Psyche, Science, and Society

Strong supporter of health plan failed to reveal $297,600 grant

One of the most popular academics supporting the Senate-Obama health plan has apparently failed to disclose his $297,600 contract contract with the Department of Health and Human Services. From emptywheel. As pointed out below, he is a major source for claims that taxing “expensive” health plans is effective policy:

Jonathan Gruber Failed to Disclose His $297,600 Contract with HHS

By emptwheel

MIT health economist Jonathan Gruber has been the go-to source that all the health care bill apologists point to to defend otherwise dubious arguments.  But he has consistently failed to disclose that he has had a sole-source contract with the Department of Health and Human Services since June 19, 2009 to consult on the “President’s health reform proposal.”

He is one source for the claim that the excise tax will result in raises for workers (though his underlying study is in-apt to the excise tax question). He is the basis for the argument that the Senate bill reduces families’ risk–even if it remains totally unaffordable. Even Politico stenographer Mike Allen points to Gruber’s research.

But none of the references to Gruber I’ve seen have revealed that Gruber has a $297,600 contract with HHS to produce,

a technical memorandum on the estimated changes in health insurance coverage and associated costs and impacts to the government under alternative specifications of health system reform. The requirement includes developing estimates of various health reform proposals on health insurance coverage and cost. The alternative specifications to be considered will be derived from the President’s health reform proposal. [my emphasis]

(h/t Mote Dai)

The President’s health reform proposal? But I thought this was the Senate’s health reform proposal?!?!? (wink!)

Now, HHS says they had to put Dr. Gruber in charge of evaluating health care reform proposals because he’s got,

a proven micro-simulation model with the flexibility to ascertain the distribution of changes in health care spending and public and private sector health care costs due to a large variety of changes in health insurance benefit design, public program eligibility criteria, and tax policy.

Even assuming that Gruber is the only one in the world who can run these simulations, don’t you think it’s rather, um, dubious that the guy evaluating the heath care reform–for $300,000–is also the package’s single biggest champion?

And no one has been transparent about this contract?

January 8th, 2010

Norway prevents resistant infections by reducing antibiotic use

From Norway comes news of a simple, but effective, solution to the problem of Methicillin-resistant Staphylococcus aureus (MRSA) or “superbugs” that, as they spread, pose extreme dangers to us and our healthcare system. In the US and other countries, a visit to the hospital means worrying about exposure to MRSAs. There are 19,000 MRSA deaths in the US every year. But not in Norway.

The reason: Norwegians stopped taking so many drugs….

Norway’s model is surprisingly straightforward.

• Norwegian doctors prescribe fewer antibiotics than any other country, so people do not have a chance to develop resistance to them.

• Patients with MRSA are isolated and medical staff who test positive stay at home.

• Doctors track each case of MRSA by its individual strain, interviewing patients about where they’ve been and who they’ve been with, testing anyone who has been in contact with them.

They allow minor illnesses to take their course:

“We don’t throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better,” says Haug.

However, Norwegian society has a crucial difference that allows them to wait. They have a social democracy:

All workers are paid on days they, or their children, stay home sick.

Can you imagine such a radical idea in the US?

Acting reasonably also pays off in reduced costs:

Norway responded swiftly to initial MRSA outbreaks in the 1980s by cutting antibiotic use. Thus while they got ahead of the infection, the rest of the world fell behind.

In Norway, MRSA has accounted for less than 1 percent of staph infections for years. That compares to 80 percent in Japan, the world leader in MRSA; 44 percent in Israel; and 38 percent in Greece.

In the U.S., cases have soared and MRSA cost $6 billion last year. Rates have gone up from 2 percent in 1974 to 63 percent in 2004. And in the United Kingdom, they rose from about 2 percent in the early 1990s to about 45 percent, although an aggressive control program is now starting to work.

Alas, Norway is not separate from the rest of the world. It’s success may not last:

But Elstrom [Norway's MRSA control director] worries about the bacteria slipping in through other countries. Last year almost every diagnosed case in Norway came from someone who had been abroad.

