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* Egypt is where Iraq is supposed to be.

Honorable Congressman Rangel:

I am currently very fortunate to have a job with a terrific health benefits package.

I haven't always been so fortunate. For periods between jobs, or when freelancing and self-employed I had to pay all my doctor bills out-of-pocket. That usually meant staying away from medical care--including preventive care--except for the Emergency Room.

But I couldn't afford that either.

I have wanted to go into business for myself for a couple of years now, but with a wife and child, I can't afford to pay the high insurance premiums, co-pays, and deductibles I would be forced to put up myself if we had an individual family policy.

My wife had breast cancer last year. It was diagnosed just after she had had major shoulder surgery.

We were lucky. We happened to have good coverage at the time, so she got the treatment she needed without waiting, haggling, or forgoing necessary tests and procedures.

HR636 -- Medicare for all -- is the most popular health reform legislation in the House, with ninety-four co-sponsors, and counting.

President Obama has explained why the steps to single-payer are beyond our accomplishing this year. Very well. Let us at least take good steps in that direction.

A strong public insurance option, available nationwide to everyone from the day the legislation takes effect could make health INSURANCE--if not CARE--accessible to everyone.

It's already a compromise from the reasonable solution: Single-payer healthcare.

We need to get the insurance companies and lobbyists out of our hospitals, clinics, and doctors' offices. They make universal healthcare unaffordable. Besides, there can be no meaningful cost reductions in a fee-for-service model.

Please fight for the right of your constituents to insure ourselves through a strong public insurance option, available to everyone nationwide, without delays or triggers, and under the control of Congress and the voters.

This is the only way to begin to work toward Single-payer, which is the long term solution to the problem of rising medical costs.

The problem of delivery of services is a different "bottle of medicine." Service delivery problems are not the same thing as payment/cost problems in our healthcare system. Yet neither set of issues can be resolved independently of the other.

Thank you for your leadership in the fight for a strong Public Insurance Option. We must win this fight.

It is only the first step on the path to an affordable and equitable system, and we still have very far to go.

Thank you and God bless you!

Sincerely,

Tracking the Blue Dogs

Scroll down for list of Blue Dogs in the Energy and Commerce Committee and the stats on how America's Affordable Healthy Choices Act will help the people in their districts.



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Blue Dogs Bark Up Wrong Tree

As Paul Krugman points out in his typically incisive and reasonable editorial in the Times today, An Incoherent Truth,

a plan without a public option to hold down insurance premiums would cost taxpayers more than a plan with such an option.

Government Information Warfare Pervasive

Many of these governments have honed their Internet strategies beyond censorship and are employing more subtle (and harder to detect) ways of controlling dissent, often by planting their own messages on the Web and presenting them as independent opinion. Op-Ed Contributor - Propaganda.com

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Obama's Birth Certificate

Go see for yourself

Maybe with universal healthcare somebody can get these sickos some antipsychotics.

On Oct. 31, 2008, Dr. Chiyome Fukino, director of the Hawaii Department of Health, issued this statement: "There have been numerous requests for Sen. Barack Hussein Obama’s official birth certificate. State law prohibits the release of a certified birth certificate to persons who do not have a tangible interest in the vital record.

"Therefore I, as director of health for the state of Hawaii, along with the registrar of Vital Statistics who has statutory authority to oversee and maintain these type of vital records, have personally seen and verified that the Hawaii State Department of Health has Sen. Obama's original birth certificate on record in accordance with state policies and procedures.

"No state official, including Gov. Linda Lingle, has ever instructed that this vital record be handled in a manner different from any other vital record in the possession of the state of Hawaii."

Even the governor of Hawaii, Linda Lingle, a Republican who at the time was stumping for John McCain, said it was on the up-and-up.

health care cost and access

Keeping the Wingnuts on the Front Page, Seriously

Nagouney takes the trouble to include this comment from Lamar Alexander in his new health care policy debate article in Political Memo:

There’s a huge price to be paid,” he added. “Bipartisanship is absolutely possible and it’s absolutely necessary, even when you have a Democratic president with huge majorities.

I wish Nagourney could have gotten a little more detail and specificity out of Senator Alexander, especially as far as "possible," "necessary,' and "price" are concerned.

