Reported Missing: Chuck Grassley’s Honor and Integrity

Grassley praises Medicare as part of ‘social fabric’ of America, but also criticizes it as a ‘predator.’

During this morning’s debate over Sen. Jay Rockefeller’s (D-WV) public plan amendment, Sen. Chuck Schumer (D-NY) challenged Sen. Chuck Grassley’s (R-IA) claim that the public option would lead to single payer health care. The exchange flustered Grassley. He admitted that Medicare is part of the “social fabric” of America and praised the competition between traditional Medicare and Medicare Advantage, but then said moments later that the government is a “predator.” “So you don’t want Medicare?” Schumer asked. Grassley concluded, “Medicare is part of the social fabric of America, and I think there’s a lot wrong with it.” Watch it:

According to a Congressional Budget Office analysis of Rockefeller’s amendment — which establishes a plan that reimburses providers at 5% above Medicare rates for the first two years — the public option would save the government an estimated $50 billion. Only eight million Americans would sign-up for the program, leaving the overwhelming majority of Americans to private coverage. Rockefeller’s amendment ultimately failed by a vote of 15-8. via ThinkProgress

MSNBC airs discredited allegation linking White House to ACORN

The Lynching Of ACORN

Study details mainstream media's biased reporting on ACORN

Why Is Our Health Care System So Screwed Up

Why Is Our Health Care System So Screwed Up
There are times when it's comforting to imagine that at some point in our history Satan hired Dr. Frankenstein to help him stitch together our health care system.

You can picture the Dark Lord standing over the good doctor in his underground lab barking orders for creating the most insane and irrational health care system in the industrialized world.

"It must cost more per person than any other health care system, and it must leave tens of millions uninsured!" Satan cackled. "It must rely on private markets that give most people no choice in who covers them! It must produce hundreds of thousands of bankruptcies every year! And, and, and! It must produce a system where some patients get excessive and wasteful care, while others have to shuttle off to emergency rooms just to receive primary care treatment! Mwah-ha-ha!"

The reason I consider this scenario to be "comforting" is because it's far less depressing than the actual truth, which is that our medical system has been haphazardly pieced together over the last century almost by accident.

After all, even the most dedicated malevolent entity lacks the creative imagination to devise a system that swallows up 16 percent of our economic output on health care while still producing lower average life expectancies than most industrialized nations.

This raises the question, though, of why our system is so screwed up.

Part of the problem that reform advocates have had in making their case to the public is that our insane system has so many moving parts and uniquely inefficient features that it's been extremely difficult to craft a master narrative that the average person can understand (opponents, meanwhile, only have to tell people that Barack Obama wants to slaughter the elderly).

This article is meant to serve as a basic guide for why our health care system is the most inefficient in the industrialized world and why reforming it has proven so incredibly difficult.

Follow the Money

Let's start with a simple premise: The problem with American health care has nothing to do with the quality of our doctors and hospitals and everything to do with how we pay them.

Most industrialized countries pay for their health care either through a single-payer system where hospitals receive payments directly from the government, or through a series of nonprofit private insurers who pay fees based on a rate negotiated by the government. In both models, the government assumes the role of primary negotiator for setting prices.

In the United States, needless to say, this is not the case. We rely on private insurers as the primary price negotiators for medical services. But because insurers lack the cohesion and clout to really drum down prices, Americans spend a lot more on health care than any other country in the world. A lot, lot, lot, lot more.

In 2007, the United States spent an average of $7,290 per person on health care -- 16 percent of gross domestic product. By contrast, our Canadian neighbors spent an average of $3,895 per person, or 10 percent of GDP. The British spent $2,992 per person, or 8.4 percent of GDP. And the Japanese, who have some of the longest life expectancies in the world, spend $2,581 per person, or 8 percent of GDP.

The numbers for the U.S. are ridiculous by any measure, even if all this spending was producing a race of super beings capable of outswimming sharks and defeating grizzly bears in steel-cage death matches. But no: most studies of the world's healthiest nations don't even place the United States in the top 10, and the World Health Organization ranks our health care system 37th, just ahead of Slovenia's.

