Bob Cesca's Awesome Blog
August 31, 2009
Lesson in Republican politics.
When does it end?
Unless the bill privatizes Medicare, abolishes Social Security and replaces Secretary Sebelius with Kelly Prejean, Republicans will vote against any healthcare reform bill.
I don't agree that the White House and the Democrats need to employ the crazy, illegal tactics of the Bush administration. But crumbling and capitulating every time the Republicans make a loud noise is disgraceful.
Copyright 2009 Bob Cesca's Awesome Blog
Yes, the president would do well to make a much stronger push for the public option. But it's really not up to him. Congress writes the law. And the following might be the most effective argument in support of the public option when it comes down to attacking the Republicans and the Blue Dogs who are threatening to kill the plan:
The CBO estimates that the public option would save about $150 billion over the next ten years -- that's roughly $1,100 for every taxpayer. I'm certainly not thrilled to have to pay an additional $1,100 in taxes because some Blue Dog Democrats want to placate their friends in the insurance industry.
Why do the Blue Dogs and Republicans want to raise my taxes? This is a terrific argument and we should be repeating this to everyone who will listen. Especially the lawmakers on our contact list.
Adding... Of course I understand and embrace the moral reasons for the public option. This is about hitting the Republicans and Blue Dogs from their right flank on something that resonates with voters: taxes.
Copyright 2009 Bob Cesca's Awesome Blog
The future of healthcare in America, according to Sarah Palin, might look something like this: A sick 17-year-old girl needs a liver transplant. Doctors find an available organ, and they're ready to operate, but the bureaucracy -- or as Palin would put it, the "death panel" -- steps in and says it won't pay for the surgery. Despite protests from the girl's family and her doctors, the heartless hacks hold their ground for a critical 10 days. Eventually, under massive public pressure, they relent -- but the patient dies before the operation can proceed.
It certainly sounds scary enough to make you want to go show up at a town hall meeting and yell about how misguided President Obama's healthcare reform plans are. Except that's not the future of healthcare -- it's the present. Long before anyone started talking about government "death panels" or warning that Obama would have the government ration care, 17-year-old Nataline Sarkisyan, a leukemia patient from Glendale, Calif., died in December 2007, after her parents battled their insurance company, Cigna, over the surgery. Cigna initially refused to pay for it because the company's analysis showed Sarkisyan was already too sick from her leukemia; the liver transplant wouldn't have saved her life.
That kind of utilitarian rationing, of course, is exactly what Palin and other opponents of the healthcare reform proposals pending before Congress say they want to protect the country from. "Such a system is downright evil," Palin wrote, in the same message posted on Facebook where she raised the "death panel" specter. "Health care by definition involves life and death decisions."
Coverage of Palin's remarks, and former House Speaker Newt Gingrich's defense of them, over the weekend did point out that the idea that the reform plans would encourage government-sponsored euthanasia is one of a handful of deliberate falsehoods being peddled by opponents of the legislation. But the idea that only if reform passes would the government start setting up rationing and interfering with care goes beyond just the bogus euthanasia claim.
Opponents of reform often seem to skip right past any problems with the current system -- but it's rife with them. A study by the American Medical Association found the biggest insurance companies in the country denied between 2 and 5 percent of claims put in by doctors last year (though the AMA noted that not all the denials were improper). There is no national database of insurance claim denials, though, because private insurance companies aren't required to disclose such stats. Meanwhile, a House Energy and Commerce Committee report in June found that just three insurance companies kicked at least 20,000 people off their rolls between 2003 and 2007 for such reasons as typos on their application paperwork, a preexisting condition or a family member's medical history. People who buy insurance under individual policies, about 6 percent of adults, may be especially vulnerable, but the 63 percent of adults covered by employer-provided insurance aren't immune to difficulty.
"You're asking us to decide that the government is to be trusted," Gingrich -- who may, like Palin, be running for the GOP's presidential nomination in 2012 -- told ABC's "This Week With George Stephanopoulos" on Sunday. But as even a quick glance through news coverage of the last few years shows, private insurers are already doing what reform opponents say they want to save us from. (The insurance industry, pushing back against charges that they're part of the problem, said last month that "healthcare reform is far too important to be dragged down by divisive political rhetoric." The industry has long maintained that its decisions on what to cover are the result of careful investigations of each claim.) Here is a look at a handful of healthcare horror stories, brought to you by the current system. It took Salon staff less than an hour to round these up -- which might indicate how many other such stories are out there.
