31 August 2007

Colorado's Perlmutter quotes old polical boss

By Donna Smith

DENVER -- Ed Perlmutter, the U.S. Representative for House District 7 in Colorado, spoke to a group of constituents in Lakewood, Colo., on Wednesday and quoted an old political powerhouse when I asked him about health care lobbyist money as an influence on the health care reform debate.

The quote, in its cleaned-up form, turns out to be well-known:

"If you can't take their money, drink their liquor, screw their women, and then come in here the next day and vote against them, you don't belong here." -- Jesse Unruh, Speaker, California State Assembly, 1961-1969.

Known as “Big Daddy Unruh,” he also was credited with saying that money is the mother’s milk of politics. He was a powerful force on the national political scene and his political life served as a case study on “machine politics.”

It was interesting to have Unruh’s name come up in today’s session.

During the questions and answer period of Perlmutter’s meeting, I asked the freshman Congressman about making meaningful changes in health policy law and about bringing debate on health care reform to Congress. He pointed out that Rep. Diana DeGette of Colorado’s 1st Congressional District is in a powerful position a vice chair on the Energy and Commerce Committee, where health care is a major focus.

I countered that I appreciated DeGette’s potential power, but that I had concerns about the fact that her second highest contributing group in terms of her campaign financing is from health care related lobbyists. I suggested that while that doesn’t unequivocally mean that her loyalty is to those lobbyists that it does and should raise a red flag for voters like me who are concerned about health care reform.

When Perlmutter came to her defense with the Unruh quote, I was a bit taken aback. He went on to explain that because he represents a diverse district with Republicans, Democrats and Independents, he receives campaign contributions from a wide variety of individuals and interests, but that does not mean he panders to individual contributing interests. “I have faith in Diana,” he added.
Audience members added their questions about why the U.S. is the only industrialized nation without universal health care.

Another woman echoed my concerns about why those approved for Social Security Disability must then wait two years for Medicare health benefits. That seems inherently unfair when a person has been determined to be too disabled to work but then languishes without insurance or burdens other insurance plans or is unable to secure coverage at any price in today’s health insurance environment.

I told Perlmutter that Rep. John Conyers of Michigan, chair of the House Judiciary Committee, told me he would look into that too and would work to change that. The lag time between my husband Larry’s approval for Social Security Disability and his eligibility for Medicare coverage was one of the financially devastating factors that led to our bankruptcy as he fought his artery disease and I fought cancer.

All-in-all, Perlmutter said he is anxious to read all the health care reform proposals selected by Colorado’s 208 Commission and learn about the provisions of each proposal before settling on his preferred position. He pointed out that health care issues drive nearly 20 percent of the national economy and it is a complicated problem. He did not offer much support for universal health care. He didn’t speak against it.

I thanked him for his attentiveness, gave his staffer a copy of my July 17, 2007, testimony before the House Judiciary sub-committee, and told him I looked forward to meeting with him in Washington, D.C., as scheduled for Sept. 26, before the vigil on the Lincoln Memorial steps on Sept. 28 at sundown.

Bravo to Larry Smith

Donna Smith yesterday posted an entry on Michael Moore's blogsite about her husband Larry's rather brilliant idea about unionizing patients. It's pretty simple. Don't patronize doctors who aren't for single-payer, universal health care. Larry's a union man, and it shows in his thinking here. (By the way, if you've never heard Natalie Merchant sing this classic, you'll be richer for finding a way to hear it.)

Florence Reece/ Stormking Music, Inc.(BMI)

Come all you good workers
good news to you I’ll tell
of how the good old union
has come in here to dwell

Which side are you on boys?
Which side are you on?

My daddy was a miner
he’s now in the air and sun
he’ll be with you fellow workers
until the battle’s won

Which side are you on boys?
Which side are you on?

They say in Harlan County
there are no neutrals there
you’ll either be a union man
or a thug for J. H. Claire

Which side are you on boys?
Which side are you on?

Oh workers can you stand it?
oh tell me how you can
will you be a lousy scab
or will you be a man?

Which side are you on boys?
Which side are you on?

Don’t scab for the bosses
don’t listen to their lies
poor folks ain’t got a chance
unless they organize

Which side are you on boys?
Which side are you on?

