It was never about health care

September 11 let the air out of many Americans' sense of invulnerability. Fear filled the vacuum left behind and intensified the darkness already there. Fear of change. Fear of the unknown. Fear of the Other.

At dinner last night we talked about what was really behind the right's histrionic response to enactment of health insurance reform -- reform based in too large a part on Republican ideas. By the time the Sunday New York Times was online, Frank Rich had transcribed the essentially the same conversation under the title we might have given it, The Rage Is Not About Health Care:

Healthcaremageddon

A post by David Frum, the former speechwriter for President George W. Bush, David Frum, that I cited Sunday night was all over the Net on Monday. Frum's take on the anti-government hysteria surrounding the health care debate included this:

Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

Today, President Obama signs the Senate bill passed on Sunday. Passage of the health care bill is a Republican Waterloo, Frum writes. Maybe. But I’ll be holding my breath for some time afterwards.

It’s Not Real Reform If It Doesn’t End The Need For This

From the National Association of Free Clinics event going on now in Kansas City, MO:



Over at Firedoglake, nyceve has more. At timestamp 3:06, she starts losing it:



(Cross-posted from Scrutiny Hooligans)

Nevadans Not Wild About Harry

Jane Hamsher at Firedoglake has been warning that Harry Reid will pay a steep price if he doesn’t do whatever it takes (including using reconciliation) to pass a Senate health care bill with a public option intact.

A recent Mason-Dixon poll shows that Reid has plenty of trouble ahead even without incurring the wrath of the blogosphere.

Two potential Republican challengers – former Nevada basketball star, Danny Tarkanian, and former state GOP chair and former television anchorwoman, Sue Lowden – both outpoll Reid by a minimum of six percentage points. Both outpoll Reid among independents by double digits.

Politics Daily suspects there may be “an anybody-but-Reid sentiment at work more than a preference for a Republican.”

That and the voter enthusiasm gap mean Reid had better not fail on health care.

(Cross-posted from Scrutiny Hooligans.)

Corporate Ventriloquism

Jane Hamsher of Firedoglake had a dustup a few weeks ago with Rep. Anna Eshoo (D-CA) over an amendment to H.R. 3200 that Eshoo sponsored governing the licensing of biologic drugs. Hamsher, a three-time breast cancer survivor, contended that a loophole allowed manufacturers to extend their twelve-year exclusive license to drugs by making minor tweaks to the molecules.

Eshoo got testy about being called out, saying, “My amendment prohibits by its plain language exactly what Ms. Hamsher alleges it would encourage.” But other experts contended that Eshoo didn’t understand the “plain language” of her own amendment, that it said just the opposite of what she thought. Also, Energy and Commerce chair Henry Waxman’s statements supported Jane’s contention that the provision contained a loophole that allowed Big Pharma to “evergreen” its exclusive licenses to biologic medications.

This morning, Marcy Wheeler pointed to an NYT piece describing the pushback from Big Pharma. They worked at getting congresscritters from both sides of the aisle to enter their talking points into the Congressional Record:

Statements by more than a dozen lawmakers were ghostwritten, in whole or in part, by Washington lobbyists working for Genentech, one of the world’s largest biotechnology companies.

E-mail messages obtained by The New York Times show that the lobbyists drafted one statement for Democrats and another for Republicans.

[snip]

Genentech, a subsidiary of the Swiss drug giant Roche, estimates that 42 House members picked up some of its talking points — 22 Republicans and 20 Democrats, an unusual bipartisan coup for lobbyists.

[snip]

Members of Congress submit statements for publication in the Congressional Record all the time, often with a decorous request to “revise and extend my remarks.” It is unusual for so many revisions and extensions to match up word for word. It is even more unusual to find clear evidence that the statements originated with lobbyists.

It would be nice to see those e-mails, by the way. It makes you wonder who wrote the “plain language” for Eshoo’s anti-evergreening amendment.

(Full disclosure: This writer has had Roche as a client.)

(cross-posted from Scrutiny Hooligans)

Which Public Is That?

The Beltway cognoscenti keep telling us that a bipartisan solution to health care reform is what the public wants. Just what public is it that's more interested in process than results?

Conventional wisdom says that Obama has failed to make Washington more bipartisan if Democrats ram through a health reform bill without Republican support. That would be the Republican support that House Republican whip Rep. Eric Cantor just swore Democrats will never get. “[N]ot one Republican will vote for this bill," Cantor told a “tea party” crowd on Thursday.

