With millions of Americans out of work, House Republicans are focusing in on real priorities: decimating private abortion coverage and crippling public funding for abortion, as Jessica Arons reports in RH Reality Check.
In AlterNet, Amanda Marcotte notes that the No Taxpayer Funding for Abortion Act, or H.R. 3, also redefines rape as "forcible rape" in order to determine whether a patient is eligible for a Medicaid-funded abortion. Under the Hyde Amendment, government-funded insurance programs can only cover abortions in cases of rape and incest, or to save the life of the mother. Note that the term "forcible rape" is legally meaningless. Supporters of the bill just want to go on the record as saying that a poor 13-year-old girl pregnant by a 30-year-old should be forced to give birth.
Feminist blogger Sady Doyle has launched a twitter campaign against the bill under the hashtag #dearjohn, a reference to Speaker John Boehner (R-OH). Tweet to let him know how you feel about a bill that discriminates against 70% of rape victims because their rapes weren't violent enough for @johnboehner, append the hashtag #dearjohn.
Everybody chill out
A federal judge in Florida ruled the entire Affordable Care Act unconstitutional on Monday. However, as political scientist and court watcher Scott Lemieux explains at TAPPED, the ruling is not necessarily a death blow to health care reform:
[T]his ruling is less important than the controversy it will generate might suggest. Many cornerstone programs of the New Deal were held unconstitutional by lower courts before being upheld by the Supreme Court. This ruling tells us nothing we didn't already know: There is a faction of conservative judges who believe the individual mandate is unconstitutional. Unless this view has the support of five members of the Supreme Court -- which I still consider very unlikely -- it won't matter; Vinson's reasoning would have a much greater impact if adopted by the Court, but for this reason it is even less likely to be adopted by higher courts.
In a follow-up post, Lemieux explains the shaky legal reasoning behind Judge Robert Vinson's decision. The judge asserts bizarrely that being uninsured has no effect on interstate commerce. That premise is objectively false. Health insurers operate across state lines and the size and composition of their risk pools directly affects their business.
Given the glaring factual inaccuracies, Judge Vinson's decision may be overturned by a higher court before it gets to the Supreme Court.
Scamming Medicare
Terry J. Allen of In These Times win's the headline of the week award for an article entitled "Urology's Golden Revenue Stream." She reports that increasing numbers of urologists are investing millions on machines to irradiate prostate cancer in the office. The doctors can bill Medicare up to $40,000 per treatment, but they have to use the machines a lot to recoup the initial investment. So what does this mean for patients? Allen explains:
Rather than accessing centralized equipment and sharing costs, physicians are concentrating their own profits by buying expensive in-practice technologies that pay off only if regularly used. One result is overtreatment, which is driving up health care costs, exposing patients to unnecessary radiation and surgeries, and is frequently no better than cheaper approaches.
One third of Medicare patients with prostate cancer undergo the expensive IMRT therapy, as the procedure is known. In 2008, Medicare shelled out over a billion dollars on a treatment that has not shown to be any better for patients than less expensive therapies.
Obstetric fistula in the developing world
Reproductive Health Reality Check is running a special series on the human rights implications of obstetric fistula. Fistula is a devastating complication of unrelieved obstructed labor in which the baby's head gets stuck in the birth canal and presses against the soft tissues of the pelvis. If labor goes on long enough, the pressure will starve the pelvic tissues of blood, and they will die, creating a hole between the vagina and the bladder, and/or between the vagina and the rectum. Fistula patients face lifelong incontinence, chronic pain, and social ostracism.
The condition is virtually unknown in the developed world, where women with obstructed labor have access to cesarean delivery. However, an estimated 2 million women, primarily in sub-Saharan Africa and Asia, have untreated fistulas with an estimated 50,000 to 100,000 new cases occurring each year. Without reconstructive surgery, these women will be incontinent for life.
Sarah Omega, a fistula survivor from Kenya, tells her story. Omega sustained a fistula when she delivered her first child at the age of 19. She suffered for 12 years before she finally obtained the surgery she needed. As Agnes Odhiambo explains in another installment in the series, fistula is a symptom of a dysfunctional health care system. Women suffer needlessly because they can't get access to quality health care.
The most likely victims of fistula are the most vulnerable members of their respective communities. Early childbearing increases a woman's risk of fistula. Pregnant rape victims may face even greater barriers to a safe delivery, thanks to the social stigma that accrues to victims of sexual violence in many societies. (Not to mention any names, House Republicans...)
Preventing and repairing obstetric fistula is a major human rights issue. The U.S. should make this effort a high priority for foreign aid.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
A proposed program to cover counseling sessions for seniors on end-of-life care has risen from the ashes of health care reform and found a new life in Medicare regulations, Jason Hancock of the American Independent reports.