Who Has Access To Max Baucus? : NPR

Who Has Access To Max Baucus? : NPR

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Blue Dogs Liberal With Lobbyists' Agenda

Over at Salon, Joe Conasen writes:

At a time when the Pentagon's annual cost overruns approach $300 billion a year -- dwarfing the entire defense budgets of most developed countries -- these "fiscal watchdogs" simply have nothing useful to say on the subject.

"Fiscally Conservative" Blue-Dog, Mike Ross is only fiscally conservative when it pleases his sponsors,... or, make that, donors.

A sample of Ross's press releases include:

*
Ross Helps Pass Pay-As-You-Go Rule for Federal Budget
Wednesday July 22, 2009 < Read more >
*
Ross Secures $4,000 in House for Yellow Bend Port
Tuesday July 21, 2009 < Read more >
*
Ross Secures $9,605,000 in House for Ouachita and Black Rivers
Tuesday July 21, 2009 < Read more >
*
Ross Secures $4,505,000 in House for Narrows Dam
Tuesday July 21, 2009 < Read more >
*
Ross Secures $5,122,000 in House for Millwood Lake
Tuesday July 21, 2009 < Read more >
*
Ross Secures $40,516,000 in House for McClellan-Kerr Arkansas River Navigation System
Tuesday July 21, 2009 < Read more >
*
Ross Secures $7 Million in House for DeGray Lake
Tuesday July 21, 2009 < Read more >
*
Ross Secures $1,366,000 in House for Gillham Lake
Tuesday July 21, 2009 < Read more >
*
Ross Secures $1,360,000 in House for Dierks Lake
Tuesday July 21, 2009 < Read more >
*
Ross Secures $1,752,000 in House for DeQueen Lake
Tuesday July 21, 2009 < Read more >
*
Ross Secures $2,485,000 in House for Boeuf and Tensas Rivers
Tuesday July 21, 2009 < Read more >
*
Ross Secures $7 Million in House for Blakely Mountain Dam
Tuesday July 21, 2009 < Read more >
*
Ross Secures Over $2 Million in House for Research at Dale Bumpers Center in Booneville
Wednesday July 15, 2009 < Read more >
*
Ross Secures $319,000 for UAM's Forestry Research Center
Wednesday July 15, 2009

I Hate The New Republic--But This is "Sadly Refreshing"

The Politics of Health Care Reform - The Plank

There's no mechanism in the current media configuration that would allow them [Democratic politicians] to convey the details of the plan in a positive way without getting overrun by negative process stories

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Status Quo Acceptable For Now, Ryan Intimates

Paul Ryan on Public Health Care Option:

The idea that the government should make decisions about how long people should live is deeply offensive to everything America stands for. It is no answer to say that health care resources are limited and will be rationed one way or another.

I guess he hasn't figured out yet that the US already rations healthcare on the basis of race, wealth and geographic location.

Big Media Power For Doublethink

It looks like the corporate media are still calling the dance tune for American thinking and political discourse:

"The public wants help with their health care bills and supports health reform, but the hotter the debate and the longer it lasts, the more anxious the public will become," said Kaiser President and CEO Drew Altman.

Regulation versus Chaos: Rep. Alan Grayson on What Really Happend at AIG

Is there any reason YOU can think of that this clip is buried in the CSPAN archives and not going viral on COMMERCIAL media--where the general public might actually see it?

The Birthers: Dobbs and Conservative Media Feeding "The Nutcases"

The Charlatans of Corporate Media get paid for misleading the unintelligent with falsehoods and partisan propaganda.

We Already Ration

So, why should everyone flinch at the idea of rationing health care?

Can you say, "Media Consolidation?"

But the British media leapt on the theme of penny-pinching bureaucrats sentencing sick people to death. The issue was then picked up by the U.S. news media and by those lobbying against health care reform in the United States.

Corporate media and their sponsors will tell the public what's in the public interest. No other ideas will enter the debate.