Although private insurers lack the ability to effectively bring down costs, they are able to compensate for high treatment prices in other, more pernicious ways.

First, they work like hell to deny coverage to people. Not only do they refuse to sell insurance policies to people with pre-existing medical conditions, but they spend a great deal of energy trying to rescind coverage for patients who dare to rack up big medical bills.

As they've faced increasing pressure to pay for rising medical costs over the years, insurers have expanded the definition of "pre-existing condition" to include such modern plagues as acne, pregnancy and hemorrhoids.

The other way insurers compensate for rising medical prices is to simply pass the cost on to the consumer, something that they've done with great success recently; insurance premiums have more than doubled over the last decade and have grown more than twice the rate of inflation.

Now, you might say that if premium prices get too high, then more consumers will opt out and thus force the insurers to bring down prices. And if Americans primarily purchased their insurance on an individual basis, that might certainly be the case.

But no! In America, most people get their insurance through their employers. This means that price increases are passed on to them indirectly in the form of stagnating wages.

In other words, if you've wondered over the past few years why you've gotten a paltry raise, no raise or even a pay cut, chances are it's because your company is struggling to foot the bill for your health insurance premiums. The bottom line is that insurance companies can get away with gouging consumers because consumers don't really know that they're being gouged.

.....more at link

Joe Wilson Lied, Pete Stark Told the Truth. Rabid Right Calls Hypocrisy Where There is None

Conservative Republicans as Virulent as Ever

Clinton: Right wing conspiracy v. Obama "virulent"

On Sunday, when David Gregory asked former President Clinton whether Obama was facing the "vast right wing conspiracy" that targeted him, Clinton said an emphatic yes.

"Oh, you bet. Sure it is. It's not as strong as it was, because America's changed demographically, but it's as virulent as it was," he replied.

That's an interesting answer. I understand Clinton's distinction between "strong" -- as in able to shift votes -- and "virulent" -- as in the ability to spread the way disease does. I think he's right. I wrote about Obama's sharp drop among white voters two weeks ago, and the fact is, he probably only lost the approval of white voters who hadn't voted for him -- his white approval rating has stayed roughly the same as his November share of the white vote, 43%. His standing with the folks who voted for him last year looks pretty solid.

But the "virulent" nature of the organized campaign against Obama is disturbing, and it's fostered by many of the same characters who targeted Clinton. Mostly they are disgraced GOP leaders and has-beens -- the abandoned former speaker and three-time-adulterer Newt Gingrich; the forced out of office and indicted Tom Delay; the congressional failure but corporate-cosseted Dick Armey. There are also new crazies like Rep. Michele Bachmann and Sarah Palin, plus formerly dignified conservatives like Chuck "Pull the plug on Grandma!" Grassley and Jon "I don't need no stinkin' maternity care" Kyl.

I think that Clinton's attempt to remind the media that Obama is facing a tried and true GOP character assassination -- since they didn't have programs to counter Clintons, or Obama's -- is very important.

But I'm also hugely disturbed that Clinton was used this past week by the dumb as a box of rocks media as a foil for President Carter, after Carter bravely said that the opposition to Obama was spurred by at least some racism. "Bill Clinton: Carter Wrong On Obama And Racism," screamed the pro-Obama but often a little seasick Huffington Post. Other news organizations with no track record understanding race followed suit.

If you examined Clinton's statements about Carter's remarks, which the Huffington Post story did not, and genuinely tried to understand what he said, there was no way not to conclude that Clinton agreed with Carter. Even in the HuffPo and AP snippets, Clinton said "I sympathize with" Carter's feeling that racism drives the most extreme attacks on Obama and "there's no question" racism is behind the most vicious anti-Obama outbursts of the last few months. But he also said -- and I agree -- that he believes that if Obama "were not an African-American, all of the people who were against him on health care would still be against him. They were against me, too."