In August, former Alaska governor Sarah Palin started a rumor via her Facebook page that the the Obama administration was backing "death panels" that would vote on whether the elderly and infirm had a right to live. In reality, the goal was to have Medicare reimburse doctors for teaching patients how to set up their own advance directives that reflect their wishes on end-of-life care.
Patients can use their advance directives to stipulate their wishes for treatment in the event that they are too sick to make decisions for themselves. They can also use those directives to demand the most aggressive lifesaving interventions.
Waste not, want not
Though end-of-life counseling was ultimately gutted from the Affordable Care Act (ACA), the legislation will eventually ensure health coverage for 32 million more Americans. However, Joanne Kenen in The American Prospect argues it will do comparatively less to curb the high costs of health care. The architects of the ACA had an opportunity to include serious cost-containment measures like a robust public health insurance option to compete with private insurers, but they declined to do so.
Kenen argues that the government should more aggressively target waste within the health care delivery system, especially Medicare and Medicaid. Unchecked and rising health care costs through Medicare and Medicaid are a significantly greater driver of the deficit than Social Security or discretionary spending:
"The waste is enormous," says Harvard health care economist David Cutler. "You can easily convince yourself that there is 40 to 50 percent to be saved." Squeezing out every single bit of that inefficient or unnecessary care may not be realistic. But it also isn't necessary; eliminating even a small fraction of the current waste each year over the next decade would make a huge difference, he added. Health care would finally start acting like "a normal industry." Productivity would grow, in the one area of the economy where it has not, and with productivity gains, prices could be expected to fall.
The new end-of-life counseling program will help reduce waste in the system, not by pressuring people to forgo treatments they want, but by giving them the tools to refuse treatments they don't want.
Teen births down, but why?
The teen birth rate has dropped again, according to the latest CDC statistics. Births to women under the age of 20 declined by 6% in 2009 compared to 2008. One hypothesis is that the reduction is an unexpected consequence of the recession, an argument we pointed to in last week's edition of the Pulse. John Tomasic of the Colorado Independent is skeptical of the recession hypothesis. He writes:
Emily Bridges, director of public information services at Advocates for Youth, agrees with other observers in pointing out that teens aren't likely to include national economics as a significant factor in pondering whether or not to have unprotected sex. Peer pressure, badly mixed booze, general awkwardness, for example, are much more likely than the jobless recovery to play on the minds of horny high schoolers.
Some states with weak economies actually saw a rise in teen birth rates, Tomasic notes. However, this year's sharp downturn in teen births parallels a drop in fertility for U.S. women of all ages, which seems best explained by economic uncertainty.
It's true that prospective teen moms are less likely to have jobs in the first place, and so a bad job market might be less likely to sway their decisions. However, young women who aren't working are unlikely to have significant resources of their own to draw on, which means that they are heavily dependent upon others for support. If their families and partners are already struggling to make ends meet, then the prospect of another mouth to feed may seem even less appealing than usual.
Abortion is the elephant in the room in this discussion. The CDC numbers only count live births. Logically, fewer live births must be the result of fewer conceptions and/or more terminations. Some skeptics doubt that economic factors have much to do with teens' decisions about contraception. However, it seems plausible that decisions about abortion would be heavily influenced by the economic health of the whole extended family.
Last year's decrease was notably sharp, but teen birth rates have been declining steadily for the last 20 years. The Guttmacher Institute, a New York-based non-profit that specializes in research on reproductive choice and health, suggests that successive generations of teens are simply getting savvier about contraception. Births to mothers between the ages of 15 and 17 are down 48% from 1991 levels, and births to mothers ages 18 to 19 are down 30%.
Stupid drug dealer tricks
Martha Rosenberg of AlterNet describes 15 classic dirty tricks deployed by Big Pharma to push drugs. These include phony grassroots patient groups organized by the drug companies to lobby for approval of dubious remedies. Another favorite money-making strategy is to overcharge Medicare and Medicaid. Pharmaceutical companies have paid nearly $15 billion in wrongdoing settlements related to Medicare and Medicaid chicanery over the last five years.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
The co-chairs of the 18-member deficit commission issued a preliminary presentation two weeks ago that favored tax breaks for the wealthy and left open the possibility of deep cuts to Social Security, Medicare and other social programs. But there's still time for the commission to radically reshape its message before it issues its final report.
In the event of a Republican takeover of one or both houses of Congress on November 2nd, it won't be long before the Tea Party Movement and the G.O.P. will be involved in one or more train wrecks, some of which could be pretty dramatic. These train wrecks will arise from fundamental differences in philosophy and will occur over a period of time that could begin sooner rather than later. Upending Republican establishmentarians during primaries was relatively easy; winning general elections where competitive ideas are at issue could be a bit harder. Governing will be much harder still, particularly when you take into account the differences between Tea Party rhetoric and American political reality.
