that were central in defeating President Bill Clinton’s health care proposals 16 years ago, including the editorial board of The Washington Times, the American Spectator magazine and Betsy McCaughey, whose 1994 health care critique made her a star of the conservative movement (and ultimately, New York’s lieutenant governor).

There is nothing in any of the legislative proposals that would call for the creation of death panels or any other governmental body that would cut off care for the critically ill as a cost-cutting measure. But over the course of the past few months, early, stated fears from anti-abortion conservatives that Mr. Obama would pursue a pro-abortion, pro-euthanasia agenda, combined with twisted accounts of actual legislative proposals that would provide financing for optional consultations with doctors about hospice care and other “end of life” services, fed the rumor to the point where it overcame the debate.

On Thursday, Mr. Grassley said in a statement that he and others in the small group of senators that was trying to negotiate a health care plan had dropped any “end of life” proposals from consideration.
Rachel commits more journalism - but it is no surprise with her. She always does. This is a terrific segment, that points out the astonishing hypocrisy of the republicans on this issue. .
Even they don't believe what they're saying Aug. 13: Rachel Maddow talks about the prominent Republicans have suddenly sudden reversed their positions on the role of the government in end-of-life matters from what they argued in the case of Teri Schiavo.
Columbia Journalism Review, Ryan Chittum: Investor’s Business Daily Short-Arms Correction

Investor’s Business Daily corrected an embarrassing boo-boo in an editorial and in the process made another huge error.

In an editorial ginning up fear over Obama’s health-care plan and comparing it to the dread National Health Service in the UK, IBD wrote that the famed physicist Stephen Hawking would have been toast had he lived in the UK because, IBD said, ridiculously, the country’s eugenics-like health policies deem handicapped people worthless.

Of course, Hawking is British and has lived there his whole life. He’s a professor at Cambridge for crying out loud.

Jay Bookman of the Atlanta Journal-Constitution caught the whopper and it was picked up by other outlets, including Talking Points Memo.

Here’s the original line, which is now stricken from the editorial:

People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

This is sick, dishonest stuff, so it’s sweet that Hawking himself calls it out, telling a TPM blogger “I wouldn’t be alive today if it weren’t for the NHS. I have received a large amount of high quality treatment without which I would not have survived.”

But IBD’s correction creates another problem. Here is its entire text:

Editor’s Note: This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.

It has removed the Hawking reference from the story (even, apparently, in Factiva, which doesn’t have it either), but short-arms the correction, which should have read something like: “This version corrects the original editorial which falsely implied that physicist Stephen Hawking would be dead as a doornail if he lived in the UK and had to use the National Health. Hawking has lived in the UK his entire life, and as of press time, is still alive.

In my dream world they’d also tack on an “Also, this basically kills the premise of our entire editorial, which never should have been written. We resign in disgrace.”

Alas, that’s not going to happen. But IBD ought to go ahead and correct the false information contained in its quote of the notorious Betsy McCaughey, who says the House’s bill “compels seniors to submit to a counseling session every five years,” which is an easy-to-figure-out fact error, as The Atlantic’s Conor Clarke makes plain. I’m sure there are a few other fact errors in there. Send me an email or post a comment if you see one.

I don’t have much of an opinion on Obama’s health-care plan. I do think we ought to have the debate on the facts and not on fallacious and dangerous talking points about “death panels” and the like.

And if you correct a serious mistake, you have to be clear about what you’re really correcting, no matter how embarrassing or how much it kills your argument.

This may look like more of the same. It is not. And Rachel remains amazed that most of the media is failing to cover the truth behind the shouting.

Political outrage for hire Aug. 13: Sen. Bernie Sanders, I-VT, joins Rachel Maddow to talk about an anti-health care reform Web site that is actually run by a high profile Republican P.R. firm.
Krugman: Republican Death Trip

“I am in this race because I don’t want to see us spend the next year re-fighting the Washington battles of the 1990s. I don’t want to pit Blue America against Red America; I want to lead a United States of America.” So declared Barack Obama in November 2007, making the case that Democrats should nominate him, rather than one of his rivals, because he could free the nation from the bitter partisanship of the past.