And I completely agree with Clinton, but that doesn't mean Obama's opponents aren't coating their opposition with the sweet special sauce of racism. Obama knows that, both Clintons know that, and smart Democrats need to know that, asap.

I spent 2008 telling Obama-supporting Democrats that they would need to learn quickly from the lessons the Clintons learned painfully. It was great to find out that Obama agreed with me after his nomination, when he courted the Clintons, picked Hillary as Secretary of State and worked on various fronts with President Clinton. I still think grassroots Democrats and those in Congress need to look back at the Clinton years with a lot more candor and toughness than they've mustered so far, and remember that an administration that tried to buck corporate interests and transform our health care system was brought down, mainly by ridiculous, irrelevant issues, even while President Clinton's public approval ratings held strong, especially at the end of his term.

President Obama knows that as well as anyone else in his administration, but I think those who wants to fight on the frontlines with him in these next crucial weeks needs to get it as well.
-- Joan Walsh

Ayman al-Zawahri, Al Qaida No. 2, Calls Obama A "Fraud"

Al-Qaida's deputy leader on Monday seized upon President Barack Obama failure to bring about a freeze in Israeli settlement construction in the West Bank and called him a "fraud" in a new audio message.

Ayman al-Zawahri's 28-minute audio message was mainly to deliver a eulogy for slain Pakistani Taliban leader Baitullah Mehsud, but he also took the opportunity to slam NATO member states operating in Afghanistan, including Germany, which he criticized for keeping troops there.

The recording comes after a series of al-Qaida videos this past month, including several attacking Germany and threatening attacks against Berlin's military mission in Afghanistan. Those releases have raised concerns among German authorities ahead of parliamentary elections which ended Sunday.

Al-Zawahri reserved special scorn for Obama, whom he has insulted in nearly every one of his messages since the latter's historic election as U.S. president.

Many experts believe that Al-Qaida is struggling in the face of Obama's popularity in the Muslim world, especially compared to his predecessor George W. Bush.

Obama publicly called for an Israeli freeze in settlement construction in order to restart the peace talks, but was rebuffed by Israeli Prime Minister Benjamin Netanyahu last week.

"Here is Obama, the fraud, who pretended to be affected by the suffering of the Palestinians and then allows the settlements to flourish in the West Bank and in Jerusalem ... while pressing the weak (Arab) leaders to offer more concessions," al-Zawahri said.

Uninsured 22-Year-Old John Boehner Constituent Dies From Swine Flu

Uninsured 22-Year-Old John Boehner Constituent Dies From Swine Flu
Even though Boehner represents a large university, he has been an outspoken opponent of a public option that would make insurance cheaper and more accessible to recent graduates like Young. On Meet the Press last week, the Minority Leader continued to stick to the obstructionist Frank Luntz-endorsed talking points, dismissing the public option as “big government” while defending a watered-down plan.
Update TPM writes, "Still, if Young's lack of insurance did contribute to her not seeking treatment sooner, it would be hard to find a starker or more compelling example of the need to fix our broken health insurance system. And the fact that she was a constituent of the man who's leading House Republicans' in their effort to block reform only underlines the point.

Newsbuster’s Bizarre and Hypocritical Attack on FCC Appointee

Bush Officials Try to Alter Ethics Report - Focus Is Approval of Harsh Interrogations - May 6, 2009

Anti-ACORN Bill Ropes In Defense Contractors, Others Charged With Fraud

Anti-ACORN Bill Ropes In Defense Contractors, Others Charged With Fraud
Going after ACORN may be like shooting fish in a barrel lately -- but jumpy lawmakers used a bazooka to do it last week and may have blown up some of their longtime allies in the process.

The congressional legislation intended to defund ACORN, passed with broad bipartisan support, is written so broadly that it applies to "any organization" that has been charged with breaking federal or state election laws, lobbying disclosure laws, campaign finance laws or filing fraudulent paperwork with any federal or state agency. It also applies to any of the employees, contractors or other folks affiliated with a group charged with any of those things.