The first obstacle newly elected members of the movement will face is the institutional nature of Congress. Tea Party freshmen in both the House and Senate will be at the bottom of Congressional seniority lists and thus not immediately in line for leadership roles as committee chairpersons. Thus they will be in the position of having to sell their policy proposals to the existing leadership. That leadership may be more amenable to the ideas of the newcomers given the fact that several veteran Republican lawmakers are no longer around thanks to the Tea Party. Conversely the G.O.P. leaders may let Congress work the way it always has thereby attenuating the influence of the Tea Party. In the Senate in particular the likely Republican winners are veteran politicians who will come to the office with considerable experience. According to political observer David Herszenhorn: "Insurgent challengers may be grabbing all the headlines in midterm elections this year, but most of the Republicans who are best positioned to snap up Senate seats currently held by Democrats are veteran politicians - and most of them have already served in Congress. Based on their experience, the 2010 class of Senate Republican freshman could well prove to be relatively pragmatic and wise to the ways of legislative deal making - almost certainly more so than the Tea Party-backed firebrands like Sharron Angle in Nevada and Rand Paul in Kentucky, who have built their campaigns around ideological demands and an end to business as usual." In all of the discussions surrounding this election, few have pointed out the difference between those candidates who come out of, or are closely aligned with the Tea Party Movement and those who have received the movement's support solely because of their Republican affiliation. This second group will not necessarily move in lock step with the hard-core ideologues of the Tea Party seeing as they are not beholden to the movement in any meaningful way. Therein lay the seeds of intra-party conflict and controversy.
The next challenge facing newly elected members of the Tea Party Movement will be the reconciliation of their penchant for spending cuts and ending earmarks versus what can be achieved in the realm of the possible. These desires will butt up against the fact that cutting government spending during a severe economic downturn could only make things worse and many Republicans favor an ending of the G.O.P.'s moratorium on the use of earmarks. There's a reason that the G.O.P's leadership has been mum on the political talk show circuit when it comes to detailing the particulars of spending cuts and the reason is that they don't have a viable plan. Even as late in the game as this morning, Haley Barbour, appearing on "Meet the Press" was unable or unwilling to fill in the blanks when asked how a Republican controlled Congress will reduce the size of government. Tom Brokaw, appearing on this same show pointed out that many Republican candidates have made rash promises on the campaign trail that can't be kept or will be nearly impossible to keep given the current political situation. Again we see the future of conflict as already being baked into the cake, so to speak.
I read "A Pledge to America" and it is full of general statements regarding spending cuts, but for the scope of its discussion, it lays out few policy specifics. The "Pledge" is equal parts indictment, rallying cry and Act of Contrition, but what it isn't is a blueprint for reducing government. I can't help but wonder why the G.O.P. trotted out the "Pledge" when they have Congressman Paul Ryan's (R-WI) "A Roadmap For America's Future" which is a well reasoned analysis full of specific proposed cuts. Again to Herszenhorn: "while polls show that the Republicans' message is succeeding politically, Republican candidates and party leaders are offering few specifics about how they would tackle the nation's $13.7 trillion debt, and budget analysts said the party was glossing over the difficulty of carrying out its ideas, especially when sharp spending cuts could impede an already weak economic recovery...(both) parties share blame for the current fiscal situation, but federal budget statistics show that Republican policies over the last decade, and the cost of the two wars, added far more to the deficit than initiatives approved by the Democratic Congress since 2006...Calculations by the nonpartisan Congressional Budget Office and other independent fiscal experts show that the $1.1 trillion cost over the next 10 years of the Medicare prescription drug program, which the Republican-controlled Congress adopted in 2003, by itself would add more to the deficit than the combined costs of the bailout, the stimulus and the health care law." Moreover, most Republicans are calling for the permanent extension of all Bush-era tax cuts and that would add $700 billion more to the deficit over the next 10 years.