Republican strategist Mike Murphy from Thursday’s Morning Edition (NPR):

… I think the great mistake of the Obama presidency, the thing that has taken his numbers among the critical independents who put him in office from very high to low now, is they were elected as a bipartisan problem solver, almost a post-partisan politician. But from the day they've been in, they got a little drunk on the power and they've governed as a one-party liberal party. It's been more of the Democratic dogma, particularly in the House under Pelosi.

And while they have the pure political power to force some things through with their majorities, the Democrats, in my view, are governing too far to the left. They're losing the middle of the country.

Put aside for a moment the up-is-downisms. The public is disillusioned because, as Murphy suggests, Democrats aren’t being bipartisan enough? Or is it really because they have accomplished too little in trying to placate an avowedly obstructionist opposition party?

Observe the coverage of the off-year elections. It is the end of the honeymoon, says Murphy. The media made it out to be a turning point for the White House -- picking up two House seats is, of course, bad news for the Democrats. It's a wonder television news didn't brand the coverage with a catchy name and trademarked graphics.

This should give health care reformers in Congress pause, suggest our media mavens. Why?

Suspense, drama, conflict and histrionics are the stuff of good TV. One would think the media would be egging on Democrats to use the reconciliation process to pass health care reform – with a public option. Think of the ratings. You ain't seen nothin' yet.

See Rep. John Boehner crying on the House floor, streaking his bronzer! Hear Congresswoman Michele Bachmann declare President Obama the antichrist on the steps of the Capitol! Experience the riveting oratory of Joe the Bummer! Watch conservatives in Congress rend their garments as tea partiers fling themselves onto a pyre of burning Constitutions!

Now that’s must-see TV. So why is our “liberal” media suggesting that that would be the worst that could happen? For whom, exactly? It is because the corporate titans behind mass media have a vested interest in seeing health reform fail?

There are more questions than answers.

What public is it that would rather have a bad bipartisan bill rather than a more robust single-party one? The public that's disenchanted because health reform has not been passed already? The majority of Americans that consistent polling shows want a bill with a public option? The people already suffering under a failed and costly health care system? The pragmatic average Joes who go to see Larry the Cable Guy shout "Git ‘Er Done!" from the stage?

That public is more interested in process than results?

Cross-posted from Campaign for America's Future.

Lucky or Good?

The congressman’s staffer said her goodbyes and left the service desk. The cashier, pleasant-looking and about fifty, had listened to the health care conversation from behind the counter. Now that it was just the two of them, she opened up to my wife.

It has been a bad three years. She had been healthy, she said, until she developed a blood disorder. After the diagnosis, her health insurance was cancelled.

There has been a string of cancers diagnosed in her family – six or seven – including her father. The stress on the family is severe. Her mother had a stroke.

But she is lucky – blessed she said – to have this new job. And in this economy, she’s right. The health benefits are especially good. The women’s clothing company is a big supporter of the Susan G. Komen for the Cure movement to fight breast cancer.

Lucky for her again. Since taking the job, she has been diagnosed with breast cancer. Fortunately, her employer is supportive.

Because what with her mother’s stroke, she didn’t want to stress her parents further. She avoided telling them about her breast cancer until she began radiation treatments recently.

They say it’s better to be lucky than good. That is employer-based health care in America. The lucky get treatment until they are too sick to work and their employer has to let them go. Business is business.

It is a good thing the cashier likes her new job. She had better not lose it – for any reason. She’ll lose her insurance too.

Wide-eyed, it had never occurred to her that she could call her congressman or senators and tell them her story, that they might actually listen. My wife urged her to visit or call, and soon.

Because very soon, all of America will find out if they’re listening and if we're lucky.

(Cross-posted from Campaign for America's Future.)

The Public Necessity

The health care debate – with its leaks, mixed signals and close-to-the-vest dealing – has reform supporters losing their cool while Obama, infuriatingly, maintains his. The uncertainty has strained the tenuous loyalties of a fickle American left. How much talk about "triggers" is real, how much is process, and how much is rope-a-dope?