Cancer Society focuses ads on uninsured

The New York Times reports today that the Cancer Society's $15 million ad budget for the coming year will focus on the uninsured. The article notes, "The campaign was born of the group’s frustration that cancer rates are not dropping as rapidly as hoped, and of recent research linking a lack of insurance to delays in detecting malignancies."

Other disease-fighting charities have applauded the move.

Before we get too misty-eyed about what a good sign this is, let's point out that the Cancer Society's theme is the "consequences of inadequate health coverage." That promotes buying more health insurance, putting more money into bonus checks to Aetna executives at the expense of struggling families. j

Then again, before we get to cynical, the Cancer Society risks its funding with these ads from foundations associated with the obscenely profitable medical-industrial industry. That money is crucial to the existence of the society. They have to walk a fine line here.

Celinda Lake's research shows that fear entrenches the status quo. Hopefully these ads will inspire anger and not fear. Which will it be?
One features images of uninsured cancer patients, appearing hollow and fearful. “This is what a health care crisis looks like to the American Cancer Society,” the narrator begins. “We’re making progress, but it’s not enough if people don’t have access to the care that could save their lives.”

The other commercial depicts a young mother whose family has gone into debt because her insurance did not fully cover her cancer treatment. “Is the choice between caring for yourself and caring for your family really a choice?” the narrator asks.
The NYT piece also refers to a 2003 study estimating that one of every 10 cancer patients was uninsured and other surveys that "have found that one of every four families afflicted by cancer, which is projected to kill 560,000 Americans this year, is effectively impoverished by the fight, including one of every five with insurance."

30 August 2007

What she has learned

Heather Bennett, a daughter of Larry and Donna Smith, was in "SiCKO" along with her parents. It was her house in Denver that the couple were headed to at the film's beginning — Heather's husband on his way to Iraq to do "some plumbing," as her son explained. Heather describes herself as "the proud daughter of Larry and Donna Smith." She's right to be proud, because her parents have done this country proud by not shutting up, not resting, but instead relentlessly leading and speaking out. They've done that despite the uncomfortable label of "health care system victim" that catapulted them into what might seem to be a catbird's seat. In fact, both Donna and Larry are more akin to being transformed into canaries in the mine.

Those of us who have been hurt by the despicable U.S. healthcare system have a duty, as Christians, Jews, Muslims, atheists, Wiccans, mothers, friends, and most of all as human beings, to speak out. The private health insurance industry will hurt you too. And if that doesn't outrage you, like the bumpersticker says, you're not paying attention. Heather's family understands. Here's Heather's column.

What I have learned...

By Heather Bennett, proud daughter of Larry and Donna Smith

My parents are featured in the Michael Moore film, "SiCKO." I am one of their six children and I am the daughter who volunteered her home when they had no place to go. I offered my home out of love and understanding that this was what I could do for them at the time. I could not erase the years of financial burden placed on them by their health care woes, but I could offer a soft place to land. For them, the opportunity to tell their story in this movie has been uplifting, dignifying and — and admittedly difficult at times. What people do not know — what people cannot see - is the private struggle behind the scenes for them and for their adult children.

It bothers me that our family did not feel comfortable sitting down and having this conversation together. Perhaps it is too idealistic to think that families do that today. Do adult children know how their parents have planned for the future? Do parents talk about health care concerns and needs? Or are we so caught up in the “me” and in keeping everything private that we don’t stop to talk about it? What is the emotion behind this? Is it fear, embarrassment or shame?

When people ask me why my parents are in the film and why I think this is so important, I answer that my parents are an example of what a couple might have to go through even though they are both working and are fully covered under multiple insurance plans. What I have come to understand over the past few weeks is that the importance of this movie is even simpler than that. It is about having the conversation and then doing something about it.

Inability to have conversations is a big part of the problem in America today. We are so careful about what we say, how we say it, when we say it and to whom we say it that often we decide it is easier not to have the conversation at all. As Michael Moore asks in this film, “Who are we?” My answer is that we are lots of individuals or small family units that are pretty uncaring and unconcerned for those around us. I would argue that Moore’s statement about the “me not we” ideology has bled past our every day dealings with the outside world, straight into our family lives. I know that I myself have learned things about the struggles they have faced by watching them give interviews or reading my mom’s eloquent words posted on a blog or a newspaper article. I also know that I feel utterly unprepared to assist as my parents age.