The "Pledge" has come in for scathing criticism on the right as well as the left. Janet Hook and Naftali Bendavid of the Wall Street Journal made the following observations: "The new policy manifesto released by House Republicans Thursday is laced with ideas and rhetoric designed to appeal to the surging tea-party movement. But it left some conservatives disappointed with its omissions and complaining that the plan had limited sweep... Yet the new agenda was silent on some of the most sought-after goals on the tea-party wish list, such as a balanced budget constitutional amendment and a ban on special-interest appropriations called earmarks." Many conservatives look to what is now happening in the United Kingdom as a model of inspiration for cut backs here. But that program involves a significant reduction in defense spending; something that would have to be included here as well as those outlays constitutes 58% of discretionary federal spending. With a large portion of federal spending being committed to Social Security, Medicare, Medicaid and paying off interest on Treasury Bonds, the amount of money subject to discretionary spending reduction is only one third of all outlays. There is a growing minority within the G.O.P. on Capitol Hill who are making the case that the projected debt is too big to handle through spending cuts alone. According to Saxby Chambliss (R-GA): "Everything has got to be on the table for discussion... "there are a lot of things people are going to have to be educated about, on the spending side as well as the revenue side. They're thinking we can come in and eliminate earmarks and everybody's going to be happy on the spending side. Gee, that just scratches the surface." Is Senator Chambliss tacitly acknowledging that tax cuts will have to expire or even that tax increases may be needed to deal with the deficit? The "Pledge" is notoriously silent on the subject of earmarks and seeing as they are a major source of spending, this is sure to give rise to a rift within the new Republican caucus on Capitol Hill. It doesn't take a soothsayer or a professional handicapper to see that the G.O.P. and the Tea Party Movement are on a collision course with regard to spending and the practical ability to reign in that spending given the current economic situation and the present composition of federal government outlays. Thus there is little reason to believe that the Republican rhetoric of the campaign trail will carryover to policies that actually achieve what that rhetoric has promised. Therein lies the root of yet another G.O.P. - Tea Party collision.
Newly elected Tea Party Movement lawmakers may find themselves running into some strong headwinds in the form of those special interests that have invested heavily in this election on behalf of conservative causes. While it is now likely that in the final analysis Democrats may end up spending more money than their opposition, there is an unprecedented amount of money flowing to the Republican side from outside sources as a result of the Citizens United ruling. According to OpenSecrets.org the 2010 midterms have seen a whooping 186.7 million dollars flowing into Republican coffers vice 88.6 million for the Democrats. Likewise an article on the U.S. Chamber of Commerce and business donations shows the tide running against the Democrats among these groups at a rate of almost two to one. Ostensibly one would say what difference does it make where all this money is coming from if the Democrats are actually spending more? But within the confines of this argument, what matters is that this tidal wave of money spent by outside interests is being spent for a reason, to influence the election's outcome and thereafter to buy influence with the winners. Washington lobbyists are already courting the potential new Congressional chairmen and in the process could effectively be
outmaneuvering the Tea Party activists in the game of power and influence. Thus the many questions that beg to be asked: Won't all of this money muscle out the grassroots crowd and how will the Tea Party activists compete for attention with the lobbyists who are already prowling the halls of Congress and the bars and restaurants of downtown Washington? Is the movement about to get mugged on K Street? Are the rank and file Tea Party patriots in the process of "taking their country back" just to have it taken away in turn by the wealthy interests who have spent all of this money to influence the outcome of the 2010 elections? Surely this money was not spent because it was burning a hole in someone's pocket. Does anyone believe that these special interests were in the mood to do the activists a favor on November 2nd? Will the rank and file Tea Partier unwittingly deliver "his country" as a gift to a new class of plutocrats that will have no use for him except for his vote during the next election cycle and his attendance at rallies? Don't look now but we may be about to witness the greatest political hustle since the evangelicals came out in force for George W. Bush only to get nothing of substance in the bargain.
Finally, the Tea Party Movement will continue to run up against the fact that many of its essential beliefs are divorced from reality and therein lay the seeds of train wrecks to come. First and foremost is one of its core ideas, that Americans are over taxed. The fact is that taxes are as low as they have been in sixty years; lower than they were when Ronald Reagan was President. As Senator Chambliss implied above, increased taxes may be inevitable if people are serious about reducing the deficit. The Tea Party waxes nostalgic for the Reagan era, yet unemployment was higher when the "Gipper" went into his first midterm election than it is now and his approval rating was roughly the same as Obama's. The movement preaches fiscal restraint while refusing to consider reductions in defense spending where wasteful spending is well documented and widespread. This will lead to calls for a reduction in social programs during the worst economic downturn since the 1930s and that will only create resistance on the left and reluctance on the part of practical Republican officeholders on the right. The Tea Partiers clamor, "keep your hands off my Medicare" but underplay how to reign in the program's cost increases. They rail against TARP, blaming Obama for its inception all the while ignoring the fact that many of the very Republicans running for re-election are the ones who originally put the bailout in place. How will they address the fact that TARP's costs will be less than originally anticipated? Even conservative observer Ross Douthat admits that for all its shortcomings TARP was a necessary evil at the time of its inception. On the issue of repealing health care reform there is now no clear consensus to do so, according to the latest CBS poll, yet repeal is a major Tea Party goal.