“So far we’ve managed to contain it, but if we lose this, it will be a huge problem,” he said. “To be very depressing about it, we might in some years be in a situation where MRSA is so endemic that we have to stop doing advanced surgeries, things like organ transplants, if we can’t prevent infections. In the worst case scenario we are back to 1913, before we had antibiotics.”

Fortunately, Norway’s success is replicable elsewhere:

But can Norway’s program really work elsewhere?

The answer lies in the busy laboratory of an aging little public hospital about 100 miles outside of London. It’s here that microbiologist Dr. Lynne Liebowitz got tired of seeing the stunningly low Nordic MRSA rates while facing her own burgeoning cases.

So she turned Queen Elizabeth Hospital in Kings Lynn into a petri dish, asking doctors to almost completely stop using two antibiotics known for provoking MRSA infections.

One month later, the results were in: MRSA rates were tumbling. And they’ve continued to plummet. Five years ago, the hospital had 47 MRSA bloodstream infections. This year they’ve had one.

“I was shocked, shocked,” says Liebowitz, bouncing onto her toes and grinning as colleagues nearby drip blood onto slides and peer through microscopes in the hospital laboratory.

When word spread of her success, Liebowitz’s phone began to ring. So far she has replicated her experiment at four other hospitals, all with the same dramatic results.

“It’s really very upsetting that some patients are dying from infections which could be prevented,” she says. “It’s wrong.”

Around the world, various medical providers have also successfully adapted Norway’s program with encouraging results. A medical center in Billings, Mont., cut MRSA infections by 89 percent by increasing screening, isolating patients and making all staff — not just doctors — responsible for increasing hygiene.

In Japan, with its cutting-edge technology and modern hospitals, about 17,000 people die from MRSA every year.

Dr. Satoshi Hori, chief infection control doctor at Juntendo University Hospital in Tokyo, says doctors overprescribe antibiotics because they are given financial incentives to push drugs on patients.

Hori now limits antibiotics only to patients who really need them and screens and isolates high-risk patients. So far his hospital has cut the number of MRSA cases by two-thirds.

In 2001, the CDC approached a Veterans Affairs hospital in Pittsburgh about conducting a small test program. It started in one unit, and within four years, the entire hospital was screening everyone who came through the door for MRSA. The result: an 80 percent decrease in MRSA infections. The program has now been expanded to all 153 VA hospitals, resulting in a 50 percent drop in MRSA bloodstream infections, said Dr. Robert Muder, chief of infectious diseases at the VA Pittsburgh Healthcare System.

“It’s kind of a no-brainer,” he said. “You save people pain, you save people the work of taking care of them, you save money, you save lives and you can export what you learn to other hospital-acquired infections.”

Pittsburgh’s program has prompted all other major hospital-acquired infections to plummet as well, saving roughly $1 million a year.

“So, how do you pay for it?” Muder asked. “Well, we just don’t pay for MRSA infections, that’s all.”

Will this approach catch on?

Meanwhile, the Norwegian experience is another reminder that, in healthcare, less is not always worse. If only the breast cancer “advocates” who came out so strongly against the reasonable new recommendations of the US Prevention Task Force that not all women between 40 to 50 need to be screened and that, for many other, biannual screening is enough had understood this lesson.

January 3rd, 2010

The creation of a new “disease,” osteopenia, to sell Merck’s Fosamax

NPR recently had an amazing story by Alix Spiegel of how pharmaceutical company Merck help turn a research term, osteopenia, into a diagnosis “treated,” often ineffectively, by Merck’s drug Fosamax. The story involves the creation of osteopenia, a supposed subthreshold version of osteoporosis or low bone density. I also involves the systematic dissemination of inexpensive “diagnostic” machines for the new disorder that, however, fail to assess bone density where most breaks occur, that is, where it really matters. It involves Merck funding a number of organizations to lobby for the Medicare law to be changed, allowing doctors to be reimbursed for using these new machines of questionable utility. And it involves Merck selling a lot of Fosamax to women with the new “disorder” and making a lot of money. And it involves questions as to whether Fosamax is actually helpful, or may even be harmful, in these women who a few years ago were only experiencing normal aging. It also involves a lack of any plans to conduct the long-term follow-up studies necessary to determine if this treatment is helping, useless, or harmful.