In other words, the bill could plausibly defund the entire military-industrial complex. Whoops.

Rep. Alan Grayson (D-Fla.) picked up on the legislative overreach and asked the Project on Government Oversight (POGO) to sift through its database to find which contractors might be caught in the ACORN net.

Lockheed Martin and Northrop Gumman both popped up quickly, with 20 fraud cases between them, and the longer list is a Who's Who of weapons manufacturers and defense contractors.

The language was written by the GOP and filed as a "motion to recommit" in the House, where it passed 345-75.

POGO is reaching out to its members to identify other companies who have engaged in the type of misconduct that would make them ineligible for federal funds.

Grayson then intends to file that list in the legislative history that goes along with the bill so that judges can reference it when determining whether a company should be denied federal funds.

The Florida freshman is asking for direct assistance. He has set up a Google spreadsheet where people can suggest contractors who have been charged with violations and include a link to a media or government report documenting the alleged transgression.

....

SHOCKING OUTRAGEOUS NEA Revelations

By way of A.L. - The NEA "Scandal": That's It?
Right wing bloggers are all hyperventilating today over a supposed "scandal" involving the National Endowment of the Arts. The basis of the hysteria is this post over at Andrew Breitbart's Big Hollywood site (the same outfit that posted the ACORN "sting" videos).

The site has posted a recording and transcript of a conference call that it describes as "explosive." The call is actually old news at this point, having already been hyped by Glenn Beck an others weeks ago, so I'm not sure what all the excitement is about.

Though I have better things to do, I actually read through the transcript of the call just now to see if there was really anything "explosive" inside. There wasn't.

The post claims, as Beck did previously, that this call proves that the Obama administration is using the NEA for partisan political purposes, and strongly implies (without actually saying so) that NEA money is somehow being funneled to progressives causes.

But the call is actually far more benign. It appears to have been organized by a group of progressive artists who want to, through their art, raise public awareness about various issues they care about. Invited to participate on the call were a low-level staffer from the White House Office of Public Engagement and the former Communications Director at the NEA (he was apparently transferred to another position at the NEA after this story broke).

When asked to speak, the White House staffer gives some boilerplate talking points about how the art community can really make a difference politically if they put their minds to it. The NEA communications guy is then given a similar chance to talk and says much of the same things, indicating how happy he is to be working at the NEA and encouraging the artists on the call to get involved.

In terms of optics, it was certainly not a good idea for the NEA communications director to participate in such a call (which is probably why he is not the communications director anymore). That organization is not supposed to be involved in political advocacy.

But unless Breitbart's got a lot more, this is the political equivalent of jaywalking.



Some nice satire on this mini-controversy here, Conservatives are outraged over an actual outrage? Color me impressed.

Some appropriate discipline has been handed out, but apparently Big Hollywood and Glenn beck will not be happy until someone gets the electric chair, Yosi Sergant, Administration Aide Demoted: Glenn Beck Strikes Again

"On August tenth, the National Endowment for the Arts participated in a call with arts organizations to inform them of the president's call to national service. The White House office of public engagement also participated in the call, which provided information on how the Corporation for National and Community Service can assist groups interested in sponsoring service projects or having their members volunteer on other projects. This call was not a means to promote any legislative agenda and any suggestions to that end are simply false. The NEA regularly does outreach to various organizations to inform of the work we are doing and the resources available to them."

[UPDATE: The NEA adds this line to the statement: "As regards Yosi Sergant, he has not left the National Endowment for the Arts. He remains with the agency, although not as director of communications." Sources familiar with the situation say that the move represents a significant step down and was the result of the controversy. Discussion about his new duties is still ongoing.]

An artist on the call recorded it and gave the recording to Beck, who played it on air as proof of a government conspiracy to co-opt arts organizations and warp the minds of Americans. "Your government is trying to trick you, use your tax dollars to change your mind. It's called propaganda. The people involved in the conference call, including the White House, knew that this was on the fence if not outright illegal," says Beck.

