"With that in mind, I have two suggestions going forward. First, reform proponents should probably start telling the public that even Dick Armey thinks the idea of a public option sounds like 'a wonderful gift.'
And second, Democrats should declare, publicly and loudly, that in response to popular demand, they've decided to make the public plan purely optional. Conservatives drive a hard bargain, but reform proponents are not above compromise. As this item, posted by Josh Marshall, put it, 'I think Obama should use all the fictional friction points as bargaining chips. You want us to give up the tyranny of compulsory coverage? You win, Dick Armey. Will you support the bill now?'"
"If one sifts through the nonsense, looking for something substantive, what we're left with is Steele's uninformed opposition to the creation of an Independent Medicare Advisory Council (IMAC). The idea is to have appointed IMAC members -- physicians and medical experts, appointed by the White House and confirmed by the Senate -- who would have some added authority to help control what Medicare pays doctors and hospitals. The panel would probably help lower costs more effectively than Congress, which isn't especially good at these technical, medicinal, and scientific questions.
The idea was originally proposed by conservatives, embraced by Democrats, and would serve as part of a larger effort to save money and take political considerations out of the process.
And now Michael Steele wants seniors to think big bad Democrats are trying to undermine Medicare."
Michael Steele, the inept chair of the Republican National Committee, needs to pay a visit to the would be HR department that Jon Stewart runs on the west side of Manhattan. In a essay at the Wash Post today, Steele put forth the same misrepresentations, or lies, that Betsy McCaughey uncontrollably spewed last week. Steele:
"Third, we need to outlaw any effort to ration health care based on age. Obama has promoted a program of "comparative effectiveness research" that he claims will be used only to study competing medical treatments. But this program could actually lead to government boards rationing treatments based on age. For example, if there are going to be only so many heart surgeries in a given year, the Democrats figure government will get more bang for its buck if more young and middle-aged people get them."
Steele goes on to call for a bi-partisan approach on health care. The mind of Steele must have forgotten that President Obama has put health care reform in the hands of our only bi-partisan branch of government only to have anything but flexibility or compromise from the Republican party. Steele writes:
"Reversing course and joining Republicans in support of health care for our nation's senior citizens is a good place to start. Doing so will help him restart the reform process to give Americans access to low-cost, high-quality health care."
Perhaps this faux call for bi-partisanship should start with Michael Steele telling us where the party he leads is flexible and willing to compromise on it core values. I don't think he can do it, obstructing and killing legislation is not a core value.
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The White House needs to abandon dreams of bi-partisanship and get their Democratic Ducks in order.
There will be no health care bill that gets more than one to two Republican votes. It is time for the White House to play harder with the Democrats in Congress, particularly the Senate Dems.
Over the next two election cycles there are eight Democratic Senators running for re-election. It may be time for the party and the President to take advantage of this reality. I don't think it helps these eight Democrats to have a new president under cut on what is likely the biggest policy initiative of his presidency. It would pay off for congressional Democrats to strengthen Barack Obama's political power by passing reform in the strongest form possible.
Since the President, and politics in general, is fond of sports methaphors we can call this last week of August half time. The President needs to set the tone for the team that he leads and have them running out of the locker room with a new game plan and all on the same page. If he can't get firm commitments from the Democrats that strayed from the pack he and the party needs to use real internal party pressure on these politicians. Right now Barack Obama is still the most popular figure in the country and the fundraising possibility is amazing. If the Congressional Democrats want a piece of that they need to get in line. They should be told to imagine the possible electoral and fund raising power of a President that passed a major policy initiative and what that power does for them. Remind them that avoiding huge losses in the mid-terms is good for them as much as it is for the White House.
This week while vacationing in Martha's Vineyard Barack Obama should also make time to sit with Massachusetts Governor Deval Patrick and Democratic legislative leaders to stress the importance of changing state succession laws for the US Senate seats as soon as possible. Along with Patrick, President Obama stress to Senator Kennedy the need to resign if the State does change the succession law. It secures the Senator's legacy if a strong bill passes with him in retirement not if a weak bill fails with him kind of in office. A similar conversation should take place with Senator Robert Byrd in West Virginia.