This is a story that tells us so much about what is wrong with our healthcare system. Questionable diagnoses created and treatments administered to make money for large corporations. Alas, the recent reactions to the changed breast cancer screening guidelines suggest that once a constituency of doctors, drug dealers companies, and advocacy groups sees “benefits” from a new prevention approach, it will be extremely difficult to change.

Read or listen to the story here.

January 1st, 2010

Bob Herbert on Senate plan to screw workers

As Bob Herbert points out today, the Senate-Obama health plan wants to decrease my access to healthcare and reduce my wages. For, you see, my health plan is on the verge of being one of those Cadillac plans that only workers get. and everyone knows that workers get too much of everything.

The Senate has decided that, rather than tax the wealthy, they will try and destroy the healthcare received by many of us. I live in Massachusetts. Healthcare costs are high here and rising rapidly. Our insurer, ever concerned about keeping costs down, raised the insurance rate 22% this year. My employer, suffering its financial problems of its own, decided to pass on all the costs. Fortunately, we could increase costs by only 15% by switching to a worse plan. But even that plan is so expensive it is on the verge of being a Cadillac plan, being taxed at 40%.

This is what Senate Dems and Obama call reform? If the final bill includes this awful tax, it will be a disaster for millions.  Bob Herbert explains:

A Less Than Honest Policy

By Bob Herbert

There is a middle-class tax time bomb ticking in the Senate’s version of President Obama’s effort to reform health care.

The bill that passed the Senate with such fanfare on Christmas Eve would impose a confiscatory 40 percent excise tax on so-called Cadillac health plans, which are popularly viewed as over-the-top plans held only by the very wealthy. In fact, it’s a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care.

Which is exactly what the tax is designed to do.

The tax would kick in on plans exceeding $23,000 annually for family coverage and $8,500 for individuals, starting in 2013. In the first year it would affect relatively few people in the middle class. But because of the steadily rising costs of health care in the U.S., more and more plans would reach the taxation threshold each year.

Within three years of its implementation, according to the Congressional Budget Office, the tax would apply to nearly 20 percent of all workers with employer-provided health coverage in the country, affecting some 31 million people. Within six years, according to Congress’s Joint Committee on Taxation, the tax would reach a fifth of all households earning between $50,000 and $75,000 annually. Those families can hardly be considered very wealthy.

Proponents say the tax will raise nearly $150 billion over 10 years, but there’s a catch. It’s not expected to raise this money directly. The dirty little secret behind this onerous tax is that no one expects very many people to pay it. The idea is that rather than fork over 40 percent in taxes on the amount by which policies exceed the threshold, employers (and individuals who purchase health insurance on their own) will have little choice but to ratchet down the quality of their health plans.

These lower-value plans would have higher out-of-pocket costs, thus increasing the very things that are so maddening to so many policyholders right now: higher and higher co-payments, soaring deductibles and so forth. Some of the benefits of higher-end policies can be expected in many cases to go by the boards: dental and vision care, for example, and expensive mental health coverage.

Proponents say this is a terrific way to hold down health care costs. If policyholders have to pay more out of their own pockets, they will be more careful — that is to say, more reluctant — to access health services. On the other hand, people with very serious illnesses will be saddled with much higher out-of-pocket costs. And a reluctance to seek treatment for something that might seem relatively minor at first could well have terrible (and terribly expensive) consequences in the long run.

If even the plan’s proponents do not expect policyholders to pay the tax, how will it raise $150 billion in a decade? Great question.

We all remember learning in school about the suspension of disbelief. This part of the Senate’s health benefits taxation scheme requires a monumental suspension of disbelief. According to the Joint Committee on Taxation, less than 18 percent of the revenue will come from the tax itself. The rest of the $150 billion, more than 82 percent of it, will come from the income taxes paid by workers who have been given pay raises by employers who will have voluntarily handed over the money they saved by offering their employees less valuable health insurance plans.