David Dayen defines the problem for Firedoglake:

Is the White House “insisting” on triggers to take the heat off of Harry Reid, who is having trouble finding the last votes for cloture? Are they drawing fire away from Senate moderates? Are they doing it to keep Snowe thinking the White House is on her side? Do they want to pull a switcheroo in conference committee? Do they actually think that the public option will need some time to get right, so a trigger might help to aid that delay? Are these the words of one rogue faction in the White House that can’t stand the public option and the “left of the left”?

Reports about Thursday night’s White House meeting between Senate Majority Leader Harry Reid and President Barack Obama suggest that Obama is not prepared to twist the arms of remaining Senate holdouts to secure a bill with a public option (sans “triggers”), even though that goal now seems within reach:

"Everybody knows we're close enough that these guys could be rolled. They just don't want to do it because it makes the politics harder," said a senior Democratic source, saying that Obama is worried about the political fate of Blue Dogs and conservative Senate Democrats if the bill isn't seen as bipartisan. "These last couple folks, they could get them if Obama leaned on them."

Meanwhile, Obama's Organizing for America (OFA) found its legs on October 20th, generating 315,000 phone calls to Capitol Hill in support of health care reform. While the approved script called for supporting the “the President’s plan for health reform” – whatever that is – many OFA volunteers support a “robust public option.” OFA’s back channel exhortations for supporters to increase the pressure and “win this thing” tell a very different story from the media narrative about a reluctant, unengaged president.

After eight years of Bush-Cheney, the left was primed for the change Obama promised – and thoroughly distrustful of Washington politics, even his. The mixed signals have Obama’s base clinging to the hope that their leader is playing rope-a-dope with opponents, while other progressives are already declaring Obama a conservative.

If it makes them dig in and fight harder, fine.

But Thomas P.M. Barnett's warning to the Pentagon is one to which progressives should pay heed: "we field a first-half team in a league that keeps score until the end of the game." Progressives have to maintain focus and momentum if they hope to punch through the insurance industry’s goal-line defense. “Allies” in Congress won’t manage that on their own. One year after November 2008, will voters again rise to the occasion or remain on the sidelines with an “Obama hangover”?

A society accustomed to sitting on the couch and being passively entertained is one more accustomed to being governed rather than to governing. Once the vote-counting is over, many citizens tune out again until the next election. A colleague echoing the familiar FDR “make me do it” anecdote, noted that few realize just how hard it is for even their favorite leaders to change things themselves without being pushed hard by supporters.

Anna Quindlen argues in Newsweek that the founding fathers engineered our system to resist radical changes of direction, that Obama is a process-oriented centrist more than the populist firebrand progressives thought they were electing, and that health reform therefore may be more incremental than sweeping.

Perhaps. But that very system did not inhibit the Bush administration from taking the country in a radical direction overnight, nor did it stop a population alarmed by those radicals from firing them overnight. Obama didn’t do that. We did.

Quindlen concludes by reminding readers that if Americans want change, they had best not sit back and expect someone else to do it for them, because

“... if the American people want the president to be more like the Barack Obama they elected, maybe they should start acting more like the voters who elected him, who forcibly and undeniably moved the political establishment to where it didn't want to go.”

OFA got a taste again of what that's like on October 20th. If the rest of America really believes that the health reform it needs is not just a public option, but a public necessity, more Americans will have to get up off the couch and go get it. Neither Obama nor the Democrats will deliver it to their doorstep like a pizza.

(Cross-posted from Campaign for America's Future.)

We’re Number Last!

FactCheck.org sent out one of its regular e-mail updates this week. They examine the “37th in the world” statistic bandied about in the health reform debate. The 2000 World Health Organization report has not been updated, they note, and has its critics and limitations.

The Annenberg Public Policy Center looks at some more recent figures to put things in perspective:

Among the other stats on how the U.S. health care system and health stacks up internationally: A 2007 Commonwealth Fund report ranked the U.S. last out of six industrialized countries in health system performance, which included measures on quality, access, efficiency, equity of care and healthy lives. “Access” and “equity” measures are affected by the lack of universal health care. On life expectancy, the U.S. ranks 50th and below France, Canada, the U.K. and the European Union average, according to the CIA World Factbook. Infant mortality is also higher in the U.S. than all of those countries and more. A 2006 report on infant mortality by the nonprofit Save the Children showed the U.S. tied for next to last among industrialized countries.

America retains its #1 ranking on health care costs, spending nearly twice as much, on average, as other developed countries. But when it comes to health care, Wal-Mart Nation still pays more and gets less. And for reform opponents, that’s a record worth defending, even if it’s not something to brag about.