What is likely to be the most important piece of legislation to come out of the Congress in nearly forty years and will create huge changes in our society over the next forty and beyond should not be held up by the lack of congressional and presidential leadership.
"Obama's message of conciliation worked perfectly in the '08 campaign in part because it's an authentic reflection of his personality. Axelrod harbored doubts about whether Obama's aversion to confrontation when it becomes nasty and personal would hamper him as a candidate. 'When it comes to taking a punch, I don't know whether you're Muhammad Ali or Floyd Patterson,' Axelrod wrote to Obama in a November 2006 memo reported in a new book that reprises the campaign by Washington Post political reporter Dan Balz and former Post writer Haynes Johnson. Now Obama supporters are wondering about their man. If they're to see what he's made of, Obama has to first get in the ring. Forget the niceties, it's time to fight."
It is past the time for Barack Obama to get involved in this process. He needs to put out some strong speeches about the moral obligations we have to secure health care for everyone but he needs to get the politics in his party together first.
"Alas, we can't even critique the phenomenon known as Heisenberg's Principle of Observation without circling back to Herr Hitler. Physicist Werner Heisenberg, leader of Hitler's atomic bomb project, came up with an "uncertainty principle" that has been used -- some say misused -- to suggest that things observed are altered by the fact of observation.
Translation: When you turn on the camera, the presence of the camera alters whatever transpires.
There isn't much we can do about the convergence of technology and the persistent plague of narcissism, but there is something we can do about Hitler. The moment he shows up in any form, turn off the cameras. Consider it an act of nonviolent protest -- and self-respect."
With no indication that last nights appearance on The Daily Show with Jon Stewart Betsy McCaughey gas resigned her position from Cantel Medical. Cantel makes dialysis machine and other medical devices.
A release from Cantel said:
"announced that on August 20, 2009 it received a letter of resignation from Ms. Elizabeth McCaughey as a director of the Company. Ms. McCaughey, who had served as a director since 2005, stated that she was resigning to avoid any appearance of a conflict of interest during the national debate over healthcare reform."
I can't believe that she would resign because of the possible appearance of conflict of interest. It seems that they asked her to leave.
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"Here are the net favorability ratings for Obama — i.e., the difference between the favorable and unfavorable ratings — broken down by party and compared with the previous week:
"And I am further intrigued by Krauthammer's claim that his living will is 'more a literary than a legal document.' I've filled out some impressively boring legal documents, but they don't exactly hold a candle to Dickens."
I am outraged by the people that say, “there are no ‘death panels’ in the Democratic health-care bills, and to say that there are is to debase the debate” but then go on to say that end of life counseling is the “subtle pressure applied by society through your doctor” to “gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.”
These quotes come from Charles Krauthammer in the Washington Post.His goal in the essay is surely not to assert that the “death panel” claims is a bunch of lies, it is to assert that there is no efficacy in the living will as a legal document.
Krauthammer writes about his own living will:
“My own living will, which I have always considered more a literary than a legal document, basically says: ‘I've had some good innings, thank you. If I have anything so much as a hangnail, pull the plug.’ I've never taken it terribly seriously because unless I'm comatose or demented, they're going to ask me at the time whether or not I want to be resuscitated if I go into cardiac arrest. The paper I signed years ago will mean nothing.”
I think he has missed the point of a living will and perhaps documents naming health care proxies.I find the claim that a family can know a person’s wishes better than that person knows himself or herself dubious.Krauthammer passes along a story about the death of his father.He writes:
“When my father was dying, my mother and brother and I had to decide how much treatment to pursue. What was a better way to ascertain my father's wishes: What he checked off on a form one fine summer's day years before being stricken; or what we, who had known him intimately for decades, thought he would want? The answer is obvious.”
Just because you say it is obvious does not make it correct or obvious.This confuses a family’s emotional desire to not lose a loved one with the wishes of the loved one.If the efficacy of the living will is so limited why have one at all.