Can you believe it?

I asked Richard Trumka, president of the A.F.L.-C.I.O., about this. (Labor unions are outraged at the very thought of a health benefits tax.) I had to wait for him to stop laughing to get his answer. “If you believe that,” he said, “I have some oceanfront property in southwestern Pennsylvania that I will sell you at a great price.”

A survey of business executives by Mercer, a human resources consulting firm, found that only 16 percent of respondents said they would convert the savings from a reduction in health benefits into higher wages for employees. Yet proponents of the tax are holding steadfast to the belief that nearly all would do so.

“In the real world, companies cut costs and they pocket the money,” said Larry Cohen, president of the Communications Workers of America and a leader of the opposition to the tax. “Executives tell the shareholders: ‘Hey, higher profits without any revenue growth. Great!’ ”

The tax on health benefits is being sold to the public dishonestly as something that will affect only the rich, and it makes a mockery of President Obama’s repeated pledge that if you like the health coverage you have now, you can keep it.

Those who believe this is a good idea should at least have the courage to be straight about it with the American people.

December 29th, 2009

Is Dean now endorsing healthcare bill?

Howard Dean seems to hae changed his mind and is now suggesting that the healthcare bill should pass. Frankly, I think Dean owes the public more than the glib explanation he has far provided for his change.

December 24th, 2009

Rep. Slaughter: Senate bill not reform

Rep. Lousise Slaughter, chair of the House Rules Committee, condemns the Senate bill, though a spokesperson says she may still vote for the final bill:

A Democrat’s view from the House: Senate bill isn’t health reform

By Louise M. Slaughter

Editor’s note: Rep. Louise M. Slaughter, a Democrat, represents the 28th Congressional District of New York. Slaughter is the first woman to chair the House Rules Committee and the only microbiologist in Congress.

Washington (CNN) — The Senate health care bill is not worthy of the historic vote that the House took a month ago.

Even though the House version is far from perfect, it at least represents a step toward our goal of giving 36 million Americans decent health coverage.

But under the Senate plan, millions of Americans will be forced into private insurance company plans, which will be subsidized by taxpayers. That alternative will do almost nothing to reform health care but will be a windfall for insurance companies. Is it any surprise that stock prices for some of those insurers are up recently?

I do not want to subsidize the private insurance market; the whole point of creating a government option is to bring prices down. Insisting on a government mandate to have insurance without a better alternative to the status quo is not true reform.

By eliminating the public option, the government program that could spark competition within the health insurance industry, the Senate has ended up with a bill that isn’t worthy of its support.

The public option is the part of our reform effort that will lower costs, improve the delivery of health care services and force insurance companies to offer rates and services that are reasonable.

Although the art of legislating involves compromise, I believe the Senate went off the rails when it agreed with the Obama Administration to water down the reform bill and no longer include the public option.

But that’s not the only thing wrong with the Senate’s version of the health care bill.

Under that plan, insurance companies can punish older people, charging them much higher rates than the House bill would allow.

In the House, we fought hard to repeal McCarran-Ferguson, the antitrust exemption that insurance companies have enjoyed for years. We did that because we believed firmly that those Fortune 500 corporations should not enjoy special treatment.

Yet the Senate bill does not include that provision — despite assurances from some members that they will seek to add it. By ending that protection, we will be able to go after insurance companies with federal penalties for misleading advertising or dishonest business practices.

The House bill would cover 96 percent of legal residents, while the Senate covers 94 percent. Compared with the House bill, the Senate’s bill makes it much easier for employers to avoid the responsibility of providing insurance for their workers.

And of course, the Senate bill did not remove the onerous choice language intended to appeal to anti-abortion forces.

Now don’t get me wrong; the current House and Senate bills are a significant improvement over the status quo. Given the hard path to reform and the political realities of next year, there is a sizable group within Congress that wants to simply cut any deal that works and call it a success. Many previous efforts have failed, and the path to reform is littered with unsuccessful efforts championed by Franklin Delano Roosevelt, Harry Truman and Bill Clinton.