(Crossposted from Scrutiny Hooligans)

Projection TV: Real Americans Watch Fox News

A focus-group study by Democracy Corps explains that Republican base voters live in “a world apart from the rest of America.”

The Tea Parties of August already made that pretty clear.

Republican base voters believe themselves an oppressed minority that possesses “knowledge and insight that the majority of Americans – whether too lazy or too misguided to find it for themselves – do not possess.” And – surprise – they get their special knowledge and insight largely from Fox News.

In 1999, Al Franken wrote the same thing. During the Clinton health care debate, the Annenberg School for Communications found that conservative talk radio listeners judged themselves the most informed on the topic. Testing, however, revealed that they were the least informed.

Franken wondered [my edit],

But why would people so woefully lacking in the basic facts of an issue think they were the best informed? Social scientists call the phenomenon "pseudo-certainty." I call it "being a f*#king moron."

A decade later we have Glenn Beck reinforcing his viewers' paranoid proclivities and helping them project their own darkest impulses onto opponents.

According to Democracy Corps, four core beliefs set the Republican base apart:

1. Deception and a Hidden Agenda – “Obama is deliberately and ruthlessly advancing a ‘secret agenda’ to bankrupt our country and dramatically expand government control over all aspects of our daily lives.”

2. Speed – Obama is implementing change rapidly to keep ordinary Americans from knowing what he is doing.

3. Driving Government to the Brink and Total Control – Obama is deliberately trying to burden America with so much debt that citizens will be unable to resist efforts to implement Obama’s ultimate plan ...

4. The Ultimate Goal: Socialism and End to Liberties – Government takeover of health care is just the first step towards a complete suppression of liberty by our inefficient, ineffective and corrupt government.

It is a pretty stunning case of projection, as one of Andrew Sullivan’s readers suggests:

[Obama] is the out of control spender when they sat on their hands through all of Bush's malfeasance. That is why his talking to schoolchildren is dangerous when our government wiretapping its citizens wasn’t. That is why saving the financial system from years of Republican regulation is taking away our future. The more evil revealed about the right’s excesses on torture, or wars of choice, or nearly destroying the economy, the more evil Obama will look in their eyes, as they cannot tolerate owning responsibility, because in their own minds they are only good.

Paul Rosenberg explains the viewpoint in a separate discussion at Open Left:

[T]he disconnect is particularly strikingly. That is, until you take a step back, and see the underlying consistency ... in their minds, they alone are America. If they're not running things, then it's not America... If you are the real America and everyone else is not, well, then, you can do pretty much whatever you want – and do it all in the name of America.

Conservatives and independents in the Democracy Corps focus group were sensitive to charges that racism is behind their criticism of Obama. So much so, that they came back to it “again and again.”

However much it is, their discomfort is not all about race. It’s broader. It’s tribal.

“Real Americans” view those outside their tribe with suspicion, like teenagers in the mall they are convinced are there to shoplift – illigitimate, untrustworthy, low-caste Irresponsibles, bad apples who don’t deserve America. Those outside their tribe don’t deserve to carry the flag, don’t deserve to wear the uniform or to enjoy the blessings of liberty. Especially, they don’t deserve to vote.

“Real Americans” believe America’s bad apples pay no taxes. The “lucky duckies” don’t even pay sales tax, property tax, tax on gasoline, on heating oil, cigarette tax, telephone excise tax, unemployment tax, Social Security tax, Medicare and Medicaid.

“Real Americans” would love to repeal the 16th Amendment, but so long as they pay taxes, they'll be the betters of countrymen they think pay any less. They will rail about how unfairly they’re treated and what a drag on the economy and their fortunes are the great unwashed who have turned this once great country into one "where poor people can put billionaires out of business."

These Atlases see themselves stoically carrying America upon their shoulders while being dragged relentlessly down by the grubby, grasping hands of the less well-born; by people not as honest, upstanding and hard-working as they are; by the parasites of capitalism who contribute nothing; by deadbeats and losers who have structured their lives so they can spend them sucking the teat of real America.

No wonder they feel "a world apart." And Fox News is there to remind them, if they ever have doubts.

(Crossposted from Huffington Post.)

What Civilized Country Operates Like This?