-- In June 2008, Robin Beaton, a retired nurse from Waxahachie, Texas, found out she had breast cancer and needed a double mastectomy. Two days before her surgery, her insurance company, Blue Cross, flagged her chart and told the hospital they wouldn't allow the procedure to go forward until they finished an examination of five years of her medical history -- which could take three months. It turned out that a month before the cancer diagnosis, Beaton had gone to a dermatologist for acne treatment, and Blue Cross incorrectly interpreted a word on her chart to mean that the acne was precancerous.
Not long into the investigation, the insurer canceled her policy. Beaton, they said, had listed her weight incorrectly when she bought it, and had also failed to disclose that she'd once taken medicine for a heart condition -- which she hadn't been taking at the time she filled out the application. By October, thanks to an intervention from her member of Congress, Blue Cross reinstated Beaton's insurance coverage. But the tumor she had removed had grown 2 centimeters in the meantime, and she had to have her lymph nodes removed as well as her breasts amputated because of the delay.
-- In October 2008, Michael Napientak, a doorman from Clarendon Hills, Ill., went to the hospital for surgery to relieve agonizing back pain. His wife's employer's insurance provider, a subsidiary of UnitedHealthCare, had issued a pre-authorization for the operation. The operation went well. But in April, the insurer started sending notices that it wouldn't pay for the surgery, after all; the family, not the insurance provider, would be on the hook for the $148,000 the hospital charged for the procedure. Pre-authorization, the insurance company explained, didn't necessarily guarantee payment on a claim would be forthcoming. The company offered shifting explanations for why it wouldn't pay -- first, demanding proof that Napientak had tried less expensive measures to relieve his pain, and then, when he provided it, insisting that it lacked documentation for why the surgery was medically necessary. Napientak's wife, Sandie, asked her boss to help out, but with no luck. Fortunately for the Napientaks, they were able to attract the attention of a Chicago Tribune columnist before they had to figure out how to pay the six-figure bill -- once the newspaper started asking questions, the insurer suddenly decided, "based on additional information submitted," to cover the tab, after all.
-- David Denney was less than a year old when he was diagnosed in 1995 with glutaric acidemia Type 1, a rare blood disorder that left him severely brain damaged and unable to eat, walk or speak without assistance. For more than a decade, Blue Cross of California -- his parents' insurance company -- paid the $1,200 weekly cost to have a nurse care for him, giving him exercise and administering anti-seizure medication.
But in March 2006, Blue Cross told the Denney family their claims had exceeded the annual cost limit for his care. When they wrote back, objecting and pointing out that their annual limit was higher, the company changed its mind -- about the reason for the denial. The nurse's services weren't medically necessary, the insurers said. His family sued, and the case went to arbitration, as their policy allowed. California taxpayers, meanwhile, got stuck with the bill -- after years of paying their own premiums, the Denney family went on Medi-Cal, the state's Medicaid system.
-- Patricia Reilling opened an art gallery in Louisville, Ky., in 1987, and three years later took out an insurance policy for herself and her employees. Her insurance provider, Anthem Health Plans of Kentucky, wrote to her this June, telling her it was canceling her coverage -- a few days after it sent her a different letter detailing the rates to renew for another year and billing her for July.
Reilling thinks she knows the reason for the cutoff, though -- she was diagnosed with breast cancer in March 2008. That kicked off a year-long battle with Anthem. First the company refused to pay for an MRI to locate the tumors, saying her family medical history didn't indicate she was likely to have cancer. Eventually, it approved the MRI, but only after she'd undergone an additional, painful biopsy. Her doctor removed both of her breasts in April 2008. In December, she went in for reconstructive plastic surgery -- and contracted a case of MRSA, an invasive infection. In January of this year, Reilling underwent two more surgeries to deal with the MRSA infection, and she's likely to require another operation to help fix all the damage. The monthly bill for her prescription medicines -- which she says are mostly generics -- is $2,000; the doctors treating her for the MRSA infection want $280 for each appointment, now that she's lost her insurance coverage. When she appealed the decision to cancel her policy, asking if she could keep paying the premium and continue coverage until her current course of treatment ends, the insurers wrote back with yet another denial. But they did say they hoped her health improved.
-- Additional reporting by Tim Bella
Copyright ©2009 Salon Media Group, Inc.