We live in a different time. Gone are the days that families stayed close together, generation upon generation living in the same community - taking care of each other. In our family, discussions on health care issues, financial issues and independent living issues rarely take place. What is the source of the stubbornness that stops these conversations from happening? How can we regain that connectedness?

If you are the child of an aging parent, I urge you to sit down with your parent(s) and have this discussion. Talk to them about their health. Talk to them about their healthcare. Ask the tough questions. What will happen if there is a major illness? What will happen if that illness is so debilitating that assisted living is required? Would your parent be able to survive the financial drain that a health issue can cause?

Not only do these conversations need to happen within families, but we need to take those discussions and turn them into action. Start with your State Representative, your Congressional Representative and your Senator. Where do they stand on universal health care or a single-payer plan. Have they taken money from the health care lobby? If so, why? Pledge your support for a bill in Congress - HR 676. Challenge each of the Presidential Candidates for 2008 to really explain their health care plan. The voices that rise up from our families, to each state House to the halls of Washington should be filled with anger and outrage at a system that is failing so many. For every day that we do not take action, 50 more people will die.

I wish that I had asked these questions earlier. I wish that I had been engaged in discussions with my parents on an entirely different level. In America, we must get back to a focus on “we”. It starts with asking the questions and planning for the future. Parents must feel no shame or loss of dignity in telling their children what they might need to survive a major illness. Children need to be prepared before something happens.

I urge you to see this movie - parents and children together. Start the conversation and then take action. When you start the conversation, you may be surprised at what you learn. I know I have been.

29 August 2007

Kaiser disinformation about Colorado proposals

Kaiser's "daily reports" gives absolute misinformation, the opposite of the truth, on the Colorado health care reform proposals. If they weren't expert on this, I'd say it was a misunderstanding. But these guys know what they're doing. This therefore seems malicious.

They write, "The most expensive option would be the government-run single-payer plan, which would cost an estimated $26.6 billion annually."

That's in contrast with the $30 billion we now pay for health care in Colorado.

I wrote Kaiser:
Your daily report is inaccurate. Read the Lewin Group's report on the Colorado reform proposals. The single-payer option is the least expensive, not the most, as you state. One proposal would cost $595 million more; one $1.3 billion more; one $271 million more; and the single-payer program SAVES $1.4 billion.

SAVES! That's the opposite of what you wrote. Please correct this immediately.

This is from the Lewin report:
The Lewin Group Technical Assessment of Four Health Care Reform Proposals (Proof Report)
August 20, 2007 Prepared for: The Colorado Blue Ribbon Commission for Health Care Reform
BETTER HEALTH CARE FOR COLORADO - Provides care through a public program expansion and access to private insurance coverage with low-income subsidies through a Health Insurance Exchange. Individuals who purchase private coverage would have access to a limited core set of benefits, with premiums copays.
467,200 - number remaining uninsured $595 million - increase in health spending

SOLUTIONS FOR A HEALTHY COLORADO - Provides coverage to Colorado residents under a Core Limited Benefit Plan in the private sector and expands coverage under Medicaid and Child Health Plus (CHP+). Low-income people who are not be eligible for the government programs would receive a premium subsidy.
133,400 - number remaining uninsured $271 million - increase in health spending

A PLAN FOR COVERING COLORADO - Provides coverage to Coloradans through a public program expansion and a mandatory private pool for all residents not eligible for the public program. It provides a minimum benefits package in a private pool and premium assistance based on income for those who cannot afford insurance. All plans would provide a comprehensive minimum benefits package, and differ mainly on cost-sharing amounts.
106,500 - number remaining uninsured $1.3 billion - increase in health spending

COLORADO HEALTH SERVICES SINGLE PAYER PROGRAM - A single payer plan that would provide coverage to all residents of the state, including state and local workers, and residents currently covered under Medicare, Tricare, Veteran’s Health, Indian Health Services and Federal Health Benefits programs. Provides comprehensive health care benefits for all - benefits of the Colorado Medicaid benefits package plus
preventive dental. Consumers would have their choice of providers and hospitals within the state.
0 - number remaining uninsured $1.4 billion - decrease in health spending

How is that the most expensive program?

Write them too.

The Science of Change

How do people change?

After a rough day yesterday, I was ready to say that they don't.