The continued Tea Party fixation with Obama as a Socialist, Fascist or both at the same time reveals a lack of understanding of what actually comprises these two somewhat similar yet fundamentally different schools of political thought. If it's not that, then what else could it be other than a deliberate attempt to misinform the public for partisan ends. It goes without saying that this is something that can only contribute to further gridlock. This fact stands in direct contrast to what the public wants. The latest polling by both Bloomberg and the New York Times / CBS News reveals an electorate that wants compromise not confrontation. Yet with the arrival of Tea Party backed lawmakers the stage is now set for a political environment more favorable to confrontation than to compromise. Attempts to fix the blame on President Obama for the current economic situation are likely to fail as well as "nearly 60 percent of Americans were optimistic about Mr. Obama's next two years in office and nearly 70 percent said the economic slump is temporary. Half said the economy was where they expected it would be at this point, and less than 10 percent blamed the current administration for the state of the economy, leaving the onus on former President George W. Bush and Wall Street." In the final analysis, the 2010 election is shaping up to be something of an anomaly. On the one hand you have widespread voter dissatisfaction with the status quo while at the same time the party likely to gain seats has a favorability rating below the party that will be turned out of office. Thus for the Republicans this victory will be a political windfall rather than an endorsement of the party and its platform. The G.O.P. will find itself in an inopportune marriage of convenience with the Tea Party Movement which in the long haul may turn out to the G.O.P.'s detriment as the public grows weary of the gridlock and political train wrecks that are sure to come. Rather than being on the cusp of a Republican revival or a "return to our core values" we are more likely on the verge of an environment of political chaos which is just what we don't need at this point in time and that chaos may well come back to haunt the Republican Party and hobble its chances in the 2012 election and beyond. Ladies and Gentlemen, fasten your seat belts.
During Netroots Nation, we are running Golden Oldies plus a few surprises. Regularly Scheduled programming will resume on July 26.
A Paul Rosenberg Golden Oldie From Sat Jan 17, 2009. Original here.
Did you know that Obama has a mandate to slash Medicare and Medicaid? Probably not, I'd wager. But it seems that Obama believes he has such a mandate, according to an item at the Washington Posts' website ( h/t Digby ), that reads, in part:
Obama To Hold Fiscal Responsibility Summit
President-elect Barack Obama will convene a "fiscal responsibility summit" in February designed to bring together a variety of voices on solving the long term problems with the economy and with a special focus on entitlements, he said during an interview with Washington Post reporters and editors this afternoon.
"We need to send a signal that we are serious," said Obama of the summit.
Those invited to attend will include Senate Budget Chairman Kent Conrad (N.D.), ranking minority member Judd Gregg (N.H.), the conservative Democratic Blue Dog coalition and a host of outside groups with ideas on the matter, said the president-elect....
Obama said that he has made clear to his advisers that some of the difficult choices--particularly in regards to entitlement programs like Social Security and Medicare - should be made on his watch. "We've kicked this can down the road and now we are at the end of the road," he said.
This is not just something he didn't run on. It is, in fact, the exact opposite of what he ran on-or at least appeared to, as can be seen from economist Dean Baker's op-ed in The Guardian, a few days earlier, in which he wrote:
Although Social Security is paid for long into the future, Medicare does face problems due to the explosion of private sector health care costs. The way to address Medicare's shortfall is to fix the private health care system, as President Obama has pledged to do.
The truth of Baker's statement is readily apparent from the following chart, which I presented in my diary from last April, "Medicare Myths--Don't Blame The Boomers". Our medical costs are far higher than other countries with a significantly larger share of older citizens:
Not only is Obama's "fiscal responsibility" kick at odds with his actual mandate and his own health care proposals, it reflects a deeply ideological worldview that--far from being bipartisan or "post-partisan"--is strongly opposed by solid majorities across the political spectrum. It is the very essence of Versailles insiderism.
Christian groups are trying to create a run around health care reform by setting up alternative, unregulated religious health care bill collectives-and movement conservatives are cheering them on.
Religious right-watcher Sarah Posner reports on so-called Christian health care-sharing ministries in the American Prospect. Health-sharing ministries (HCSM) bill themselves as godly alternatives to health insurance. HCSM are groups of Christians who promise to cover each other's heath care costs. About a hundred thousand people nationwide belong to these collectives. The Alliance of Health Care Sharing Ministries and its army of lobbyists convinced Senate lawmakers to exempt HCSMs from health care reform's individual mandate.
Obliterating patient privacy
According to Posner, anti-reform conservatives are talking up these groups because they see them as a way to undermine the individual mandate. But if you think HCSM are a convenient loophole to avoid paying for insurance, think again. Posner describes the criteria for joining Samaritan Ministries International (SMI), one of the largest HCSM:
"To join the HCSM, applicants must agree to a statement of faith that they are a 'professing Christian, according to biblical principles' set out in Romans 10:9-10 and John 3:3. They must agree to adhere to guidelines that include no sex outside of "traditional Biblical marriage," no smoking or drugs, and mandatory church attendance.