I don’t understand why Krauthammer believes that doctors, the “white-coated authority whose chosen vocation is curing and healing”, would ignore, in the end of life consultations, the possibilities of life saving efforts that “can prolong the patient's otherwise hopeless condition for another six months” and focus on “hospice care and palliative care and other ways of letting go of life.”
I am sure Krauthammer would agree that life and death are both serious matters, as is the choices people make in both.So why would we want to diminish people’s wishes and minimize the value of a legal document that people create when they are thinking about the seriousness of death.
The question that needs to be asked is, when are we able to rationally think about our own mortality?Is our approach to death more practical as we get closer to mortality or in an earlier time in our lives?These are important questions that should be pondered by serious people.If Krauthammer has written a legal document that he does not take seriously why should we take him seriously?
Jon Stewart at The Daily Show does a fine job of staying ahead of McCaughey. Her arguments are not very robust and neither are Stewart's but he is a comedian. His arguments are more than sufficient to handle McCaughey's fear based misrepresentations.
McCaughey does come off as awfully condescending. Throwing out that she has a Phd and saying about Stewart, "Isn't he cute" as he is making his point (I think she did this twice. Perhap one time she called him funny not cute).
McCaughey sounds very disingenuous and came across as a paranoid. Stewart is an incredibly patient man. You can read the McCaughey "plan" to cover the uninsured it is not very clear or detailed. as Stewart points out the math doesn't quite work out.
It seems the tone of the agriculture town halls are more civil than those for health care. The respective stories for each are also more imaginative and pleasant. Ria Misra at Politics Daily:
"On Wednesday at the Iowa State Fair, a group of farmers gathered from all over the state. Walking straight past the 1,000-pound squash, a 600-pound butter sculpture of a cow and the stand selling fried Milky Way bars, the farmers sat down to detail some of the problems they were facing to their former governor."
But the two town halls intersect. Misra:
"It's not just the lack of insurance that's troubling farmers. Vilsack estimated that the out-of-pocket costs for people living in rural communities was about $1,000 more per year than their urban counterparts pay. 'Rural America really comes out at the short end of a very long stick under the current health care system,' he said."
You would think that Iowa's senior Senator would be talking about the health care plight of Iowan farmer's.
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"The members of that ultimate federal board will themselves not have examined or seen the patient in question. For another example of the growing, tumultuous resistance to "Dr. Obama," particularly among seniors, there is a July 29 Washington Times editorial citing a line from a report written by a key adviser to Obama on cost-efficient health care, prominent bioethicist Dr. Ezekiel Emanuel (brother of White House Chief of Staff Rahm Emanuel)."
And this:
"'As the Washington Post's Charles Lane penetratingly explains (Undue influence,' Aug. 8): the government would pay doctors to discuss with Medicare patients explanations of 'living wills and durable powers of attorney ... and (provide) a list of national and state-specific resources to assist consumers and their families' on making advance-care planning (read end-of-life) decisions.
Significantly, Lane adds that, 'The doctor 'shall' (that's an order) explain that Medicare pays for hospice care (hint, hint).'
But the Obama administration claims these fateful consultations are 'purely voluntary.' In response, Lane - who learned a lot about reading between the lines while the Washington Post's Supreme Court reporter - advises us:
'To me, 'purely voluntary' means 'not unless the patient requests one.''"
And this:
"I wonder whether Obama would be so willing to promote such health care initiatives if, say, it were 60 years from now, when his children will - as some of the current bills seem to imply - have lived their fill of life years, and the health care resources will then be going to the younger Americans?"
I appreciate his acknowledgement of the scarcity of medical care.His basic economics is correct that as demand rises prices will likely rise as well.The assumption misses the possibility that there is already demand for and consumption of medical care by the currently uninsured that helps to drives medical cost up.It is not as if the uninsured will be entering the market for health care for the first time.They will enter it in a more efficient method as opposed to the emergency room door.
As Stossel agrees with most reasonable people that the government is not actively trying to kill people with “death panels” so why is rationing an issue.Why shouldn't scarce resources be rationed or prioritized?We currently try to ration medical resources such as vaccines.We prioritize older people and younger people to be vaccinated for flu primarily because we have a scarcity of vaccines and some people are more vulnerable.