Supporters of the weak Senate bill say “just pass it — any bill is better than no bill.”

I strongly disagree — a conference report is unlikely to sufficiently bridge the gap between these two very different bills.

It’s time that we draw the line on this weak bill and ask the Senate to go back to the drawing board. The American people deserve at least that.

*********

The opinions expressed in this commentary are solely those of Louise Slaughter.

December 23rd, 2009

Drew Westen on Ed Schultz Show

Psychologist Drew Westen, author of Looming Losses in 2010: Pretty Speeches, Compromised Values, and the Quest for the Lowest Common Denominator, talks about Obama and the disheartened base:

December 23rd, 2009

National Nurses United opposes Senate healthcare bill

Raw Story reports that the newly-formed National Nurses United has apparently come out in opposition to the Senate healthcare bill, claiming that it may actually make healthcare worse.

In a statement, the union has identified 10 major flaws in the bill:

1. The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.
2. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.
3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.
4. The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they’d pass the higher costs to their employees.
5. Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:
   • Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.
   • Insurers are permitted to sell policies “across state lines”, exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.
   • Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.
   • Insurers may continue to rescind policies for “fraud or intentional misrepresentation” – the main pretext insurance companies now use to cancel coverage.
6. Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California’s largest insurers have rejected more than one-fifth of all claims since 2002.
7. Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.
8. New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn’t want.
9. Reduced reproductive rights for women.
10. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.

Here is the Raw Story article:

Nurses explain how health bill could make crisis worse
‘Unchecked influence of health industry lobbyists’ means bill could be weakened in the future, union’s reps say

By Daniel Tencer

The newly-formed nurses’ “mega-union” has issued a scathing indictment of the Senate health bill expected to be voted on this week, calling it a “deeply flawed” piece of legislation that could make the US health care system’s problems worse.

National Nurses United, the US’s largest nurses’ union since it was formed earlier this month, issued a statement Monday implying that it doesn’t support the health care reform bill championed by the White House and Senate Majority Leader Harry Reid.

“It is tragic to see the promise from Washington this year for genuine, comprehensive reform ground down to a seriously flawed bill that could actually exacerbate the health care crisis and financial insecurity for American families, and that cedes far too much additional power to the tyranny of a callous insurance industry,” said NNU co-president Karen Higgins, a registered nurse.

The nurses’ statement implied that it would be better if Congress passed no reform legislation, rather than the current proposed bill. NNU co-president Deborah Burger dismissed arguments that the bill can be improved in the future, and that it marks the start of a comprehensive overhaul of the US health care system.

“Those wishful statements ignore the reality that much of the expanded coverage is based on forced purchase of private insurance without effective controls on industry pricing practices or real competition and gaping loopholes in the insurance reforms,” said Burger.

And Jean Ross, another NNU co-president, said it’s likelier that the health care bill will be weakened, rather than strengthened, in the coming years, “due to the unchecked influence of the health care industry lobbyists and the lessons of this year in which all the compromises have been made to the right.”

The NNU’s statement lists what it sees as 10 major flaws with the bill, including the bill’s mandate requiring individuals to purchase health insurance, without doing enough to reduce insurance costs; no limitations on health insurance monopolies in certain states and cities; and “reduced reproductive rights for women.”

The NNU also points to little-discussed provisions in the bill it says put the lie to the idea that the bill will stop insurance companies from canceling policies on account of pre-existing conditions.

– Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

– Insurers are permitted to sell policies “across state lines”, exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.

– Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.

– Insurers may continue to rescind policies for “fraud or intentional misrepresentation” – the main pretext insurance companies now use to cancel coverage.

National Nurses United is a member of the umbrella labor group AFL-CIO. Last week, the AFL-CIO’s president, Richard Trumka, called the Senate health bill “inadequate and too tilted toward the insurance industry.” The NNU’s criticism this week indicates that the labor movement is lining up against the Senate version of the health bill, which — unlike the House version — doesn’t include any sort of public option.