When the media feature someone like Bruce Hardy or Jack Rosser, we readily relate to individuals who are harmed by a government agency’s decision to limit the cost of health care. But we tend not to hear about — and thus don’t identify with — the particular individuals who die in emergency rooms because they have no health insurance.

tns media intelligence/cmag

tns media intelligence/cmagCampaign Media Analysis Group is working to tell you what to think about health care legislation (along with a bunch of other pr firms)

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More Health Care PR

Harry and Louise return with a newmessage

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Sickening Amounts of Healthcare Lobbying | Center for Media and Democracy

Sickening Amounts of Healthcare Lobbying | Center for Media and Democracy

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What the Media Isn't Covering in the Health Reform Debate--And Why It Matters

Frank Pasquale @Balkinization

1) There has been virtually no coverage of the views of those Americans who want more thoroughgoing reform than is currently on the table.

2) We hear very little about the $1.4 million dollars a day spent by lobbyists to water down or otherwise obstruct reform. As Ezra Klein notes, "At times, the efforts at influence peddling border on the comic: One June 10 meeting saw Max Baucus's aides sitting down with two of Max Baucus's former chiefs of staff, who were representing different groupings of health-care industry interests."

3) I can almost guarantee that no mainstream TV outlet will explore in detail the real economic dynamics that now dominate health care--despite the fact that "few markets are as concentrated, opaque and complex, and subject to rampant anticompetitive and deceptive conduct."

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Small Business Faces Big Bite - WSJ.com

WSJ quotes lobbyists to promote anti-reform positions

"This bill costs too much, it covers too few and it has way too much government involvement," said Michelle Dimarob, a lobbyist with the National Federation of Independent Business, the main trade group for small firms. "Small business doesn't want any of those things."

If small business doesn't want any of those things, they should tell the Senate Republicans and House minority leaders, who are all lobbying intensively to retain the employer-based structure. It's much more expensive than the Public Option or Single Payer.

The CBO estimated the public plan offered by the bill would be roughly 10 percent less expensive than other plans in the insurance exchange...


U.S. Congress,

Congressional Budget Office,

Washington, DC, January 21, 2009.

Hon. Charles B. Rangel,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.

DEAR MR. CHAIRMAN: At your request, CBO has analyzed the effect on federal direct spending and revenues of the Health Information Technology for Economic and Clinical Health (HITECH) Act as posted on the Web site of the Committee on Ways and Means on January 16, 2009. 1

[Footnote]

[Footnote 1: See http://waysandmeans.house.gov/media/pdf/110/sbill.pdf. The HITECH Act is title IV.]

The HITECH Act would establish payment incentives in the Medicare and Medicaid programs to encourage providers to adopt health information technology (health IT). Health IT refers to information technology applications specifically designed for the practice of clinical medicine, including electronic health records (EHR), personal health records, health information exchange, computerized physician order entry, clinical decision support systems, and electronic prescribing. To meet the requirements set forth in the bill, providers would have to purchase a `qualifying electronic health record' system with a standard package of functionalities. Although adoption would be encouraged through payment incentives in the Medicare and Medicaid programs, all health care spending--both public and private--would be affected by the increased use of health IT. CBO expects that its adoption on a nationwide basis would reduce total spending on health care by diminishing the number of inappropriate tests and procedures, reducing paperwork and administrative overhead, and decreasing the number of adverse events resulting from medical errors.

The bill also would accelerate spending from the Medicare Improvement Fund, provide funding for some costs incurred by the Centers for Medicare & Medicaid Services in administering the payment-incentive provisions, and make other changes to the Medicare program.

As a result of the HITECH Act's effects on direct spending and revenues, CBO estimates that enacting the bill would increase on-budget deficits by a total of $17.1 billion over the 2009-2019 period; it would increase the unified budget deficit over the same period by an estimated $15.8 billion (see attached table). The effects on direct spending and revenues over the 2009-2013 and 2009-2018 periods are relevant for enforcing pay-as-you-go rules under the current budget resolution. CBO estimates that those effects would increase on-budget deficits by $15.5 billion over the 2009-2013 period and $19.8 billion over the 2009-2018 period.

This legislation also would authorize the appropriation of such sums as are necessary for the Office of the National Coordinator for Health Information Technology to develop a national infrastructure for health IT, as well as activities related to the promotion of IT adoption. The amount of such funding could vary greatly depending on what the Congress decides to appropriate for those purposes.