You have seen it. The plastic bucket beside the cash register at the convenience store. A photo is taped to it. A child needs an operation. His father lost his job. The family lost its insurance. They are about to lose their home. Can you spare some change?

What civilized country operates like this? In case God-and-country defenders of the status quo need reminding, America’s for-profit health insurance system serves neither.

Reform advocates must hammer away at this relentlessly: health insurance reform is a moral issue more than an economic one.

Nicholas Kristof delivered further proof that the system is morally bankrupt in the October 4 New York Times.

Travis and Michael Waddington hoped to donate a kidney to their father, David, 58, a wine retailer and victim of polycystic kidney disease. PKD had destroyed David’s kidneys. Since the disease is genetic, Travis and Michael needed to be tested for the disease themselves before donating. Yet a positive result might mean the sons might never be able to get insurance. So their doctors advised against getting tested. Another advised getting tested under fictitious names. To protect their sons, husband and wife shot down the idea, even at the risk of David’s life.

Eventually, David received a kidney from a deceased donor, but Michael recently began experiencing PKD symptoms and now faces an insurance nightmare now all too familiar, obtaining affordable insurance – or any insurance – after being diagnosed with a serious illness.

Closer to home, an acquaintance recently donated a kidney to his father under somewhat different circumstances, but with similar risks. Such acts of mercy by organ donors (talk about risky behavior) present insurers with an elective pre-existing condition, and present donors with a moral dilemma. Fortunately, his father’s insurance covered both transplant surgeries. But both the son’s own physician and the transplant surgeons recommended that he say nothing to his insurer. It was illegal to deny coverage or insurance to organ donors, doctors told him. Nonetheless, they often heard of it happening.

Why tempt fate? He told his insurer nothing.

Kristoff calls an insurance system that forces patients into such impossible choices, “the disgrace of the industrialized world.”

But that’s putting it mildly. As T.R. Reid puts it in The Healing of America, our system is virtually a worldwide laughingstock. One thing on which experts at international health care symposia can agree, Reid explains, is that the U.S. for-profit insurance system is a mess. “Bashing the U.S. system is a standard agenda item.”

Joanne Ford, a patient on Social Security disability and wearing Coke-bottle eyeglasses, arrived for a Remote Area Medical free clinic in Knoxville. She came hoping to get a new pair for free. But nearly last in line, she almost missed her chance. Interviewed by 60 Minutes, Ford said tearfully, “I am sad that we are the wealthiest nation in the world and we don’t take care of our own.”

Even the socialist bogeymen of Europe treat their own better.

For-profit insurance can be cruel and capricious, not unlike the age of Dickens that Keith Olbermann invoked in a recent hour-long commentary. America’s uninsured have "a 40 percent higher risk of death than their privately insured counterparts," a new Harvard study finds. Furthermore, 45,000 Americans a year die from lack of health insurance. Like Dickens’ London, America’s working poor too often are either invisible or else blamed as surplus population –– impediments to the economic fortunes of their “betters.”

It is a seasonal tradition to revisit cherished redemption stories during the coming dark nights around the solstice, to refresh human connections not just to family and friends, but to our fellow men. Defenders of the status quo, especially, need to refresh theirs.

America would do well to revisit those redemption stories earlier this year as it considers how best to rehabilitate a business more informed by Wall Street than A Christmas Carol. For-profit health insurance is rare in the civilized world, and rightly so. It is a cold-hearted business more interested in serving the numbers on its balance sheets than the humanity behind the numbers.

That calls into question the humanity of its defenders, like the conservative radio icon who brags about taking on all comers with half his brain tied behind his back. That would be the feeling half. The human half. The half that Messrs. Scrooge and Potter let atrophy as an impediment to being good men of business.

Right now, a popular caterer downtown has posters on her door. A child needs an operation. A strawberry blonde boy in an adult-sized straw hat. He has a severe immune deficiency disease. He is with his parents at Duke University Medical Center for a bone marrow transplant. There's a pancake breakfast to raise money.

You might as well hold a bake sale to buy a bomber.

What civilized country operates like this?

(Cross-posted from Huffington Post.

Better Dead Than Insured

The New York Times/CBS News poll out yesterday posed the following question:

57. Would you favor or oppose the government offering everyone a government administered health insurance plan — something like the Medicare coverage that people 65 and older get — that would compete with private health insurance plans?