Earlier this month, as the union was being formed, NNU Co-President Burger criticized the health bill — even before the Medicare buy-in was removed.

“What we’ve got now isn’t really health care reform, it’s a reshuffling of the deck chairs on the Titanic as far as our patients are concerned, and we’re going to make sure that we … have universal health care that is truly universal and has eliminated the insurance companies,” she told Reuters.

December 22nd, 2009

Huffington: Stop the special interest healthcare bill

Ariana Huffington describes the #1 reason she hopes the healthcare bill is defeated. I am glad she brought up the No child Left Behind debacle as I’ve been thinking about it a lot recently as I’ve tried to figure out whether I would vote for or against this bill, if I had a vote. I still haven’t decided. but I do know that, regardless of the vote, I’d feel like vomiting, just as I do when I hear Obama, Axelrod, and other figures describe this massive gift to the insurance and pharmaceutical industries as a great victory for you and me:

The Senate Health Care Bill: Leave No Special Interest Behind

By Ariana Huffington

With Monday morning’s 1 a.m. 60-40 vote, the Senate’s health care bill took another step towards passage, prompting a fresh round of public celebrations. “I think it’s very exciting,” HHS Secretary Kathleen Sebelius told HuffPost. “It’s a big day.”

Even many of those with serious reservations about the bill were slipping on their party hats. “Make no mistake about it,” said SEIU president Andy Stern, “for working Americans, this vote signals progress.”

And Paul Krugman, while calling the legislation “a seriously flawed bill we’ll spend years if not decades fixing,” applauded it as “an awesome achievement.”

This typifies the current thinking of the “Don’t let the perfect be the enemy of the good” crowd. Unfortunately, there are three faulty premises at work in this line of reasoning. First, that those who oppose the bill do so because it’s not perfect (as opposed to because it’s a hot health care mess). Second, that the bill is, well, good (as opposed to a total victory for Pharma and the insurance industry — witness the spectacular spike in health care stocks following Monday’s vote).

Third is the premise that this is as good a bill as we can get right now, and we can always go back and improve it later.

It doesn’t work that way. We heard the same kinds of sentiments about No Child Left Behind when it passed in 2001. Backers on both sides of the aisle had problems with it, but both sides celebrated it as a major step forward — and promised to make it better in the future.

“The agreement we reached reflects the best thinking of both sides,” said Sen. Joe Lieberman.

“This was a reform bill. We can’t have reform without resources, and that will be the next step,” said Sen. Tom Daschle.

“This is a good bill… And there are going to be many additional steps that will be necessary along the way, but all of us are committed to following in those steps,” said Sen. Ted Kennedy, the primary Democratic co-sponsor of the bill.

But despite the widespread commitment to taking the “many additional steps” needed, the steps were never taken, the resources were never allocated, the bill was never improved, and, indeed, is now generally regarded as a disaster (or, as Bill Clinton put it last year, “a train wreck”).

In an ominous sign of things to come, Vicki Reggie Kennedy, Sen. Kennedy’s widow, made many of the same arguments that were used in support of No Child Left Behind in her Washington Post op-ed promoting passage of the current health care bill.

It’s a moving piece of writing — and nobody doubts her late husband’s heartfelt dedication to health care reform. But nobody doubted his dedication to education reform, either.

If the miserable Senate health care bill becomes the law of the land, it’s only going to encourage the preservation of a hideously broken system. Just how broken the system is is summed up in the fate of Byron Dorgan’s drug re-importation amendment.

This is an idea that Obama co-sponsored when he was in the Senate and unequivocally championed on the campaign trail: “We’ll allow the safe re-importation of low-cost drugs from countries like Canada.”

But when Dorgan introduced an amendment that would do just that, the White House, sticking to the deal it made with the pharmaceutical industry, lobbied against it — and the commissioner of the supposedly non-political FDA just happened to release a letter citing “significant safety concerns” about all those dangerous drugs from Canada. Big Pharma’s many congressional lackeys trumpeted the letter and the amendment was killed.