Sergant has a long history with the Obama campaign, having led the media effort for Shepard Fairey, the artist behind the iconic "Hope" portrait that Obama has credited with helping him win. (See this L.A. Weekly profile to get a feel for Sergant.)

On Sept. 1, Beck came after Sergant. After claiming that Nazi propaganda was based on America's early 20th-century progressive movement, Beck says that the progressives are at it again.

WATCH:

The Corporation for National and Community Service is a public-private partnership created in 1993 with a mission similar to one Obama pressed during his campaign, during which he repeatedly promoted national and community service.

For Beck, however, the service promotion is a specter of totalitarianism and he interviewed an artist who said that he was uncomfortable working in coordination with the White House.

WATCH:

CONTINUED:

The Washington Times editorial page also came after Sergant, asking if the NEA had invited artists to be on the conference call.

"The NEA didn't invite...We were a participant in a call. It was a third party that did the invitation," Sergant told the conservative page.

***Compare the NEA controversy to Bush era propaganda, Bush ‘planted fake news stories on American TV’

Federal authorities are actively investigating dozens of American television stations for broadcasting items produced by the Bush administration and major corporations, and passing them off as normal news. Some of the fake news segments talked up success in the war in Iraq, or promoted the companies’ products.

Investigators from the Federal Communications Commission (FCC) are seeking information about stations across the country after a report produced by a campaign group detailed the extraordinary extent of the use of such items.

The report, by the non-profit group Centre for Media and Democracy, found that over a 10-month period at least 77 television stations were making use of the faux news broadcasts, known as Video News Releases (VNRs). Not one told viewers who had produced the items.

“We know we only had partial access to these VNRs and yet we found 77 stations using them,” said Diana Farsetta, one of the group’s researchers. “I would say it’s pretty extraordinary. The picture we found was much worse than we expected going into the investigation in terms of just how widely these get played and how frequently these pre-packaged segments are put on the air.”

[ ]…The range of VNR is wide. Among items provided by the Bush administration to news stations was one in which an Iraqi-American in Kansas City was seen saying “Thank you Bush. Thank you USA” in response to the 2003 fall of Baghdad. The footage was actually produced by the State Department, one of 20 federal agencies that have produced and distributed such items.

Different Standards for ACORN and Blackwater

It's time to get real about the Republican distraction de jour - the great ACORN controversy.
The bottom line is this: if the same standard used to prevent ACORN from receiving federal contracts were applied to many large corporations -- Boeing, financial institutions like AIG and CitiCorp, not to speak of private military contractors like Blackwater -- they would all have been barred as federal contractors long ago. But instead of being blacklisted, many of them actually received billions of taxpayer dollars to bail them out.

ACORN has worked for decades to organize a nationwide grass roots community organization with a mission of empowering poor and moderate income people. ACORN has never been one of those outfits that seeks just to "represent" the interests of the poor. Since its inception it has been made up of poor and moderate income people themselves. Its members pay dues, elect their leadership and choose the battles that they fight. Its executives don't make huge salaries and - in my experience - most of its organizers and staff are true believers who really care about the battle for social justice.

The Right wing has always hated ACORN. Partially that's because the organization has been effective - especially when it comes to its battles for better housing and its campaigns to empower the poor the way we should do it in a democracy - registering people to vote. The Right wing hates it when poor people vote.

During last year's election campaign the Republicans did everything they could to discredit ACORN by exposing "irregularities" in some of its voter registration programs. They pointed to a number of instances when ACORN canvassers - who were being paid to register people to vote - registered non-existent voters like "Mickey Mouse".

It was absolutely wrong for some ACORN employees to fake registrations to meet their quotas and keep their jobs. And ACORN's voter registration operation should have caught these fake registrations with better quality control. But there was never any danger that there would be a parade of cartoon characters out of Disney World and "Mickey Mouse" or "Donald Duck" were going to show up at a polling place and cast a ballot. To hear the right wing media tell it, ACORN was engaged in a great voter fraud scheme. In reality, a handfull of its canvassers were defrauding the organization itself - and also creating a public relations nightmare.