Direct spending

Bonus Payments and Penalties. The bill would establish a schedule of Medicare bonus payments, beginning in 2011, that would be paid to hospitals and physicians that adopt and use qualifying health IT. Beginning in 2016, Medicare would reduce payment rates to hospitals and physicians that are not using qualifying health IT. (Payment adjustments also would be applied to Medicare Advantage plans that operate hospitals or employ physicians.) Medicare's bonus payments and penalties would not affect the Part B premiums (which are set to cover one-quarter of that program's costs) or the benchmarks that are used in the calculation of payment rates for Medicare Advantage plans. CBO estimates that spending for the bonuses and payment reductions from the penalties would increase net Medicare spending by $17.7 billion over the 2011-2019 period.

The bill also would establish bonus payments (but not penalties) in the Medicaid program for providers that adopt and use qualifying health IT. The Medicaid bonus payments to providers would be paid entirely by the federal government; the federal government also would pay states 90 percent of certain administrative costs related to the bonus-payment program. CBO estimates that the direct effect on Medicaid spending from those provisions would be an increase of $12.4 billion over the 2011-2019 period. In combination, net Medicare and Medicaid spending for bonuses and penalties would total $30.0 billion over that period.

Under current law, CBO estimates that about 45 percent of hospitals and 65 percent of physicians will have adopted qualifying health IT in 2019. 2

[Footnote] CBO estimates the incentive mechanism would boost those adoption rates to about 70 percent for hospitals and about 90 percent for physicians.

[Footnote 2: In Budget Options, Volume 1: Health Care (December, 2008), CBO stated that, by 2019, about 40 percent of physicians will adopt health IT that conforms to interoperability standards for that year. The higher adoption rate mentioned above reflects a less-stringent standard to qualify for bonus payments or avoid penalties under the HITECH Act.]

Spending for Benefits. CBO anticipates that accelerating the adoption of health IT would result in reductions in health care spending. Those reductions would be realized by, among other things, reducing the number of inappropriate tests and procedures, reducing paperwork and administrative overhead, and decreasing the number of adverse events resulting from medical errors. Health IT could also improve the quality of care provided to patients by improving the information available to clinicians at the time of treatment, by encouraging the use of evidence-based medicine, and by helping physicians manage patients with complex, chronic conditions. The use of health IT could also increase some costs because improved adherence to treatment protocols could increase the amount of care provided. On net, CBO estimates that the accelerated adoption of health IT that would result from implementing the HITECH Act would reduce costs in the health care system by about 0.3 percent during the 2011-2019 period. 3

[Footnote]

[Footnote 3: CBO anticipates near universal adoption of health IT over the next quarter century even without legislative action. As a result, the 0.3 percent reduction in health care costs estimated to result in the near term from enactment of this bill would diminish in later years, when the use of health IT will be more pervasive in any event.]

Under Medicare's current payment rules, the only savings in Medicare's expenditures from the adoption of health IT would be from reducing the utilization of some types of services--for example, by reducing the probability of hospital admissions resulting from preventable adverse medical events or reducing the utilization of unnecessary diagnostic services. Health IT also would help providers reduce their operating costs.

However, because Medicare's payment rates in the fee-for-service sector are not adjusted to reflect changes in such operating costs, those savings would not result in lower expenditures for the Medicare program. CBO estimates that the changes in utilization from accelerating the adoption of health IT would reduce Medicare spending by $4.4 billion over the 2011-2019 period.

By contrast, CBO expects that state Medicaid programs, plans in the Federal Employees Health Benefits (FEHB) program, and private insurance plans would negotiate payment rates with providers that would enable those payers to realize most of the savings from reductions in providers' operating costs (in addition to realizing the savings from reducing the utilization of some types of services). CBO estimates that the resulting federal savings in Medicaid would total $7.3 billion over the 2011-2019 period.