Former Governor Dick Lamm autographed his latest book for me, writing that single-payer advocates should keep up the good work: "History is on your side," he wrote.

I wasn't sure at all yesterday that was true. I'd just met with a progressive Denver group about a vigil to be held on 28 September for the victims of our health care system: 18,000 a year, 50 a day — including my brother. The spokesperson for the group wasn't as interested when I said that no, Michael Moore wouldn't be at the vigil.

Beyond that, the group's leader said they'd be happy with any reform proposal for Colorado that comes out of the 208 Commission — or actually, they'd be supportive of any progressive proposal.

I said there was only one progressive proposal that the commission was considering: the single-payer proposal from Health Care for All Colorado.

The person shrugged and said the group has members supporting all of the proposals. No doubt true — all but the underwriters' proposal, anyway.

SEIU has a proposal that has very meager benefits with a $35,000 cap — meaning that if you're in an accident forget staying out of bankruptcy. It would leave 465,000 uninsured of Colorado's 780,000 currently uninsured, at an additional cost of about $600 million. On the plus side, they don't have mandates to buy shoddy products from for-profit companies.

A group of safety-net providers has a proposal that would have both individual and business mandates to buy inadequate insurance, further enriching insurance companies, adding to the numbers of underinsured, and expanding the safety net. It would add $1.3 billion to the current total state health spending of $30 billion, with about 100,000 still uninsured.

The underwriters have a proposal that would have individual mandates to buy insurance, but no business mandates. A $50,000 cap. It would leave about 133,000 uninsured, and cost another $271 million.

Health Care for All Colorado's single-payer proposal would SAVE $1.4 billion — lowering that total health bill in the state. It would cover everyone. Three-quarters of Colorado's households would pay less for health coverage than they do now. Colorado businesses that currently insure their employees would pay less than they do now. The benefit package is a rich one.

So which is the progressive proposal? Which is the sustainable proposal?

When I heard this group would not be backing the single-payer proposal and wouldn't co-sponsor the vigil, I couldn't stop my eyes from crying. Damn eyes.

It doesn't hurt when conservatives spread their misinformation. Today's paper had a conservative columnist saying that the great challenges of the Republican party will be to maintain troops in Iraq and keep private health insurance. Eh.

What hurts is that the people who should be behind single-payer have convinced themselves that they're smarter than that — that there has to be an interim step between injustice and justice. What would that have looked like with ending slavery? With the Civil Rights Movement? And when they say that change is impossible, it makes it impossible. We won't get to single-payer until progressive groups embrace it. We'll never convince the social Darwinists and libertarians. But these folks should be with us.

It was therefore a relief to read Susan Rosenthal's The Science of Change: How it Happens and How it Doesn't. She lays out a strategy of hope. The three parts of change are:
Social support. People need support from others to overcome feelings of powerlessness, to create strategies for change and to act on them. In the context of supportive relationships, we learn that we are neither crazy nor powerless. By pulling together, we give each other hope and strength....
Presenting problems as solvable. To change their behavior, people need to see themselves and the world differently, in ways that make change seem possible....
Michael Moore’s film, "Sicko," has made a huge impact, not only because it reveals the horrors of the American medical system, but because it shows them to be neither necessary nor inevitable.
Repetition. When the level of struggle is high, people seem to change overnight in a kind of explosive chain reaction. At all other times, the dominant ideas are those that maintain the status quo. Changing those ideas requires patient and repeated encouragement. It’s like boiling water.
You put the kettle on the stove and turn up the heat, but nothing seems to happen. Do you remove the kettle in disgust at the failure of heat to boil water? Of course not!
Forcing people to buy inadequate insurance from the industry that has created our healthcare crisis is taking the kettle off the fire. It's not progressive. It's capitulation. It's not what's "feasible." It's a dead end.

If you invite them to the table....

John Edwards has this exactly right.

And it's the problem with his own health care reform proposal, which sure seems to keep the health insurance industry at the table.

His plan is, however, the best of the bunch from the three front runners.

24 August 2007

The businessman and the immigrant

A couple voices from the day —

I talked with a businessman based in Colorado Springs who said he was in favor of a 4 percent payroll tax in order to cover his employees — and that's even though he's not paying for health insurance now.

How about a 6 percent payroll tax?

Hell yes.