The Republicans knew full well that there was no danger of "Mickey Mouse" voting. But they milked the "controversy" for every ounce of bad publicity they could deliver - and did their best to paint the former community organizer Barack Obama with the same brush.

Backed Into A Corner, Boehner Admits That Obama Is Not A Socialist

Today on CNN’s State of the Union, Obama responded to these charges from conservative leaders, stating, “You know, I’m amused. I can’t tell you how many foreign leaders who are heads of center-right governments say to me, I don’t understand why people would call you socialist, in my country, you’d be considered a conservative.”

You can't complain about health care reform if you're not willing to reform your own health

You can't complain about health care reform if you're not willing to reform your own health

New Rule: You can't complain about health care reform if you're not willing to reform your own health. Unlike most liberals, I'm glad all those teabaggers marched on Washington last week. Because judging from the photos, it's the first exercise they've gotten in years. Not counting, of course, all the Rascal scooters there, most of which aren't even for the disabled. They're just Americans who turned 60 and said, "Screw it, I'm done walking." These people are furious at the high cost of health care, so they blame illegals, who don't even get health care. News flash, Glenn Beck fans: the reason health care is so expensive is because you're all so unhealthy.

Yes, it was fun this week to watch the teabaggers complain how the media underestimated the size of their march, "How can you say there were only 60,000 of us? We filled the entire mall!" Yes, because you're fat. One whale fills the tank at Sea World, that doesn't make it a crowd.

Follow Bill Maher on Twitter: www.twitter.com/billmaher

In Defense of ACORN by Joe Conason

For many years the combined forces of the far right and the Republican Party have sought to ruin ACORN, the largest organization of poor and working families in America. Owing to the idiocy of a few ACORN employees, notoriously caught in a videotape "sting" sponsored by a conservative Web site and publicized by Fox News, that campaign has scored significant victories on Capitol Hill and in the media.

Both the Senate and the House have voted over the past few days to curtail any federal funding of ACORN's activities. While that congressional action probably won't destroy the group, whose funding does not mainly depend on government largesse, the ban inflicts severe damage on its reputation.

In the atmosphere of frenzy created by the BigGovernment videos -- which feature a young man and an even younger woman who pretend to be a prostitute and a pimp seeking "advice" from ACORN about starting a teenage brothel -- it is hardly shocking that both Democrats and Republicans would put as much distance as possible between themselves and the sleazy outfit depicted on-screen.

Like so many conservative attacks, the crusade against ACORN has been highly exaggerated and even falsified to create a demonic image that bears little resemblance to the real organization. Working in the nation's poorest places, and hiring the people who live there, ACORN is not immune to the pathologies that can afflict institutions in those communities. As a large nonprofit handling many millions of dollars, it has suffered from mismanagement at the top as well -- although there is nothing unique in that, either.

Yet ACORN's troubles should be considered in the context of a history of honorable service to the dispossessed and impoverished. No doubt it was fun to dupe a few morons into providing tax advice to a "pimp and ho," but what ACORN actually does, every day, is help struggling families with the Earned Income Tax Credit (whose benefits were expanded by both Ronald Reagan and Bill Clinton). And while the idea of getting housing assistance for a brothel was clever, what ACORN really does, every day, is help those same working families avoid foreclosure and stay in their homes.

Perhaps the congressional investigation now demanded by some Republican politicians would be a useful exercise, if conducted impartially. A fair investigation might begin to dispel some of the wild mythology promoted by right-wing media outlets.

Among the most popular canards on the right, repeated constantly by conservative pundits and politicians, is that ACORN has been found guilty of engaging in deliberate voter fraud, using federal funds. In reality, ACORN has registered close to 2 million low-income citizens across the country over the past five years -- a laudable record with a very low incidence of fraud of any kind.