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

So, how’s it going?

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

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

Right now, the charge that’s gaining the most traction is the claim that health care reform will create “death panels” (in Sarah Palin’s words) that will shuffle the elderly and others off to an early grave. It’s a complete fabrication, of course. The provision requiring that Medicare pay for voluntary end-of-life counseling was introduced by Senator Johnny Isakson, Republican — yes, Republican — of Georgia, who says that it’s “nuts” to claim that it has anything to do with euthanasia.

And not long ago, some of the most enthusiastic peddlers of the euthanasia smear, including Newt Gingrich, the former speaker of the House, and Mrs. Palin herself, were all for “advance directives” for medical care in the event that you are incapacitated or comatose. That’s exactly what was being proposed — and has now, in the face of all the hysteria, been dropped from the bill.

Yet the smear continues to spread. And as the example of Mr. Gingrich shows, it’s not a fringe phenomenon: Senior G.O.P. figures, including so-called moderates, have endorsed the lie.

Senator Chuck Grassley, Republican of Iowa, is one of these supposed moderates. I’m not sure where his centrist reputation comes from — he did, after all, compare critics of the Bush tax cuts to Hitler. But in any case, his role in the health care debate has been flat-out despicable.

Last week, Mr. Grassley claimed that his colleague Ted Kennedy’s brain tumor wouldn’t have been treated properly in other countries because they prefer to “spend money on people who can contribute more to the economy.” This week, he told an audience that “you have every right to fear,” that we “should not have a government-run plan to decide when to pull the plug on grandma.”

Again, that’s what a supposedly centrist Republican, a member of the Gang of Six trying to devise a bipartisan health plan, sounds like.

So much, then, for Mr. Obama’s dream of moving beyond divisive politics. The truth is that the factors that made politics so ugly in the Clinton years — the paranoia of a significant minority of Americans and the cynical willingness of leading Republicans to cater to that paranoia — are as strong as ever. In fact, the situation may be even worse than it was in the 1990s because the collapse of the Bush administration has left the G.O.P. with no real leaders other than Rush Limbaugh.

The question now is how Mr. Obama will deal with the death of his postpartisan dream.

So far, at least, the Obama administration’s response to the outpouring of hate on the right has had a deer-in-the-headlights quality. It’s as if officials still can’t wrap their minds around the fact that things like this can happen to people who aren’t named Clinton, as if they keep expecting the nonsense to just go away.

What, then, should Mr. Obama do? It would certainly help if he gave clearer and more concise explanations of his health care plan. To be fair, he’s gotten much better at that over the past couple of weeks.

What’s still missing, however, is a sense of passion and outrage — passion for the goal of ensuring that every American gets the health care he or she needs, outrage at the lies and fear-mongering that are being used to block that goal.

So can Mr. Obama, who can be so eloquent when delivering a message of uplift, rise to the challenge of unreasoning, unappeasable opposition? Only time will tell.

Thursday, August 13, 2009

Health Care Follies

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

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

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

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

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

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

Yglesias: The Limited Powers of the Presidency

I think Ezra Klein nails this:

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

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

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

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

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

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

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

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

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

  • from the comments:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Watch it:


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Opponents of reform outnumber supporters on Fox News

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

Health Care: Chapter and Verse

About a month ago, Bill Moyers sat down with Wendell Potter, a former executive at a major health insurance company, who's become a whistleblower, explaining the way the industry "put profits before patients" and is doing everything possible to block health care reform now.

Asked what prompted his change of heart, Potter said he visited a health care expedition in Wise, Virginia, in July 2007. "I just assumed that it would be, you know, like booths set up and people just getting their blood pressure checked and things like that," he said. "But what I saw were doctors who were set up to provide care in animal stalls. Or they'd erected tents, to care for people.... I've got some pictures of people being treated on gurneys, on rain-soaked pavement. And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care."