Federal payments of FEHB premiums for retired federal employees are considered direct spending. (Most contributions for retired employees of the U.S. Postal Service are considered off-budget direct spending.) CBO estimates that enacting the HITECH Act would reduce on-budget direct spending for the FEHB program by $0.5 billion over the 2011-2019 period, and would reduce off budget direct spending for the FEHB program by an additional $0.2 billion. Thus, the total reduction in direct spending for the FEHB program would amount to $0.7 billion over the 2011-2019 period. 4

[Footnote]

[Footnote 4: CBO also estimates that enacting the HITECH Act would reduce the cost of health insurance for active federal workers by about $0.1 billion over the 2009-2014 period. Those costs are considered discretionary spending because the federal she of FEHB premiums for active workers is funded through appropriations to the agencies that employ those workers. Realizing the potential discretionary savings would require adjustments to the amounts appropriated to each agency.]

In total, CBO estimates that enacting the HITECH Act would reduce federal direct spending for benefits in the Medicare, Medicaid, and FEHB programs by about $12 billion over the 2011-2019 period.

Other Direct Spending. The HITECH Act would modify the timing of spending from the Medicare Improvement Fund, which the Secretary of Health and Human Services may use to make improvements in the fee-for-service program. The bill would accelerate that spending from 2016, 2017, and 2018 to 2014 and 2015; that change would not affect total Medicare spending over the 2009-2013 or 2009-2018 periods. The bill also would provide about $0.9 billion to pay for some of the administrative costs that the Centers for Medicare & Medicaid Services would incur in implementing the new payment-incentive provisions. It also would modify certain payment rates and rules for hospices and certain hospitals. CBO estimates those changes would cost $0.3 billion over the 2009-2019 period (with most of that spending in 2009).

Federal revenues

Because accelerating the use of health IT would lower health care costs for private payers, it would result in lower health insurance premiums in the private sector. As a result, private employers would pay less of their workers' compensation in the form of tax-advantaged health insurance premiums and more in the form of taxable wages and salaries. Therefore, federal tax revenues would increase. CBO estimates that on-budget revenues (from income taxes and the Hospital Insurance payroll tax--for Medicare Part A) would increase by $2.0 billion over the 2011-2019 period. Higher receipts from Social Security payroll taxes, which are off-budget, would add another $1.1 billion, resulting in an estimated increase in total tax revenues of $3.1 billion over the 2011-2019 period.

If you wish further details on this estimate, we wi11 be pleased to provide them. The CBO staff contact is Tom Bradley.

Sincerely,

Robert A. Sunshine,

Acting Director.

Attachment.

ESTIMATED EFFECT ON FEDERAL DIRECT SPENDING AND REVENUES OF THE HEALTH INFORMATION TECHNOLOGY FOR ECONOMIC AND CLINICAL HEALTH ACT OF 2009, AS POSTED ON THE WEB SITE OF THE COMMITTEE ON WAYS AND MEANS ON JANUARY 16, 2009

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------

by fiscal years; in billions of dollars--

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2009-2019

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------

CHANGES IN DIRECT SPENDING (Outlays)

Bonus Payments and Penalties:

Medicare 0 0 2.7 4.6 5.0 4.0 2.5 0.9 -0.2 -0.9 -1.0 17.7

Medicaid 0 0 1.5 1.9 2.2 2.1 1.7 1.5 0.8 0.5 0.3 12.4

Subtotal 0 0 4.2 6.5 7.1 6.1 4.3 2.4 0.6 -0.4 -0.7 30.0

Changes in Spending for Benefits:

Medicare 0 0 -0.1 -0.3 -0.5 -0.6 -0.6 -0.6 -0.6 -0.6 -0.6 -4.4

Medicaid 0 0 -0.4 -0.6 -0.8 -0.8 -0.9 -0.9 -0.9 -1.1 -1.1 -7.3

FEHB (on-budget) 0 0 * * -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.5

Subtotal, on-budget 0 0 -0.5 -0.9 -1.3 -1.5 -1.5 -1.5 -1.6 -1.8 -1.7 -12.1

FEHB (off-budget) 0 0 * * * * * * * * * -0.2

Subtotal, Changes in Spending for Benefits 0 0 -0.5 -0.9 -1.3 -1.5 -1.5 -1.6 -1.6 -1.8 -1.7 -12.3