Over the past several years, a handful of ACORN employees have admitted falsifying names and signatures on registration cards, in order to boost the pay they received. When ACORN officials discovered those cases, they informed the state authorities and turned in the miscreants. (That was why the Bush Justice Department's blatant attempt to smear ACORN with rushed, election-timed indictments became a national scandal for Republicans rather than Democrats.) The proportion of fraud is infinitesimal. For example, a half-dozen ACORN workers were charged with registration fraud or other election-related crimes in the 2004 election. They had completed fewer than two dozen false registrations -- out of more than a million new voters registered by ACORN during that cycle. The mythology that suggests that thousands or even millions of illegal registrants voted is itself a fraud.

Republican Corruption and Propaganda Still Haunts America

Former Health Insurance Executive Explains How Companies Pocket Billions Through ‘Rescission’

ACORN-Gotcha Gal, Hannah Giles, Gets Pass From Hannity On Her Lies, Dubious Claims And Discredited Video

Despite the fact that Andrew Breitbart and young “investigator” Hannah Giles had been punked in their previous “undercover” expose of ACORN the night before, Breitbart and Giles were back on Hannity last night (9/16/09) with another gotcha video. There was no mention that Giles had failed to verify the outlandish and, as it turned out, made-up claim of ACORN worker Tresa Kaelke that she had killed her husband. In fact, Breitbart spoke of the "murder" as though it were true. As we previously posted, a local police report indicates otherwise. Furthermore, last night, Giles falsely told Hannity, who hinted he knew better, that in every visit to an ACORN office where Giles appeared, pretending to be a prostitute, the organization had been willing to assist her proposed illegal activities.


DC Madam Customer David Vitter Is Outraged By The ACORN Prostitution Scandal
Vitter’s outrage over the latest ACORN scandal seems extraordinarily hypocritical, in light of what he went through in 2007:

A woman accused of running a Washington prostitution ring placed five phone calls to David Vitter while he was a House member, including two while roll call votes were under way, according to telephone and congressional records.

Vitter, a Louisiana Republican now in the Senate, acknowledged Monday that his number was on the woman’s call list and apologized for a “very serious sin.”

Vitter, of course, kept his federal funding, and remains in the Senate.


Poll Finds Most Doctors Support Public Health Care Option


Democrats and the Great ‘Czar’ Panic

Manu Raju talks to Senate Democrats about the Glenn Beck-driven, almost entirely hysterical campaign against “czars.” The fuel: a letter written by Sen. Russ Feingold (D-Wis.) about “czars.” I’ve reprinted the letter below the jump, but the key bit is this:

I respectfully urge you to disclose as much information as you can about these policy advisors and “czars.” Specifically, I ask that you identify these individuals’ roles and responsibilities, and provide the judgment(s) of your legal advisors as to whether and how these positions are consistent with the Appointments Clause.

Politico’s take here is — shockingly! — a bit misleading and over-wrought. In addition to Feingold’s letter, there’s Sen. Byron Dorgan (D-N.D.) saying that “you need to have confirmation” for powerful advisers. There’s Sen. Dianne Feinstein (D-Calif.), who wants more oversight but avers that the way “czars” are defined in the press is wildly misleading: “I don’t think it’s quite fair to call, for example, David Hayes at the Department of Interior a czar.” Somewhat surprisingly, conservative-leaning Sen. Ben Nelson (D-Neb.) dismisses the “czar” panic as “something that some talk show hosts have made a great deal out of.” And there’s an eight-month old letter about “czars” from Sen. Robert Byrd (D-W.Va.). Politico packages this as evidence of Democrats “joining the czar wars.”

It’s hard to overstate what a fantastic issue this is for Republicans if it’s covered hysterically. The 40 Republican members of the Senate have filibustered or put holds on many of the president’s nominees, including Dawn Johnsen for the Office of Legal Counsel and Tom Perez at the Civil Rights Division of the Justice Department. They subjected Cass Sunstein to an eight-month series of holds and filibusters which ended only last week — and they continue to include Sunstein in the roll calls of “unaccountable czars.”