Potter added that families were there from "all over the region" because people had heard, "from word of mouth," about the possibility of being able to see a doctor without insurance. He asked himself, "What country am I in? It just didn't seem to be a possibility that I was in the United States."

What's worth remembering is that this exact same scene keeps playing out, across the country. Reader R.B. sent me this item earlier:

The free medical clinic at the Forum in Inglewood [near Los Angeles] reached capacity again Wednesday, as hundreds camped out overnight to receive medical and dental care. [...]

More than 2,000 sought services on the first day of the medical clinic -- and hundreds were turned away. People were lined up Tuesday night, hoping to get in. The MTA announced it was extending service of Line 115 because of "overwhelming demand" for rides to the clinic, which runs for eight days. [...]

Doctors, nurses and other medical workers who donated their time said most visitors' ailments were basic. But "many have chronic diseases -- high blood pressure, diabetes, asthma -- conditions we can't deal with in just one day," said Dr. Nancy Greep of Santa Monica. Some had problems, such as a recurring cancer, that demand long-term treatment.

"What country am I in? It just didn't seem to be a possibility that I was in the United States."

Remember, in some conservative circles, there's still a belief that health care reform isn't necessary. Last month, one right-wing member of Congress even boasted, "There are no Americans who don't have healthcare. Everybody in this country has access to healthcare."

Here's a thought: head down to Inglewood and let folks know about this. While you're there, let them know that health care reform might lead to "rationing" and "long wait times."

DougJ: Stopped clock

Where is the real David Broder and what have you done with him?

As I later wrote, the Johnsons “were engulfed by the crowd, and for more than half an hour, were reviled and jostled as they slowly made their way across the lobby. Johnson refused offers of police assistance, telling an aide that ‘if the time has come that I can’t walk with my lady across the lobby of the Adolphus Hotel, then I want to know it.’ “

The backlash was instant and powerful. As conservative columnists Rowland Evans and Robert Novak later wrote in their book about Johnson, the scene in the Adolphus “outraged thousands of Texans and Southerners. Sen. Richard Russell of Georgia, who had not campaigned for his party’s national ticket since 1944, telephoned Johnson that evening to offer his services.” The Johnson biographers concluded that while no one could prove the case, it is “a credible hypothesis” that the Adolphus incident swung Texas and perhaps other closely contested Southern states to the Democrats.


Much improvement is needed in the health-care bills, but I think these angry opponents are playing with fire.

The health care fight turns hazardous Aug. 12: At least four Democratic congressmen have received death threats since health care town hall meetings started. Why is this hurtful speech still going on? Rachel Maddow is joined by Dr. Warren Hern, director of the Boulder Abortion Clinic in Colorado.

SGW: Better To Be Silent And Thought A Fool

Somebody should have finished that saying for teabagger Katy Abram. She brings new meaning to the phrase "no nothing". Lawrence O'Donnell was great drawing out all over her stupid for all the world to see.

She said she "saw on TV" that President Obama said we would go to a single payer system in 5 years. Anybody wanna take a bet that it was FoxNews?

Anybody? Bueller?
Think Progress: Grassley Scaremongers About Government Pulling ‘The Plug On Grandma’

Yesterday, President Obama told a New Hampshire audience that Sen. Chuck Grassley (R-IA) is “sincerely trying to figure out…a health care bill that works.”

But as The Iowa Independent reports today, during a health care meeting with constituents Grassley spouted the latest conservative conspiracy theory about health care reform — that it will put seniors to death:

Americans should be scared of provisions in a health care bill currently in the U.S. House because it will allow the government to have a say in end-of-life decisions, Republican U.S. Sen. Chuck Grassley told a crowd of more than 300 Wednesday morning.

“In the House bill, there is counseling for end of life,” Grassley said. “You have every right to fear. You shouldn’t have counseling at the end of life, you should have done that 20 years before. Should not have a government run plan to decide when to pull the plug on grandma.”