He said that right now his cost for employing his three employees was 25 percent of his budget. Not payroll, budget. He wants to insure his people, but who can spend 25 percent of their budget on it?

At the 208 Commission meeting yesterday, there was the clear implication that single-payer wouldn't be fair to small businesses, which couldn't afford a 6 percent payroll tax. It makes you wonder how many couldn't.

The San Francisco Chronicle has a piece today on businesses supporting single-payer. Turns out that 42 percent of them do. In fact, 55 percent would be willing to pay into a state fund to help cover their employees.

The other conversation was with an Englishman who had immigrated here. I didn't ask the circumstances, but he said he hadn't taken into consideration what losing the NHI would really mean in his life. He says that the enemies of single-payer make preposterous arguments. Nicely said.

22 August 2007

Divide and conquer

The Atlantic Monthly continues its downward spiral with a new writer, Megan McArdle, who fits their criteria for clever writing that leaves aside those quaint notions of morality, as Alberto Gonzolez has said. Entertaining!

The benchmark for this kind of dross ran a few years back, positing that the earth could easily support 30, 50, who knows how many billions of humans! and that our human population could vary by huge amounts — 30 billion to 3 billion! — within a few generations, without problems.

Right. Unless, I suppose, you consider starvation, war, pestilence and economic dislocations problematic.

Megan performs this trick on a smaller scale in "The Morality of Health Care Finance," by accusing those of us who see single-payer financing as a way out of the immoral and deadly morass in which healthcare is now mired in the United States. We are, she thinks, simply in love with government, and would be in favor of single-payer even if it could be proven that private health insurance could do a better, cheaper, more efficient job — "as long as a substantial population remained uninsured."



Megan. How is a system better if it leaves "substantial" numbers uninsured? How could that be cheaper in the long run? How more efficient? You've been reading too much Ayn Rand.

That's like accusing progressives of being against torture, even if it could be proven that torture does a better, cheaper, more effective job — "as long as a substantial amount of the information gathered turned out to be false."

See, the fact is that torture is wrong because it's immoral AND it doesn't work. Same as our private health insurance system.

Megan's argument that single-payer is a way to transfer money from the young and healthy to the old and infirm sounds like a trial balloon from the health insurance industry. Will we learn in a few years that she was lavishly compensated by that industry for this bit of "journalism"?

The fact is that our current system transfers money from the young and healthy to the old and infirm without benefit to the young and healthy. A single-payer system does collect from everyone, but its efficiency and appeal lie in the fact that there is benefit for the young and healthy. They have the security of knowing that if they hit a tree snowboarding next winter, they'll be cared for. They have the satisfaction of knowing that if they're one of the unlucky few who wake up tomorrow morning suddenly transformed by a diagnosis of cancer, suddenly no long one of the healthy but one of the stricken, that their children will continue to have a parent, and they can concentrate on recovery, not the consequences of bankruptcy.

Shame on you, Megan, for working to divide people, to set the young against the old, and suggest to them that their interests are served by turning their backs on others. She complains that liberals have been calling her "evil," but in fact, to work to divide people, one from the other, is an evil action.
First they came for the Socialists, and I did not speak out -
because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out -
because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out -
because I was not a Jew.

Then they came for me - and there was no one left to speak for me.
Shame. We're in this together, Megan. Because it's moral, and because it's what works.

20 August 2007

Jim Spencer reappears!

The Denver Post's fine columnist Jim Spencer was given the boot earlier this year — a matter of rationing liberal views, evidently.

We all missed him — and so I was pleased to see his byline on this column: "In the Matter of Health Care Versus Baloney" at Colorado Confidential, Colorado's preeminent progressive blog.

Spencer, as always, did his homework responding to the Rocky Mountain News's scurrilous attack on Health Care for All Colorado's proposal to the Blue Ribbon Commission for Health Care Reform. The title of that RMN piece? "Single-payer Baloney."

They got just about everything wrong. No. They got everything wrong.

Unlike the Rocky, which didn't evidently do any research, no quotes, no references, and they certainly didn't get in touch with us or the Colorado Nurses, Jim quoted Donna Smith:
But on the business side, the U.S. system “doesn’t even make economic sense,” said Donna Smith of Aurora, whose family health problems forced her and her husband to declare bankruptcy. “Single payer would lower the burden on American businesses.”