SMI members pay their own health care costs out of pocket and seek reimbursement from the group. What about privacy? In order to get reimbursed, they have to publish their health care "needs" in a monthly newsletter and hope someone sends cash. Lifetime benefits are capped at $100,000. Members waive their right to sue for any reason. SMI won't cover treatment for sexually transmitted diseases, addictions, or the pregnancies of single mothers.
It doesn't take a genius to see that this free-for-all won't end well. You can't just start a quasi-health insurance scheme in your garden shed and expect it to work out. Real insurance companies are subject to oversight to make sure that they have enough money on hand to cover their claims. Who knows what HSCM are doing with people's money? These outfits have all the disadvantages of private insurers and none of the benefits. Members are a single major illness away from bankruptcy.
Bartering for health care?
Speaking of wacky alternatives to health insurance, Sen. Harry Reid's (D-NV) main Republican challenger, Sue Lowden, insists that patients can pay for their health care via a barter system, as Rachel Slajda reports for TPMDC. Great! How many chickens for an appendectomy?
Medicare expansion doesn't equal bankruptcy
At Mother Jones, Kevin Drum debunks the latest right-wing myth about health care reform, that Medicare expansion will bankrupt the states. States pay part of the cost of Medicare, so it's true that any expansion of the program will cost the states some money. However, the talking point is that the expansion will push state budgets to the breaking point. That's false.
Drum explains that the health care reform bill exempts states from the extra cost until 2016. Even after that, the costs to the states will be minimal:
"[Health care reform] won't cost states an extra dime through 2016, by which time our recession will presumably be over, and even after that states will only pay for a tiny fraction of the increased costs. As CBPP points out, states will pay about 4% of the total costs of Medicaid expansion over the next ten years. This represents an increase in overall state Medicaid spending of slightly over 1%."
Abortion and 'convenience'
Jessica Valenti of Feministing has been taking on manipulative, anti-choice ads in the New York City subway. These ads are sponsored by an anti-abortion group. They feature various distraught-looking models staring wistfully into space. The tagline is "Abortion Changes You." The message is that if you have an abortion, you will be a guilt-racked wreck for the rest of your life. Some feminist with a wry sense of humor and a little glue pasted in another sentence on the ad (pictured above): "Now I can go to college and fulfill my dreams."
Anti-choice blogger Lori Ziganto was scandalized by the anonymous culture jammer's message. She sneered at the idea that women's lives and hopes actually matter: "Want to go to college, but there is a pesky baby growing inside of you? Abort! A life is far less important than your co-ed fun and career plans, right?"
Valenti's response: "It isn't that anti-choicers don't understand why women get abortions - it's that they care so little about women's lives that any reason given to obtain an abortion is seen as "convenient." Some things that are convenient: Providing for your existing children. Going to college. Having enough money to eat, pay rent, keep the electricity on. Not dying."
HSCMs and the subway ads are part of an enormous rift in contemporary politics: Opponents of health care reform say that they're defending freedom, but in reality, they're advocating control.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
Alright my Brothers And Sisters, the word has come down, and I doubt if many, if any of us are surprised. Once again the public option has been sacrificed, in the hopes of getting enough votes to pass Some kind of health care reform bill. And I can hear the sounds of outrage and betrayal from the ones out there who have more hope than sense. And I'm sure that there will be renewed calls to kill the bill etc. Well you know what? It's time to look to a new source for inspiration about how Progressives should proceed.
One of the few Republican ideas brought up at Thursday's Health Care Reform summit that seemed to be really popular with both parties was suggested by Senator Tom Coburn. The idea basically is to have people go and visit doctors, and try to get them to break Medicare rules. I presume that if they created such a program for Medicare they would try to see to it that it was applied to Medicaid as well. It has been compared to the practice that many fast food restaurants and retail clothing stores have been employing for a while now, commonly known as "Mystery Shopping". This is a horrible idea for several reasons, and the comparison to the Mystery Shopper, is frankly weak and ultimately inaccurate. More importantly I have a suggestion that contains none of the yuck factor of Under Cover Patients, and could potentially play a significant role in changing the way that doctors and patients relate to one another.
Allow me to make a confession. I was being naive thinking that I had any hope in hell of managing to come up with a coherent analysis of today's Health Care Reform summit in time to have it up any time today. In fact I'm not sure if it will be ready before next week. But never let it be said that I don't come through with at least a little something for my loyal readers.
Today's article comes from a comment that one of my readers at Daily Kos made in the comment section of my look at Obama's suggestions for Health Care Reform. He opined that he felt it was inappropriate for Doctors to ever have an investor interest in providing extra services. I said something to him in my reply, that the more I thought about it today seems more and more true.
I said, "What's more I'd like to see us return to a very old fashioned notion that there are simply some jobs you take expecting to not get rich. Medicine used to be one of those."