At no other time in this debate over healthcare reform has there been a more obvious set of enemies.
The Republicans, talk radio and Fox News are fabricating off-the-wall lies practically on a daily basis. The Healther crazies are mobilized by corporate lobbyists. Blue Dogs are holding up progress. The corporate press is all but signing the death sentence for Healthcare Reform 2009. And the public option? Jesus H, I long for the days when we were just fighting for that -- now it looks like we'll be lucky to get any sort of healthcare reform in general.
So what do we do when these enemies are so well defined and screaming out for razor-sharp counterattacks?
Why, we're liberals and progressives. We attack each other, of course!
For example, four of the eight Recommended Diaries on Daily Kos are screeds attacking the administration. I don't know quite what to make of this dynamic, but the overall narrative seems skewed and misguided right now. I can say for certain that, whether justified or not, there's a time and a place for everything, and, right now, there are a clear set of opposition targets and they're ripe for the picking.
Copyright 2009 Bob Cesca's Awesome Blog
He should know. Thursday was the eighth anniversary of “Bin Laden Determined to Strike in U.S.,” the President’s Daily Brief that his boss ignored while on vacation in Crawford. Aug. 29 marks the fourth anniversary of Hurricane Katrina’s strike on the Louisiana coast, which his boss also ignored while on vacation in Crawford.
So do have a blast in Martha’s Vineyard, President Obama.
Even as we wait for some unexpected disaster to strike, Beltway omens for the current White House are grim. Obama’s poll numbers are approaching free fall, we are told. If he fails on health care, he’s toast. Indeed, many of the bloviators who spot a fatal swoon in the Obama presidency are the same doomsayers who in August 2008 were predicting his Election Day defeat because he couldn’t “close the deal” and clear the 50 percent mark in matchups with John McCain.
Here are two not very daring predictions: Obama will get some kind of health care reform done come fall. His poll numbers will not crater any time soon.
Yet there is real reason for longer-term worry in the form of a persistent, anecdotal drift toward disillusionment among some of the president’s supporters. And not merely those on the left. This concern was perhaps best articulated by an Obama voter, a real estate agent in Virginia, featured on the front page of The Washington Post last week. “Nothing’s changed for the common guy,” she said. “I feel like I’ve been punked.” She cited in particular the billions of dollars in bailouts given to banks that still “act like they’re broke.”
But this mood isn’t just about the banks, Public Enemy No. 1. What the Great Recession has crystallized is a larger syndrome that Obama tapped into during the campaign. It’s the sinking sensation that the American game is rigged — that, as the president typically put it a month after his inauguration, the system is in hock to “the interests of powerful lobbyists or the wealthiest few” who have “run Washington far too long.” He promised to smite them.
No president can do that alone, let alone in six months. To make Obama’s goal more quixotic, the ailment that he diagnosed is far bigger than Washington and often beyond politics’ domain. What disturbs Americans of all ideological persuasions is the fear that almost everything, not just government, is fixed or manipulated by some powerful hidden hand, from commercial transactions as trivial as the sales of prime concert tickets to cultural forces as pervasive as the news media.
It’s a cynicism confirmed almost daily by events. Last week Brian Stelter of The Times reported that the corporate bosses of MSNBC and Fox News, Jeffrey Immelt of General Electric and Rupert Murdoch of News Corporation, had sanctioned their lieutenants to broker what a G.E. spokesman called a new “level of civility” between their brawling cable stars, Keith Olbermann and Bill O’Reilly. A Fox spokesman later confirmed to Howard Kurtz of The Post that “there was an agreement” at least at the corporate level. Olbermann said he was a “party to no deal,” and in any event what looked like a temporary truce ended after The Times article was published. But the whole scrape only fed legitimate suspicions on the right and left alike that even their loudest public voices can be silenced if the business interests of the real American elite decree it.
You might wonder whether networks could some day cut out the middlemen — anchors — and just put covert lobbyists and publicists on the air to deliver the news. Actually, that has already happened. The most notorious example was the flock of retired military officers who served as television “news analysts” during the Iraq war while clandestinely lobbying for defense contractors eager to sell their costly wares to the Pentagon.