ThinkProgress recorded Grassley’s comments on the ground. Watch it:

In endorsing this latest right-wing conspiracy theory, Grassley seperates himself from other GOP senators. Yesterday Sen. Lisa Murkowski (R-AK) told an Anchorage crowd that she was “offended” that fellow conservative Sarah Palin wrote that health care legislation will force citizens to stand before “death panels.” And Sen. Johnny Isakson (R-GA), who has authored legislation calling for government coverage of voluntary end-of-life counseling, called the conspiracy theory “nuts.”

This isn’t the first time Grassley has scare mongered about health care. Last week he told an Iowan radio host that government-run health insurance programs would force people like Sen. Ted Kennedy (D-MA), who was recently treated for a brain tumor, to die rather than treating them.

Despite all this, Senate Finance Committee Chair Sen. Max Baucus (D-MT) has continued to insist that he “couldn’t ask for a better partner” for “meaningful health care reform” than Grassley.

(HT: Washington Independent)

Update Huffington Post's Sam Stein notes that White House Press Secretary Robert Gibbs hit back at Palin today for her death panel remark, saying that the former governor had given out "information that I think many of you all pointed out was wrong."
Update Politico's Lisa Lerer reports that "Grassley flagrently refused to denounce rumors for a second time on Wednesday that the House health care bill would allow government to make end of life decisions." "With all the other fears people have and what they do in England then you get the idea that somebody is going to decide grandma lived too long," said Grassley. "You understand why you get it."


Ladies and gentlemen, I present you with the leading Republican lawmaker negotiating a "compromise" on health care reform.

One of the three Republican senators working on a bipartisan health care bill perpetuated a particularly outrageous untruth about the legislation on Wednesday.

Appearing at a town hall in his home state of Iowa, Sen. Chuck Grassley told a crowd of more than 300 that they were correct to fear that the government would "pull the plug on grandma."

"There is some fear because in the House bill, there is counseling for end-of-life," Grassley said. "And from that standpoint, you have every right to fear. You shouldn't have counseling at the end of life. You ought to have counseling 20 years before you're going to die. You ought to plan these things out. And I don't have any problem with things like living wills. But they ought to be done within the family. We should not have a government program that determines if you're going to pull the plug on grandma."

Just yesterday, President Obama described Chuck Grassley as one of his "Republican friends on Capitol Hill" who is "sincerely trying to figure out if they can find a health care bill that works." Senate Finance Committee Chairman Sen. Max Baucus (D-Mont.) recently said of Grassley that he "couldn't ask for a better partner" in working towards reform.

Obama and Baucus are wrong; and negotiating with Grassley in good faith is a mistake.

Grassley isn't serious about reform. Not at all. Seriously. He's proven this again and again. It's time to stop trying. Grassley will only let down reform advocates in the end.

Update: Joe Klein on Grassley's comments: "[H]e either (a) hasn't the vaguest notion of what's in the bill or (b) he is so intimidated by the ditto-head-brown-shirts that he is trying to fudge a response to keep them happy. Either way, he should be ashamed. And once has to wonder about the fate of the Senate Finance Committee deliberations if this is what the Administration is dealing with."

Think Progress: Steele: It was ‘proper’ for Sarah Palin to fearmonger about ‘death panels.’

On Fox News today, RNC Chairman Michael Steele became the latest right-wing figure to endorse former Alaska governor Sarah Palin’s ludicrously false claim that health care reform will contain “death panels.” “I think that’s perfectly appropriate,” said Steele:

CAVUTO: Now obviously in this environment a lot of vitriol comes forth. Michael, I just wanted to get your reaction to some of your co-party members, former Alaska governor Palin, who calls these panels that are essentially going to be dispensing care or deciding it, death panels. That sort of thing — is that proper? Is that right?

STEELE: Well, I think it’s, I think it’s proper because its within the context of what people are seeing in some of the legislation that’s floating around out there. When you’re talking about panels that are going to be imposed, that will be making life and death decisions, that will be making decisions about whether or not you get health care or don’t receive health care. I think that’s perfectly appropriate.