Sixty-five percent said yes. Twenty-six percent said no. According to health insurance reform opponents, that makes nearly two-thirds of Americans socialists or worse.

At the Washington Post, Harold Meyerson observes:

Think about that. The public option has been demonized non-stop for the past half-year; it’s the key to the Republican charge that instituting such a program is tantamount to bringing socialism to America. They have clearly rallied the Republican base to this position, just as they rallied the base to fear the coming of death panels and publicly-subsidized immigrant care. But whereas pluralities of Americans simply said they didn’t know enough to believe one thing or the other about death panels and immigrant care, virtually all Americans not in the Republican base support the public option.
[snip]
Since Republican legislators represent the 26 percent of Americans opposed to the public option, their opposition to same poses no mystery. The conundrum is why some Democrats -- all save those from the most right-wing districts -- oppose it. When The Post’s uber-policy blogger Ezra Klein asked North Dakota Democratic Senator Kent Conrad yesterday why he didn’t support the public option, Conrad replied, “I don't think a government-run plan best fits this culture.” In Conrad’s mind, such as it is, American culture doesn’t seem to be shaped by the American people.

Funny how that works inside the Beltway. The status quo -- which, presumably, Conrad does think fits this culture -- produces outcomes like this from the Dayton, Ohio Daily News:

OXFORD — Friends say the Miami University graduate who died this week after reportedly suffering from swine flu delayed getting medical treatment because she did not have health insurance.
[snip]
Young became ill about two weeks ago, but didn’t seek care initially because she didn’t have health insurance and was worried about the cost...

That puts "Kimi" among the 45,000 a year whose deaths are attributable to lack of insurance coverage in America, according to a new Harvard Medical School study.

But then, better dead than red ... at least for a noisy 1/3 of the people in our democracy. Here's what that looks like:

Kimberly "Kimi" Young, 22, died
Tuesday night Sept. 22, 2009 at
University Hospital.

(Cross-posted from Scrutiny Hooligans.)

If You Like Medical Bills, You’ll Love These

Activists in the blogosphere are studying well over 500 amendments to Sen. Max Baucus’ Senate Finance Committee health care reform bill, including three “public option” amendments. All sides will hotly debate, soundly trash, and amend the hell out of the Baucus bill, H.R.3200 (on the House side) and any others that come out of the woodwork by October.

But those aren’t the only kind of bills Americans should be worrying about.

My sister died at 37 from a metastatic sarcoma (the same cancer that took Ted Kennedy, Jr.’s leg). I watched her die, went to her funeral, and then went back to her apartment to sift through stacks of medical bills.

In exhaustion and grief, we couldn’t tell which bills were paid, which were not, which were rejected, which were under review, and which were still in the pipeline and wouldn’t arrive for weeks or months. This doesn’t happen in most industrialized countries and shouldn’t happen here. It's a disgrace, a disgrace that none of the bills pending in Congress will cure. A disgrace that health insurance conglomerates and their allies in Congress are fighting hard (and spending hard) to preserve, along with the profits the billing process helps generate.

Over 60 percent of personal bankruptcies in the U.S. are from medical bills. Over three-quarters of those are in families who had health insurance, were probably satisfied with it, and thought their coverage was adequate until a serious illness proved otherwise. But it's the burdensome billing process itself that the health care reform debate has not addressed.

At the America’s Future Now! conference in June, Dr. Salomeh Keyhani of Mt. Sinai Hospital detailed the number of weeks doctors, nurses and their staffs spend each year dealing with insurance paperwork and procedures. Insurers make it as difficult as possible for customers to collect. Bottom line: if patients and doctors get frustrated and go away, the insurer won’t have to pay. Keyhani described the labyrinthine claims process as “passive aggressive” by design.

Keyhani's name came up again last week in connection with a nationwide poll published in the New England Journal of Medicine. Keyhani helped conduct the survey funded by the Robert Wood Johnson Foundation of 5,000 physicians representing a spectrum of specialties and regions, including American Medical Association members. The survey, Keyhani told NPR, found that "nearly three-quarters of physicians supported some form of a public option, either alone or in combination with private insurance options." That included AMA members, whose organization opposes a public option.

Yet only a single-payer-style plan promises to eliminate the mountains of bureaucratic paperwork that make our patchwork system cost nearly twice what other advanced countries pay. But since a nationwide single-payer system is off the table, even if a strong public option gets to the president's desk, most Americans will be sifting through confusing stacks of insurance paperwork for years to come. Some reform.