As it has been pointed out before is insurance company rationing more desirable?
The market place for medical services for people with insurance is weird.Stossel is correct that there is a "principal-agent problem." As you enter the doctor’s examination room are you the consumer of the medical services.I don’t think so.You are the consumer of health insurance but the insurance company is the consumer of the health care since they are the ones paying the doctor. Or at least that is what Stossel leads to believe.I think he is correct but why would a government payer make this problem worse.
I now that Stossel’s concern is for self-determination. Does the current health insurance structure give people the opportunity for self-determination after the purchase of the policy?Does a public option do any less?For real self-determinative system we would need to undo all insurance and make health care fee for service. You only get it if you can pay for it.
"After being besieged by protesters at meetings across his home state of Iowa, Grassley said he has concluded that the public has rejected the far-reaching proposals Democrats have put on the table, viewing them as overly expensive precursors to ''a government takeover of health care.'"
Grassley has made himself redundant by saying that the people have rejected the current health care proposals. The Post story reports Grassley as saying:
"Calls for reform are 'not quite as loud as people that say we ought to slow down or don't do anything,' he said. 'And I've got to listen to my people.'"
Grassley has joined Bachmann in not understanding his job.
"I think it's worth mentioning that the Grassley theory of 'the public' is pretty much the exact opposite of how American democracy is supposed to function. Famously, public representatives are supposed to distinguish between the 'vicious arts' of faction (Madison's words) and the 'permanent and aggregate interests of the community' (Hamilton's). Of course, it might be the case that protestors laying seige to Fort Grassley actually represent the aggregate interests of the public. But you won't find evidence for that conclusion at a townhall meeting.
On the other hand, there's a pretty interesting question about the nature of democracy here: Formal democracy measures only the number of preferences (tallying votes), and not the intensity of preferences (like passionate townhall protests) or the quality of preferences (like the opinion of some group of philosopher kings). But I'm going to go out on a limb and assume Senator Grassley is not asking those rich philosophical quesitons."
Clarke is correct Grassley is not pursuing any grand philosophical goal. He is playing politics and not doing his job.
The Boston Globe reports that Senator Ted Kennedy of Massachusetts has begun conversations to modify the state succession law to ensure that Mass. has two senators.
Hopefully the Mass. legislature can make this change quickly. This announcement from Kennedy does sound as if he plans to step down when the law is changed if he does not die before then.
Unfortunately the Globe reports that there may not be any political will to change the law.
"It is not within our power as members of Congress, it’s not within the enumerated powers of the Constitution, for us to design and create a national takeover of health care. Nor is it within our ability to be able to delegate that responsibility to the executive."
Bachmann is wrong about the congressional authority. What can promote the general welfare of the people more than health care. Article I section 8 if the US Constitution says:
"Section 8. The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States"
"Bachmann, however, is wrong about both the contents of the health care plan and the requirements of the Constitution. There is nothing in any of the health care bills under consideration which resembles a 'national takeover of health care.' Conservatives like to use this language when referring to the public health option. Like other insurers, the public option would collect premiums from people who choose to buy into it, and then spend those premiums to insure these participants.
Had Bachmann bothered to read Article I of the Constitution before going on Fox, she would have learned that Congress has the power to 'lay and collect taxes, duties, imposts and excises" and to 'provide for….the general welfare of the United States.' Rather than itemizing specific subject matters, such as health care, which Congress is allowed to spend money on, the framers chose instead to give Congress a broad mandate to spend money in ways that promote the 'general welfare.'"
On another issue of our form of government. In the video Sean Hannity says a congressman will vote for health care reform even if some of his constituents don't want him to. Hannity goes to say that he always thought that the job of a congressman was to represent his district. I know that this is a common thought and an understandable one, but it is not true by the constitution or by other founding documents.
