Thursday, April 22, 2010

The feathers are flying ...

I really didn't intend to do three posts about this today, but Republican Senate candidate Sue Lowden keeps pressing her cluck, I mean, luck.

To briefly review, Lowden, the favorite to beat Senate Majority Leader Harry Reid (D) in Nevada this year, recently encouraged voters to "barter with your doctor." On Monday, Lowden reiterated and expanded upon this, praising a health care delivery system in line with "the olden days" when those seeking medical care "would bring a chicken to the doctor." Despite the mockery this had already received, she added, "I'm not backing down from that system."

This afternoon, the Republican candidate's spokesperson told Greg Sargent that the campaign is sticking by Lowden's argument.

"Americans are struggling to pay for their health care, and in order to afford coverage we must explore all options available to drive costs down. Bartering with your doctor is not a new concept. There have been numerous reports as to how negotiating with your doctor is an option and doctors have gone on the record verifying this."

The campaign's statement went on to blame Harry Reid because, well, just because.

There are a couple of angles to consider here. First, when Lowden's spokesperson says bartering "is not a new concept," that's true. But as Atrios explained, "All joking aside, there's a reason we no longer have a barter economy. It's tremendously inefficient."

Second, the Lowden campaign went on to distribute some kind of background document, hoping to prove that bargaining with medical professionals is possible. But as we've talked about, haggling with doctors is hardly the basis for effective care and cost controls, and for that matter, bargaining and bartering aren't the same thing.

In a purely political context, campaigns are rarely lost in April, but Lowden's position has quickly made her something of a joke -- and once a candidate is a laughingstock, it's very difficult to recover. One Nevadan has characterized this as a "macaca moment" for the Republican hopeful, and that under the circumstances, that seems more than fair.

Sue Lowden could have walked this embarrassing incident back many times, but she's now tripled down on a position that simply doesn't make any sense.

Lowden has had a year to come up with a coherent approach to health care policy, and she's failed rather spectacularly. We saw our first hint about this last month, when Lowden praised Medicare and condemned "government run health care" at the same time, and we're getting an even better sense of her confusion now.

Sometimes, candidates just aren't ready for prime time.

Kleefeld (TPM): Dems Fricassee Lowden For Chicken-Bartering Health Care Plan

The feathers are flying in the political attacks over Nevada Republican Senate candidate Sue Lowden's declarations that people could control health care costs through the use of barter.

On Monday, Lowden doubled down on the barter idea. "Let's change the system and talk about what the possibilities are. I'm telling you that this works," Lowden said. "You know, before we all started having health care, in the olden days, our grandparents, they would bring a chicken to the doctor. They would say I'll paint your house."

The Democratic Senatorial Campaign Committee rolled out its new satirical website, "Chickens For Checkups," in which readers can send a form letter to Lowden asking how they can find a doctor who would treat various olden-days ailments such as rickets, "ill humours," "the vapors" and others, in exchange for various types of livestock or even "indentured servitude." (Hat tip to Greg Sargent.)

We asked the Lowden campaign for further comment on what sort of policies Lowden might advance in order to facilitate the further use of barter -- that is, how could we incorporate these practices into an economic system in which doctors work for hospitals, which in turn are corporations that interact with insurance companies and process large amounts of money back and forth? And how would the tax implications be handled, with current law requiring that barter transactions be reported to the IRS and taxed at their market cash value?

The Lowden camp referred us back to their statement from earlier today, which declared in part: "Bartering with your doctor is not a new concept. There have been numerous reports as to how negotiating with your doctor is an option and doctors have gone on the record verifying this. Unfortunately, Harry Reid's failed leadership forces us to take drastic measures."

They also referred us to Lowden's issues page on "Health Care Solutions," which details her more general proposals on health care, and does not mention the barter system.

Marshall: ChickenCare Goes Viral

Perhaps inevitably, a progressive group has now created a special ChickenCare dance remix of senate candidate Sue Lowden's proposal to bring down health care costs by adopting a barter economy in medical care.

A bit more seriously though, this does put the Nevada senate race into a certain clarifying perspective. The Health Care Reform bill wasn't Harry Reid's bill -- ideas and strategy from lots of people went into it. And many people had endless criticisms of how he managed the process over the course of 2009 and 2010. At the end of the day, though, it passed. The Senate is where it happened. And Reid was central to the entire thing. That is an historic accomplishment. If his career in politics ends in January, his place in history will be secure.

So on the one side you have Harry Reid, a key architect of comprehensive Health Care Reform, the product of decades of activism, in all its messiness and policy complexity.

And on the other you have Sue Lowden, who thinks bartering livestock and other commodities for health care services from doctors is a way to rein in spiraling health care costs. (If you think that's an exaggeration, take a minute and watch this video.) There's no end of comedic possibilities thinking through the logistical and logical difficulties of managing co-pays and long-term care and drug costs in chickens and other barter payment. But step back and give it a serious look and ... well, this is this woman's take on confronting medical inflation. It's funny and also sad. But as a contrast it's stark and painful.

Seriously, think about it for a minute.

The Rachel Treatment.

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