The revelation of that scandal did not end the practice. Last week MSNBC had to apologizefor deploying the former Newsweek writer Richard Wolffe as a substitute host for Olbermann without mentioning his new career as a corporate flack. Wolffe might still be anchoring on MSNBC if the blogger Glenn Greenwald hadn’t called attention to his day job. MSNBC assured its viewers that there were no conflicts of interest, but we must take that on faith, since we still don’t know which clients Wolffe represents as a senior strategist for his firm, Public Strategies, whose chief executive is the former Bush White House spin artist, Dan Bartlett.
Let’s presume that Wolffe’s clients do not include the corporate interests with billions at stake in MSNBC and Washington’s Topic A, the health care debate. If so, he’s about the only player in the political-corporate culture who’s not riding that gravy train.
As Democrats have pointed out, the angry hecklers disrupting town-hall meetings convened by members of Congress are not always ordinary citizens engaging in spontaneous grass-roots protests or even G.O.P. operatives, but proxies for corporate lobbyists. One group facilitating the screamers is FreedomWorks, which is run by the former Congressman Dick Armey, now a lobbyist at the DLA Piper law firm. Medicines Company, a global pharmaceutical business, has paid DLA Piper more than $6 million in lobbying fees in the five years Armey has worked there.
But the Democratic members of Congress those hecklers assailed can hardly claim the moral high ground. Their ties to health care interests are merely more discreet and insidious. As Congressional Quarterly reported last week, industry groups contributed almost $1.8 million in the first six months of 2009 alone to the 18 House members of both parties supervising health care reform, Nancy Pelosi and Steny Hoyer among them.
Then there are the 52 conservative Blue Dog Democrats, who have balked at the public option for health insurance. Their cash intake from insurers and drug companies outpaces their Democratic peers by an average of 25 percent, according to The Post. And let’s not forget the Democratic Senate Campaign Committee, which has raked in nearly $500,000 from a single doctor-owned hospital in McAllen, Tex. — the very one that Obama has cited as a symbol of runaway medical costs ever since it was profiled in The New Yorker this spring.
In this maze of powerful moneyed interests, it’s not clear who any American in either party should or could root for. The bipartisan nature of the beast can be encapsulated by the remarkable progress of Billy Tauzin, the former Louisiana congressman. Tauzin was a founding member of the Blue Dog Democrats in 1994. A year later, he bolted to the Republicans. Now he is chief of PhRMA, the biggest pharmaceutical trade group. In the 2008 campaign, Obama ran a television ad pillorying Tauzin for his role in preventing Medicare from negotiating for lower drug prices. Last week The Los Angeles Times reported — and The New York Times confirmed — that Tauzin, an active player in White House health care negotiations, had secured a behind-closed-doors flip-flop, enlisting the administration to push for continued protection of drug prices. Now we know why the president has ducked his campaign pledge to broadcast such negotiations on C-Span.
The making of legislative sausage is never pretty. The White House has to give to get. But the cynicism being whipped up among voters is justified. Unlike Hillary Clinton, whose chief presidential campaign strategist unapologetically did double duty as a high-powered corporate flack, Obama promised change we could actually believe in.
His first questionable post-victory step was to assemble an old boys’ club of Robert Rubin protégés and Goldman-Citi alumni as the White House economic team, including a Treasury secretary, Timothy Geithner, who failed in his watchdog role at the New York Fed as Wall Street’s latest bubble first inflated and then burst. The questions about Geithner’s role in adjudicating the subsequent bailouts aren’t going away, and neither is the angry public sense that the fix is still in. We just learned that nine of those bailed-out banks — which in total received $175 billion of taxpayers’ money, but as yet have repaid only $50 billion — are awarding a total of $32.6 billion in bonuses for 2009.
It’s in this context that Obama can’t afford a defeat on health care. A bill will pass in a Democrat-controlled Congress. What matters is what’s in it. The final result will be a CAT scan of those powerful Washington interests he campaigned against, revealing which have been removed from the body politic (or at least reduced) and which continue to metastasize. The Wall Street regulatory reform package Obama pushes through, or doesn’t, may render even more of a verdict on his success in changing the system he sought the White House to reform.
The best political news for the president remains the Republicans. It’s a measure of how out of touch G.O.P. leaders like Mitch McConnell and John Boehner are that they keep trying to scare voters by calling Obama a socialist. They have it backward. The larger fear is that Obama might be just another corporatist, punking voters much as the Republicans do when they claim to be all for the common guy. If anything, the most unexpected — and challenging — event that could rock the White House this August would be if the opposition actually woke up.
Copyright 2009 The New York Times Company