The conservative videographer who donned a pimp suit to embarrass the anti-poverty group ACORN was arrested in New Orleans, LA for allegedly conspiring to bug the office of Democratic Sen. Mary Landrieu.
It's not clear why Landrieu was targeted, but many suspect that she was singled out because she played a pivotal role in advancing health care reform.
Filmmaker James O'Keefe and three other men have been charged with been charged with entering federal property under false pretenses for the purpose of committing a felony, according to Justin Elliott of TPM Muckraker. At RH Reality Check, Rachel Larris notes that, if convicted, the four could face up to 10 years in prison.
Like chum in the conservative shark tank
Landrieu, a conservative Democrat, negotiated an extra $100 million in Medicaid funds for Louisiana in exchange for allowing the health care bill to come to the senate floor. Accepting health care for the poor in the interest of health reform was like chum in the conservative shark tank.
Rush Limbaugh called her the most expensive prostitute of all time. "She may be easy, but she's not cheap," crowed Glenn Beck. It got so bad that Democrats call on Sen. David Vitter (R-LA) was called upon to denounce the chorus of conservatives attacking his fellow Louisiana senator as a prostitute. (Correction: Vitter did not call Landrieu a prostitute.)
O'Keefe must have realized that an exposé of Mary Landrieu would be a hot commodity.
"This is Watergate meets YouTube," said Mother Jones Washington Bureau Chief
Health care reform in limbo
The arrests could not have come at a better time for the Democrats. Health care reform is in limbo as congressional leaders plan their next move after losing their filibuster-proof majority. The bugging scandal is deflecting attention from tense internal negotiations.
Brian Beutler of TPMDC reports that the House Democrats are converging on a strategy to get reform done: The House will pass the Senate bill and the Senate will fix it through budget reconciliation.
The Republican counter-strategy
While the Democrats agonize over what to do next, that senate Republicans are honing strategies to thwart any Democratic attempt to pass health care reform through budget reconciliation, as Dave Weigel reports in the Washington Independent. The reconciliation process allows both sides to vote on unlimited number of amendments. GOP leadership is hinting that if Dems take the reconciliation route, they will be forced to vote on every politically embarrassing amendment the opposition can dream up.
The stakes are high. In the American Prospect, Paul Starr reminds progressives that there's till a lot worth fighting for, even without a public option. For all its faults, the Senate bill would still cover 30 million uninsured Americans, expand Medicaid, end discrimination based on preexisting conditions, and set up exchanges designed to keep rising insurance premiums in check.
A memo for reform
Finally, our sources tell us that Steve Benen of the Washington Monthly is making quite a stir on Capitol Hill with his memo advising the House Democratic caucus on the need to forge ahead with health care reform. In 1994, conservative commentator William Kristol wrote a health care memo to Republicans that became the backbone of their anti-reform strategy, even up to the present day. Benen hopes his memo will be a useful counterweight for Democrats. Benen warns the Democrats that it's far riskier to fail than to pass reform that doesn't please everyone.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
We at Open Left are taking the New Year's weekend off. Golden Oldies will run in their place. Regularly Scheduled programming will resume on January 4th--Chris Bowers
A Paul Rosenberg Golden Oldie From Sat Jan 17, 2009. Original here.
Did you know that Obama has a mandate to slash Medicare and Medicaid? Probably not, I'd wager. But it seems that Obama believes he has such a mandate, according to an item at the Washington Posts' website ( h/t Digby ), that reads, in part:
Obama To Hold Fiscal Responsibility Summit
President-elect Barack Obama will convene a "fiscal responsibility summit" in February designed to bring together a variety of voices on solving the long term problems with the economy and with a special focus on entitlements, he said during an interview with Washington Post reporters and editors this afternoon.
"We need to send a signal that we are serious," said Obama of the summit.
Those invited to attend will include Senate Budget Chairman Kent Conrad (N.D.), ranking minority member Judd Gregg (N.H.), the conservative Democratic Blue Dog coalition and a host of outside groups with ideas on the matter, said the president-elect....
Obama said that he has made clear to his advisers that some of the difficult choices--particularly in regards to entitlement programs like Social Security and Medicare - should be made on his watch. "We've kicked this can down the road and now we are at the end of the road," he said.
This is not just something he didn't run on. It is, in fact, the exact opposite of what he ran on-or at least appeared to, as can be seen from economist Dean Baker's op-ed in The Guardian, a few days earlier, in which he wrote:
Although Social Security is paid for long into the future, Medicare does face problems due to the explosion of private sector health care costs. The way to address Medicare's shortfall is to fix the private health care system, as President Obama has pledged to do.