Medicare Improvement Fund 0 0 0 0 0 9.2 1.2 -6.3 -3.5 -0.7 0 0

Mandatory Administrative Funding:

Medicare 0.1 0.1 0.1 0.1 0.1 0.1 0.1 * * * * 0.5

Medicaid * * * * * * * * * * * 0.4

Subtotal 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.9

Other Provisions 0.3 * * 0 0 0 0 0 0 0 0 0.3

Total Changes in Direct Spending 0.4 0.1 3.8 5.7 5.9 13.9 4.1 -5.4 -4.4 -2.8 -2.4 18.9

CHANGES IN REVENUES

Income and HI Payroll Taxes (on-budget) 0 0 0.1 0.1 0.2 0.3 0.3 0.3 0.3 0.3 0.3 2.0

Social Security Payroll Taxes (off-budget) 0 0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.1 1.1

Total Revenue Changes 0 0 0.1 0.2 0.3 0.4 0.4 0.4 0.4 0.4 0.4 3.1

CHANGES IN FEDERAL DEFICITS FROM DIRECT SPENDING AND REVENUES 1

On-budget Changes 0.4 0.1 3.8 5.6 5.7 13.7 3.8 -5.6 -4.7 -3.1 -2.6 17.1

Total Changes 0.4 0.1 3.7 5.5 5.6 13.5 3.7 -5.7 -4.8 -3.2 -2.8 15.8

Memorandum:

Changes in Direct Spending, by Program:

Medicare 0.3 0.1 2.7 4.4 4.5 12.6 3.2 -5.9 -4.2 -2.1 -1.5 14.2

Medicaid * * 1.2 1.4 1.5 1.4 0.9 0.6 -0.1 -0.6 -0.8 5.4

FEHB (Total) 0 0 0.0 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.7

See also Pew and New America analyses.


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Fallacy From The Oval Office

Ray McGovern points out a June 7, 2004 Legal Memo signed by President George W. Bush that was declassified in 2007, in which the President "reasons" that:

Of course, our values as a nation, values we share with many nations in the world, call for us to treat detainees humanely, including those who are not legally entitled to such treatment. (emphasis added)

This is part of the hairsplitting over the status of so-called enemy combatants as opposed to genuine prisoners of war.

Morons!

The laws of the United States and the Geneva Conventions to which the US subscribes state that all people are entitled to humane treatment. That's why the laws were codified: to give sanction and recognition to this fact.

People are not treated humanely just because the law says so. The law requires us to treat people humanely because it is right. There's no middle ground.

Furthermore, the law also states that only courts can determine the guilt or innocence of prisoners.

Or, as that legalist St. Paul said in his Letter to the Romans:

... in that which you judge another, you condemn yourself; for you who judge practice the same things. Romans 2:1.

Jane Hamsher on Health Care

This person is exactly what we need to fire up the popular pressure for real health care reform: a crusader.

How she ever got in to talk to these people is testament to her ardor and determination.

May the groundswell continue!

Settler assaults Peace Now volunteers, Channel 2 news broadcast

Here's a story never seen on American news broadcasting.

Obama's False Friends of Health Reform | Center for Media and Democracy

Good old CMD has a great blog post by Mr. Potter, the singing reformed insurance man.

The health insurance industry and its allies are working hard right now to convince you that the creation of a public insurance option would put a government bureaucrat between you and your doctor. As the 2004 Wall Street Journal article makes it clear, however, EMIS was at its heart a system that put corporate bureaucrats between people and their doctors

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Howard Kurtz's wasted opportunity | Media Matters for America

Karl Frisch is right. This post by Jameson Foser is a Must Read.

For example,

Much has been written about Kurtz's (frequently undisclosed) conflicts of interest, his fondness for right-wingers like Michelle Malkin, and his tendency to give their critique of the media more credence than more substantive and factual critiques from progressives. I think it's clear that, whether or not Kurtz personally leans a bit to the right, his media criticism certainly does.

But that isn't why many of his readers and viewers find him so frustrating. What is really bothersome about Kurtz is that he so often gives the impression that he simply lacks the competence to critique the media. He frequently seems to overlook the obvious -- and when it is pointed out to him, it sails right over his head.

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