But that didn’t stop David Axelrod from insisting in an interview with John King this weekend that “the president supports safe re-importation of drugs into this country. There’s no reason why Americans should pay a premium for the pharmaceuticals that people in other countries pay less for.”

No reason other than our broken system surrendering to the special interests.

From start to finish, the insurance and drug industries — and their army of lobbyists — had control over the process that resulted in a bill that is reform in name only. The postmortems of how they pulled it off have already begun. On Sunday, the Chicago Tribune published an exhaustive front-page analysis by Northwestern University’s Medill News Service and the Center for Responsive Politics of how it was done. The main culprit: “a revolving door between Capitol Hill staffers and lobbying jobs for companies with a stake in health care legislation.”

The study found that 13 former congressmen and 166 Congressional staffers were actively engaged in lobbying their former colleagues on the bill. The companies they were working for — some 338 of them — spent $635 million on lobbying. It was money extremely well spent — delivering a bill that, by forcing people to buy a shoddy product in a market with no real competition, enshrines into law the public subsidy of private profit.

As we approach the end of Obama’s first year in office, this public subsidizing of private profit is becoming something of a habit. It is, after all, exactly what the White House did with the banks. Just as he did with insurance companies, Obama talked tough to the bankers in public but, when push came to shove, he ended up shoving public money onto their privately-held balance sheets.

This is not just bad policy, it’s bad politics.

Sharp-eyed opponents are already seizing on the opportunity to rebrand Obama and the Democrats as the party beholden to special interests.

Sunday night, just before the post-midnight vote was taken, John McCain took to the Senate floor and, hearkening back to his days as a crusader for campaign finance reform, lambasted Obama and the Democrats’ “negotiations with the special interests,” adding: “We should have set up a tent out in front and put Persian rugs in front of it. That’s the way that this has been conducted. So the special interests were taken care of, then we had to take care of special senators.”

This kind of populist rhetoric resonates with voters across the board, including independents. If Democrats cede this turf by celebrating a bill that is a victory for special interests and special senators, look for a lot more of this kind of rhetoric in the run-up to 2010.

President Bush brought us preemptive war. President Obama’s specialty seems to be preemptive compromise. He gave the farm away to Pharma, and then had to keep on giving when Lieberman, Nelson, and the other industry-backed Senators came calling.

There are many reasons for hoping the current Senate bill doesn’t become law. But the biggest reason of all is the desperate need for a DC pattern interrupt. The desperate need to draw a line in the sand against the continued domination of our democracy — and the continued undermining of the public interest — by special interests.

December 22nd, 2009

Public loves public option, Medicare buy-in, hates Senate-Obama bill

A new poll shows yet again that the Senate-Obama bill is very unpopular, while the dropped public option and Medicare buy-in are wildly popular. Fifty percent of Republicans support the Medicare buy-in. No wonder Obama did nothing to pass the public option:

Poll: Public Still Doesn’t Like Health Care Bill — And Still Like Public Option, Medicare Buy-In

By Eric Kleefeld

A new Quinnipiac poll finds that a large majority of Americans continue to oppose the health care bill — and that two policies that have been dropped, the public option or the Medicare buy-in, which were both very popular.

The poll finds 53% of respondents saying they mostly disapprove of the health care plan in Congress, to only 36% who approve. From the party internals, support is at 64%-22% among Democrats, 10%-83% among Republicans, and 30%-58% among independents.

The now-departed public option, however, is supported by a 56%-38% majority, including a 54%-41% margin among independents. Also, the Medicare buy-in for Americans ages 55-64 was supported by 64%-30%, including 57%-36% among independents and even a 50%-44% margin among Republicans.

The poll also finds that only 31% agree both that the President and Congress must take on health care reform now and support the current proposals. Another 28% want reform now but don’t support the current proposals (a number spread pretty evenly across all partisan sub-samples), while 36% don’t think reform should be taken on now.

From the pollster’s analysis: “While the Senate leadership reportedly has the votes to pass a health care overhaul plan this week, outside the Beltway there appears to be weak support, both to what voters understand as the plan, and the need to pass that plan now.”

December 22nd, 2009