The anti-reform forces had their Tea Party in Washington on September 12. They offered no alternatives and screamed loudly about not being heard, but not loudly enough to drown out a majority that decides to speak with one voice.

President Obama must know that he has only to say the word and a sea of pro-reform supporters will travel to Washington in support of real reform and a robust public option. If summoned, supporters should bring their collections of medical bills, rejection letters and appeal forms and wave them overhead.

Talk about “Don’t Tread On Me.” Medical insurance paperwork is universally recognized and universally loathed. It could serve as a potent symbol of everything wrong with America’s dysfunctional, for-profit health insurance system.

Reform supporters might, en masse, flood congressional fax machines with their medical bills. Or stage media events with fax machines set up in public spaces for patients to fax their medical bills to Congress -- just to put an exclamation point on demands for meaningful reform.

There's something viscerally satisfying about feeding documents into a fax machine and knowing they're spitting out onto the floor of your congresscritter’s office. It's the next best thing to being there.

(Cross-posted from OurFuture.org)

What Does Happen Here

Last weekend, tens of thousands of health reform protesters prompted by Glenn Beck descended on Washington. They fear America is turning fascist because Barack Obama wants health insurance reform that reduces cost, guarantees choice, and is affordable and high quality for every American.

Diabolical.

“Don’t Tread On Me” is their battle cry — emphasis on “Me.” There is no "we" in their America, no welcome for your tired, your poor, your huddled masses of Americans, much less immigrants. E pluribus unum is Greek to them. They have reduced freedom to a fetish.

This is the kind of cheap, plastic, made-in-China patriotism you buy at Wal-Mart at everyday low prices — all packaging and empty on the inside.

Read more at Campaign for American Future.

The Bile Boils Over

Enter the Tea Baggers, the Birthers, the Deathers, Glenn Beck, town hall shouters, guys with guns, and Rep. Joe Wilson (R-SC). The right's simmering kettle of bile is boiling over.

You almost can't blame them for losing it. Conservatives spent three decades building, Bolero-like, towards their denouement: control of both houses of Congress, the Supreme Court and the White House. And a permanent Republican majority.

Their efforts climaxed with the presidency of George W. Bush. They lost it all to Barack Obama.

Bush's presidency climaxed on a pile of rubble in New York just after 9/11.

A flood of post-September 11 articles asked how the attacks happened, what we would do next, and why terrorists hate us. One savvy pundit asked, Would America keep its head?

We invaded Iraq on trumped-up intelligence. We conducted illegal surveillance on our own citizens. We imprisoned people without charge, here and abroad. We rendered prisoners for torture and tortured others ourselves in violation of international law. All the while, millions of staunch, law-and-order conservatives supported and defended it, and still do. Vigorously.

Did America keep its head? Uh, no.

But with the election of its first bi-racial president, the electorate threw the movement conservative and neocon bums out. Had America's temporary insanity finally abated? Uh, no. It's worse.

Osama was one thing. But Obama?

People weren't this crazed over Jackie Robinson, were they? Father Coughlin was off the air by then. People's minds were not as marinated in the mind poison the right-wing has pumped out daily for the last twenty years.

Case in point. I once worked in an office where a guy recorded Rush Limbaugh every afternoon. Using a small FM transmitter, he rebroadcast the show the next morning to fellow dittoheads in the building so they would be primed for Limbaugh's live broadcast at noon.

No lie.

In Appalachia, dentists call it "Mountain Dew mouth." Children carry around the acidic, heavily caffeinated soda, taking a sip every few minutes. It's "like bathing the teeth in it all day," according to one dentist. Children go from decayed to toothless.

Is the mind rot from listening to Limbaugh, Beck, Hannity or Savage every day any different? Or from passing on the sludge from Drudge or WorldNetDaily? Or from reading those chain e-mails forwarded by relatives and friends who spread them like Typhoid Mary? Inhaling mercury vapors might be less harmful.

Conservatives bathed in daily lies -- from WMDs to "death panels" -- have become so comfortable spreading them that they treat it like good, clean fun for the whole family. They spread them dutifully, no matter how extreme or outlandish (assuming they know the difference any longer).

The day of Obama's speech, Crooks and Liars' Dave Neiwert again insisted that "ideas, agendas, talking points, and memes in general regularly [migrate] from the extremist right in America into mainstream conservatism." This week we saw just how far up the infection goes.