Smith and her husband, Larry, appear in Michael Moore’s documentary “SICKO,” which lambastes the U.S. health care model. Smith testified before Congress in July about the inability of many Americans to afford health care. She just started a group called American Patients for Universal Health Care.

If you’re worried that Smith isn’t objective because she has a dog in this fight, then check with Colorado’s own financial consultant on health care reform. The Lewin Group has issued a preliminary finding that cumulatively, a single payer health system will save Colorado money on health care.
The Rocky did print Fran Ricker's and my rebuttal on Saturday — which was good of them, since it's a combined circulation that day of both Rocky subscribers and Denver Post subscribers.

18 August 2007

HCAC Boulder at the Peach Festival

Join the revolution!
HCAC's Boulder chapter turned out to gather signatures and hand out information at the Lafayette Peach Festival today. They got a great response — bravo!
Thanks to Terry Fedak for this photo.

17 August 2007

Edwards writes about his plan

It's hard to think that John Edwards isn't talking about single-payer universal healthcare when he writes like this:
We have two healthcare systems in America. People who can afford insurance get the best care in the world. But most families are one bad break, such as a lost job or a serious illness, away from going right off a cliff.

I believe we should build one America, with one health system where every person can get decent, affordable healthcare. I am proud to be the first major presidential candidate to propose a specific plan to guarantee true universal healthcare.

Under my plan, businesses would either cover their employees or help pay their premiums. The government would make insurance affordable through new tax credits and by leading the way toward more cost-effective care. New “healthcare markets” would give families and businesses purchasing power and a choice of quality plans, including one public plan. Finally, once these steps have been taken, all American residents would be required to take responsibility and get insurance.

Under my plan, families without insurance would get coverage at an affordable price. Families that have insurance today—who sometimes have trouble paying their share of health insurance payments—would pay less and get more security and choices. Businesses and other employers would find it cheaper and easier to insure their workers. I have proposed steps that would save an average family $2,000 to $2,500 a year and eliminate at least $130 billion a year in wasteful healthcare spending.

An innovative feature of my plan would give individuals in healthcare markets a choice of insurance plans including a public plan based on Medicare. That choice would force private insurers to operate in a more competitive market, holding down costs and improving care.

I also recognize that we cannot achieve true universal care without making additional transitional investments. I have been honest about how I would pay for these—by repealing President Bush’s income tax cuts for Americans who make more than $200,000 per year....

We have to stop using words like “access to healthcare” when we know with certainty those words mean something less than universal care. Who are you willing to leave behind without the care they needs? Which family? Which child? We need a truly universal solution, and we need it now.

16 August 2007

Faith and single-payer healthcare

Donna Smith, the editor who with her husband Larry was featured in "Sicko," has a new piece in The Black Commentator. It's Part 26 (!) in their series on single-payer healthcare. Donna writes:
Is universal health care the right and moral thing to do? Are we who reside in faith communities within our churches and our communities called to action on this issue? Will we cast off all the things we have accumulated and follow what we have been taught to follow, in the face of this battle on behalf of those who cannot join the fray? Or will the vast majority of us remain silent, as we have over the past 30 years, giving our power and our presence over to those who express only the narrowest of Godly intentions?
Donna also writes that "This health crisis cannot be prayed away."

It's a great piece, ending with a call to action: write or call or set up a visit with your representative to thank them for co-sponsoring HR 676 if they have, or to urge them to do so if they haven't.

Go to Healthcare-NOW to see where your legislator stands.

HCAC vs. Ave Cassandra

I'm taking another go at Ave Cassandra, hoping to find a way to balance the work I do for Health Care for All Colorado and this blog — oh, and my family. Sorry, family. Being program administrator for HCAC is stretching me to my limit — the organization is doing great, and there's enough work for half a dozen staff people.

Good grief, between Health Care for All Colorado and HCAC Foundation you could give a couple dozen people enough meaningful and crucial work to fill their days. HCAC and HCACF volunteers fill a lot of the gap, but a lot of essential work simply does not get done. If single-payer had adequate funding, just a couple years of adequate funding for education, outreach and lobbying!, we'd have single-payer. No doubt about it.

I'm thankful to have one of probably a dozen or so paid jobs in single-payer advocacy and education in the country. I'm working on delegation and prioritizing skills.