Article I does not go into detail that a representative is simply a proxy for his constituents or what method should be utilized for deciding how to vote on legislation. James Madison in Federalist Paper No. 10 was concerned with the power of factions to influence laws and how to control for faction whether they be a majority faction of minority faction. Madison understands that the problem of faction can not be removed for society. He writes:
"CAUSES of faction cannot be removed, and that relief is only to be sought in the means of controlling its EFFECTS"
He continued:
"The effect of the first difference is, on the one hand, to refine and enlarge the public views, by passing them through the medium of a chosen body of citizens, whose wisdom may best discern the true interest of their country, and whose patriotism and love of justice will be least likely to sacrifice it to temporary or partial considerations. Under such a regulation, it may well happen that the public voice, pronounced by the representatives of the people, will be more consonant to the public good than if pronounced by the people themselves, convened for the purpose. On the other hand, the effect may be inverted. Men of factious tempers, of local prejudices, or of sinister designs, may, by intrigue, by corruption, or by other means, first obtain the suffrages, and then betray the interests, of the people. The question resulting is, whether small or extensive republics are more favorable to the election of proper guardians of the public weal; and it is clearly decided in favor of the latter by two obvious considerations:
In the first place, it is to be remarked that, however small the republic may be, the representatives must be raised to a certain number, in order to guard against the cabals of a few; and that, however large it may be, they must be limited to a certain number, in order to guard against the confusion of a multitude. Hence, the number of representatives in the two cases not being in proportion to that of the two constituents, and being proportionally greater in the small republic, it follows that, if the proportion of fit characters be not less in the large than in the small republic, the former will present a greater option, and consequently a greater probability of a fit choice.
In the next place, as each representative will be chosen by a greater number of citizens in the large than in the small republic, it will be more difficult for unworthy candidates to practice with success the vicious arts by which elections are too often carried; and the suffrages of the people being more free, will be more likely to centre in men who possess the most attractive merit and the most diffusive and established characters.
Madison believes that the representatives are not the proxies for the people but a filter for the public's views that may be more consonant "to the public good" than the voice of the people themselves. It can debated whether the current health care proposals are for the public good but it is does not debatable that congress can pass reform legislation even if a faction of constituents are against it.
The constitution limits the power of the branches of government to the delimited areas but doe it also limit the power of the populous in the process of legislating? It seems that the founders wanted it that way. Maybe Hannity should get a copies of both documents and share them with Representative Bachmann.
A digression:
In going back to the Federalist Paper #10 this evening I came across this line:
"No man is allowed to be a judge in his own cause, because his interest would certainly bias his judgment, and, not improbably, corrupt his integrity. With equal, nay with greater reason, a body of men are unfit to be both judges and parties at the same time; yet what are many of the most important acts of legislation, but so many judicial determinations, not indeed concerning the rights of single persons, but concerning the rights of large bodies of citizens?"
The Wall Street Journal is reporting that the Dems plan to split the health care bill in two pieces. They hope to handle the controversial stuff first then pass it through reconciliation.
The Journal reports:
"Most legislation in the Senate requires 60 votes to overcome a filibuster, but certain budget-related measures can pass with 51 votes through a parliamentary maneuver called reconciliation.
In recent days, Democratic leaders have concluded they can pack more of their health overhaul plans under this procedure, congressional aides said. They might even be able to include a public insurance plan to compete with private insurers, a key demand of the party's liberal wing, but that remains uncertain.
Other parts of the Democratic plan would be put to a separate vote in the Senate, including most of the insurance regulations that have been central to Mr. Obama's health-care message.
That bill would likely set new rules for insurers, such as requiring they accept anyone, regardless of pre-existing medical conditions. This portion of the health-care overhaul has already drawn some Republican support and wouldn't involve new spending, leading Democratic leaders to believe they could clear the 60-vote hurdle."
"I know that there's been a lot of misinformation in this debate and there are a some folks out there who are, frankly, bearing false witness. I need you to spread the facts and speak the truth.''
The administration seems to be getting back to its massive organizing skill. The Times:
"Organizing for America, the president's political organization based at the Democratic National Committee, is trying to rally its members. Last week about 60,000 volunteers sent messages to lawmakers, urging them to support Obama's health care agenda.
Obama plans Thursday to promote his plans in a conference call and online address to supporters that could draw huge numbers of listeners. He also will speak with Philadelphia-based radio talk show host Michael Smerconish, who will broadcast from the White House."