The truth of Baker's statement is readily apparent from the following chart, which I presented in my diary from last April, "Medicare Myths--Don't Blame The Boomers". Our medical costs are far higher than other countries with a significantly larger share of older citizens:
Not only is Obama's "fiscal responsibility" kick at odds with his actual mandate and his own health care proposals, it reflects a deeply ideological worldview that--far from being bipartisan or "post-partisan"--is strongly opposed by solid majorities across the political spectrum. It is the very essence of Versailles insiderism.
During a press conference yesterday, President Obama voiced support for government-administered health insurance for all who need it (aka the "public option"), as a key component of healthcare reform. Though Obama stopped short of threatening to veto a bill that didn't contain such an option, he said that a public option is needed to enforce market discipline. If the system is going to reform, the health insurance companies can't just keep selling the same bad coverage with bigger public subsidies for their monopolies. Essentially, Obama isn't about to force taxpayers to buy overpriced insurance from private companies.
"The public plan, I think, is an important tool to discipline insurance companies," Obama said during yesterday's White House news conference. "I think there is going to be some healthy debate about the shape that this takes." He outlined three options: Get insurance through your employer, buy insurance on your own, or buy insurance from a marketplace where public and private insurance providers compete for business.
This week, the White House teamed up with healthcare industry giants for a two-day PR blitz on health reform. A coalition of industry leaders sent a letter to president Obama over the weekend, pledging to help contain healthcare costs. The signatories include PhRMA (drug makers), Advamed (device manufacturers), the AMA (doctors), the AHA (hospitals), AHIP (health insurance), and SEIU's Health Care project. The corporate signatories are the very same interest groups that have fought U.S. healthcare reform for generations. AHIP, America's Health Insurance Plans, helped torpedo the Clinton plan in the 1990s with the infamous "Harry and Louise" TV spots.
My earlier diary, "Obama's 'Mandate' To Slash Medicare, Medicaid & Social Security", focused attention on the fact that Obama's potential intention to slash Medicare, Medicaid and Social Security is wildly at odds with what his great mass of supporters wanted, and consciously voted for. Now I want to pivot, and focus attention on the small handful of folks who stand to gain exactly what they wanted from him, even though it went diametrically against the overwhelming majority of his supporters. It is, in large measure, the presence of such people in high levels of influence that substantially heightens my concern that Obama might actually take this sort of ill-advised action.
The classic definition of "chutzpah" is the kid who kills both of his parents and then begs for mercy because he is an orphan. The Wall Street crew are out to top this. After wrecking the economy with their convoluted finances, and tapping the Treasury for trillions in bailout bucks, they now want to cut Social Security and Medicare because we don't have the money.
That paragraph pretty much says it all, in terms of laying out the basic foundations of this fight. In fact, given how tenacious, how vicious, and how deeply entrenched these bastards are, we're going to be fighting them for a good long time, so you may want to print it out and tape it to you refrigerator. Or tattoo it onto your eyelids. Because they will do everything imaginable to make you forget that simple truth.
Did you know that Obama has a mandate to slash Medicare and Medicaid? Probably not, I'd wager. But it seems that Obama believes he has such a mandate, according to an item at the Washington Posts' website ( h/t Digby ), that reads, in part:
Obama To Hold Fiscal Responsibility Summit
President-elect Barack Obama will convene a "fiscal responsibility summit" in February designed to bring together a variety of voices on solving the long term problems with the economy and with a special focus on entitlements, he said during an interview with Washington Post reporters and editors this afternoon.
"We need to send a signal that we are serious," said Obama of the summit.
Those invited to attend will include Senate Budget Chairman Kent Conrad (N.D.), ranking minority member Judd Gregg (N.H.), the conservative Democratic Blue Dog coalition and a host of outside groups with ideas on the matter, said the president-elect....
Obama said that he has made clear to his advisers that some of the difficult choices--particularly in regards to entitlement programs like Social Security and Medicare - should be made on his watch. "We've kicked this can down the road and now we are at the end of the road," he said.
This is not just something he didn't run on. It is, in fact, the exact opposite of what he ran on-or at least appeared to, as can be seen from economist Dean Baker's op-ed in The Guardian, a few days earlier, in which he wrote:
Although Social Security is paid for long into the future, Medicare does face problems due to the explosion of private sector health care costs. The way to address Medicare's shortfall is to fix the private health care system, as President Obama has pledged to do.
The truth of Baker's statement is readily apparent from the following chart, which I presented in my diary from last April, "Medicare Myths--Don't Blame The Boomers". Our medical costs are far higher than other countries with a significantly larger share of older citizens:
Not only is Obama's "fiscal responsibility" kick at odds with his actual mandate and his own health care proposals, it reflects a deeply ideological worldview that--far from being bipartisan or "post-partisan"--is strongly opposed by solid majorities across the political spectrum. It is the very essence of Versailles insiderism.
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