Hillary says it right

For all those who hate Hillary, take a look at this. In "Hillary Lashes Out at Health Care Critic," she answers someone accusing her of being for "socialized" medicine, like they have in Canada.
"Do you think Medicare is socialized medicine? Clinton asked, turning the tables on her inquisitor, who did not identify himself.

"To a degree," he responded.

"Well, then you are in a small minority in America," Clinton said to applause, before explaining that Medicare allows patients to choose their doctors even though the federal government foots the bill with money deducted from workers' paychecks.

Clinton then asserted that "on balance" countries with uniform national systems of health care, including Japan, Australia and Canada, offer their citizens better health care than the U.S. The answer left her questioner shaking his head in disagreement.

"I can give you the statistics and you can shake your head," Clinton said sharply. "You come and introduce yourself to the staff. And we'll try to give you some information if you're interested in being educated instead of being rhetorical."

Educating for democracy

C-Span's on downstairs, with educators talking about how they can better educate for success.

They're right — we do have to educate for success, teach children the math and language skills they'll need to be good employees. Unemployment and homelessness and shiftlessness are no substitute even for that job at Wendy's.

However, if we're only educating to train workers for the marketplace, we've lost the foundation of democracy, which requires educated and informed citizens able to reason and question, not just follow directions and give the right change.

Voters have to be able to distinguish between fear-based appeals and real threats. We have to understand the moral underpinnings of working for the common good, whether Christian, Muslim, or atheist.

We can't just educate for success.

Private Beauchamp & the dogs

The New Republic found itself in the middle of a right-wing assault after editor Franklin Foer published a GI's story about how some of our young and immature soldiers have acted in Iraq. The right evidently thinks that all 170,000 of our soldiers there, dropped into hell with an unclear moral purpose, always channeled St. Francis when they weren't killing insurgents.

Army Private Scott Thomas Beauchamp, "the discredited soldier" who sent those reports to the magazine, has been widely reviled on the right-wing media sites. His three stories — of kids making fun of a disfigured Iraqi woman; of soldiers' finding children's bones; and of soldiers killing dogs for sport — were ridiculed. How could anyone think our boys would do such a thing?

Now comes this, in today's Denver Post:
A young man recently returned from Iraq sat in Barfield's chair while she applied a memorial tattoo.

She'd seen him in her shop before, just a regular kid. But now he told her a disturbing story about a lull between firefights. With no enemy in sight, the soldiers turned their weapons on a dog.

They fired a few rounds, but the dog didn't die. So they fired a few more. Then they ran over it with their armored vehicle, just to hear the bones crunch.

"They had programmed themselves to be hard," Barfield recalls. "The whole thing was about not losing the programming. But he was laughing when he told the story, and it kind of scared us.
Huh. War can harden hearts and damage a person inside as well as outside. Who knew?

01 August 2007

Brookings sets up new healthcare thinktank

Former Bush Medicare director and commissioner of the FDA Mark McClellan will head Brookings' new Engelberg Center for Health Care Reform.


McClellan is just the guy "to provide practical solutions for high-quality, innovative, and affordable health care."

You betcha. He's the guy, after all, who came up with Medicare Plan D, right? Otherwise known as "the doughnut hole"?

The Industry Veteran, a contributor to The Health Care Blog looked at a 2006 debate between McClellan and Uwe Reinhart:
I offer the following as a useful rule of thumb for THCB readers: whenever someone says more IT represents a principal solution to a better health care system, the red light should flash on one’s shit detector.

As uncle Marcus Aurelius advised, let’s return to first principles. Assuming THCB wishes to address the big issues and not turn into a blog for techie nerds, the problems of health care cost, quality and access in the U.S. result from some basic factors. The first of these is that there are too many middle men extracting too much profit (or, in Marshallian terms, too much economic rent) from the system. Among these, third-party payers are both pernicious and dispensable. Most analysts euphemistically classify payers and the efforts of other sectors to deal with them as “administrative costs.” It seems I’ve been seeing these administrative costs pegged at 25-30% of the health care bill for the past twenty years. Since Bush’s millenarian-oil junta has been running the country, I would guess that figure to be substantially higher because payments to providers have been tapering while premiums keep escalating. Given that the administrative costs for Medicare are approximately 2%, it appears self-evident that the current system, based on employers and insurance companies, should appeal only to Reagan-Bush types who consider the proper role of government to be one of handmaiden to business.