Watch it:

Steele also repeated his false claim that state Republican Parties are not actively encouraging town hall mobs. “Anyone out there who says that the Republican Party or state parties or Republican activists are out there” disrupting town halls “are flat-out lying. They’re wrong.”

Our Media: No Detail, Please

A few weeks ago, MSNBC's First Read had an item questioning whether President Obama "knows too much" about health care policy. The piece complained that the president is willing to offer Americans details about reform, which means going "into the weeds."

The Wall Street Journal's Jonathan Weisman raised a similar concern today, arguing that Obama cares too much about policy details.

"President Obama, not only does he want to hear about the unemployment rates -- he wants to hear about the U6, the underemployment rate! A few weeks ago, they were talking about child obesity rates, and what to do about childhood nutrition. These things go into the weeds."

This, apparently, is criticism, not praise. The president who inherited a devastating economic crisis is interested in U6 numbers -- a measure that includes the unemployed, those who are working part-time but want full-time employment, and those who've simply given up -- and this, we're told, is somehow evidence of excessive interest in detail.

It's an odd complaint. When the president goes beyond poll-tested soundbites, he's going "into the weeds." When the president wants a more reliable measurement of the employment landscape, he's gone "into the weeds." When the president can speak about childhood nutrition, he's gone "into the weeds."

Dan Froomkin has this just right.

There are all sorts of legitimate reasons to be concerned about Obama's approach to governing.

But particularly after the presidency of George W. Bush, who so often seemed detached both from details and reality, Obama's intellectual curiosity is one thing journalists in particular should celebrate, not sneer at. It's the know-nothings we should be exposing, not the know-somethings.

I can't help but wonder if there's some kind of resentment, for lack of a better word, among reporters who are annoyed by Obama's attention to detail. Perhaps they'd prefer a more superficial president because they have a more superficial perspective?

Yglesias: What Caused the Budget Deficit?

David Leonhardt has a nice article breaking down the sources of the growth in the budget deficit. Since Leonhardt works for The New York Times rather than USA Today, they didn’t see fit to illustrate his article with a pie chart, but I made one myself:


— “The first category — the business cycle — accounts for 37 percent of the $2 trillion swing.”

— Second, Bush-era legislation “like his tax cuts and the Medicare prescription drug benefit, [that] not only continue to cost the government but have also increased interest payments on the national debt.”

— Third, “Obama’s main contribution to the deficit is his extension of several Bush policies, like the Iraq war and tax cuts for households making less than $250,000 [...] 20 percent of the swing.”

— Fourth, “About 7 percent comes from the stimulus bill that Mr. Obama signed in February.”

— Fifth, “only 3 percent comes from Mr. Obama’s agenda on health care, education, energy and other areas.”

In other words, the very high deficits are not Obama’s fault according to any normal way of assessing political blame. That said, large deficits aren’t a moral failing that we need to hold someone accountable for. Rather, they’re a potential future practical problem that will have to be solved. Doing that will probably require a mixture of higher taxes, somewhat more hard-core health care reform that is likely to pass in 2009, and reductions in defense and possibly Social Security outlays. I don’t really find it especially surprising or alarming that nobody wants to vote for any of those things in 2009. After all, nobody who has to stand for election really wants to do any of that stuff. And the deficit isn’t a problem in 2009 and almost certainly won’t be in 2010. The main issue is whether Congress will be prepared to take tough measures when and if doing so actually proves necessary. Meanwhile, the health reforms being debated in congress will get us some of the way to where we need to be, and also hopefully lay the groundwork for further measures if the best hopes about what’s currently on the table don’t wind up materializing. The simple fact of the matter, after all, is that nobody really knows what the impact of something like comparative effectiveness research will be. It could save a lot of money, or it might not—we might just get healthier while spending a similar amount of money. But if we get it in place sooner rather than later, we’ll know and be in a position to act.


Perfect. Simply perfect.

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