Hours before South Carolina Republican Rep. Joe Wilson yelled "You lie!" at the president, former Speaker of the House Newt Gingrich appeared on NPR's Morning Edition and rebuffed an invitation to condemn the "death panel" rhetoric. The GOP leadership won't quit the useful idiots who do their dirty work for them.

By Obama's address that evening, "the town hall freak show" had come to a joint session of Congress.

Responding to Birthers, Deathers, and a flood of right-wing paranoia from the likes of Glenn Beck, Open Left's Paul Rosenberg discusses the mental elasticity of linear thinkers like Beck. They build elaborate conspiracies like Frankenstein's monster, linking together random bits of their own chaotic fears. "They are put together, but can't be logically deconstructed," he writes, nor argued with "any more than you can reason with a nightmare."

Responding to his flood of hate mail filled with "spitting, incoherent rage," Paul Krugman commented, "Something is going very wrong in the head of a substantial number of Americans."

The poison has spread to the GOP's very soul.

Cross-posted from Huffington Post.

Like Tax Cuts That Way

What Digby said:

This is one of the problems with health care reform, as I've mentioned before. If the economy is doing well and deficits are going down, everybody's working and the fiscal scolds insist that reform will rain on the parade and ruin everything. More people working means more people have health insurance and the calls for reform are muted. If the economy is in trouble, then the fiscal scolds insist that the sky is falling because of rising deficits and reform will make everything even worse. Fewer people working makes the need more critical, but many of them see the deficit as a sign that government is dysfunctional and so they reject reform. No matter what, "the deficit" has a stranglehold on the political discourse in ways that makes reform nearly impossible.

The economy's good? It's time for tax cuts.

The economy's bad? It's time for tax cuts.

The tax cuts don't produce jobs as promised? It just means you need more tax cuts.

It's never time for health care for all Americans.

Elsewhere on Hullabaloo:

If these Democrats had a brain in their heads they'd realize that the best way to maintain their power (and keep getting those big bucks) is to pass a good bill. Successful reform will be their only defense because the true political downside to passing a bad bill now is being out there alone selling out the American people all by themselves.

Hey, McFly! Your shoe's untied!

When are these guys going to wise up?

Do Progressives Have What It Takes To Win?

Maybe it is something congenital about the left. Faced with lies, propaganda and intimidation, liberals go to Google to arm themselves with more and better facts.

Here! See my data?

Writing on Philly.com, Dick Polman wonders "whether there is some fundamental flaw in the Democratic gene pool ..." that the Democratic leadership was caught off guard by the conservative backlash against health care reform.

Recent town hall displays -- including the swastikas and death threats, explicit and implied -- prove again that it's past time that progressives got a clue and stopped bringing letter openers to gun fights.

Read more at Huffington Post.

Something I ran across

As for the argument that government is unable to pull off anything like health care successfully, Steve Benen at Washington Monthly recalled a memorable scene from film:

It reminds me a bit of a scene in “Life of Brian.” The People’s Front of Judea are having a meeting and considering what the Romans had ever done for them. Reg asks, “Apart apart from the sanitation, medicine, education, wine, public order, irrigation, roads, the fresh water system and public health, what have the Romans ever done for us?”

Health Care Debate Loses Coherence

The descent into complete incoherence among conservatives -- especially on talk radio -- has become widespread as the health care debate intensifies. The once Mighty Wurlitzer is wheezing and groaning.

One suspects, however, that behind much of the "Don't Tread On Me" rhetoric directed at Obama is a spluttering "... but, but, but, you're black!"

Read more at Huffington Post.

The Uninsured Line Up For Care In Rural Virginia

This weekend was the tenth anniversary of Remote Area Medical’s free health fair in Wise County, VA. Stan Brock founded Knoxville-based RAM in 1985 to insert mobile medical teams into remote areas of third-world countries. Now over sixty percent of RAM’s work is in rural areas of the United States.

More than one thousand people arrived before sunup on Friday or camped out in their vehicles for a chance at health care they cannot afford to buy. Most are the working poor and hail from Virginia, with Tennessee a close second, followed by Kentucky and other surrounding states. Cars in the county fairgrounds lot held comforters and pillows, sleeping bags and sleeping people.

Read more at The Huffington Post.