Thanks to lazy and sensationalized journalism, Republicans are able to put the breaks on the president’s nominees while complaining, as Sen. Lamar Alexander (R-Tenn.) did yesterday, that President Obama’s appointees are “unaccountable to the American people through their elected representatives.” The fact that Republicans, instead of asking questions, are quietly placing “holds” on qualified nominees who have been submitted to the Senate, goes utterly unmentioned.

Tea Party 2009

They Had a Great Party and Put it All on Republicard
Five years ago, Forbes magazine performed a worthy public service. The right-leaning business publication that dubs itself, "Capitalist Tool," published a set of criteria by which to judge the economic performance of 10 post-war presidencies. It then evaluated each presidency against that set of criteria.

The criteria themselves are straightforward. They include GDP growth, real disposable personal income, employment, unemployment, inflation, and deficit reduction. All are mainstream metrics of economic performance. Data for each are readily available from public sources and are regularly updated.

It is a measure of Forbes' integrity that it let the chips fall where they may. The top three performers were all Democrats: Clinton, Johnson, and Kennedy. The bottom three were all Republicans: Nixon, Eisenhower, and Bush I. The middle was a mixture of Republicans and Democrats: Reagan, Carter, Ford, and Truman.

Interestingly, however, Forbes didn't use the criteria to evaluate the candidate it was supporting for President at the time, George W. Bush, even though the article was published in July 2004, in the middle of a presidential election. Surely they ran the numbers. One can't resist suspecting that their boy fared poorly for the comparison.

But now, with his two terms ended, it is worthwhile evaluating Bush's performance and comparing it with that of the last Democratic president, Bill Clinton's. The reason for choosing Clinton is that his is the only two-term Democratic presidency since the 1960s and the two are adjacent, sharing similar post-Cold War contexts.

A comparison is also needed because Republicans have taken to criticizing anything Obama, without offering alternatives. But Bush's economic policies were of the exact same ilk as Ronald Reagan's and his father's, George H.W. Bush. They are classic, trickle down economics whose principal purpose is to shift ever more of the nation's wealth to the already wealthy. Bush's policies ARE the Republican alternative so it's important to know the results they produce.

So what do the data show?

The first metric Forbes offered was real growth in Gross Domestic Product. GDP measures all the goods and services produced in the economy in a single year. The "real" part factors out the effects of inflation. It is the most encompassing of all measures of economic performance.

During Bush's eight years in office, real GDP grew by 2.0% per year. Over Clinton's eight years, it grew 75% faster, 3.5% per year. The difference is so great that Clinton actually added more to the GDP in his eight years than Bush did in his, despite having started from a much lower number. Clinton 1: Bush 0.

Forbes' second metric was real disposable personal income. As noted above, the "real" part factors out the effects of inflation. The "disposal" part adjusts for taxes. So real disposable personal income tells us what a person's income actually buys, after inflation and taxes. It is one of the most meaningful measures of economic well-being.

As with real GDP growth, the numbers differ greatly. Bush grew real disposable personal income by 19.6 % over his term. Clinton grew it more than 40% faster, by 28%. And this comparison is understated because the vast bulk of income growth under Bush went to the very wealthiest of income earners. Between 2000 and 2007 two thirds of all the growth in the entire economy went to the top 1%. If average incomes were considered, the difference in performance would be far more stark. Clinton 2: Bush 0.

With employment, the third measure of economic performance commended by Forbes, the differences between Bush and Clinton become monumental. Clinton's economic policies created 23 million new jobs over his eight-year tenure. It was the greatest number of jobs ever created under one presidency.

Bush's record on employment was equally legendary, but for the opposite reason. Despite inheriting an economy that was one third larger than the one Clinton inherited, Bush created a mere 5 million new jobs, one fifth the number created by Clinton. It is the lowest percentage level of job growth ever recorded for any eight year period outside of the Great Depression. Clinton 3: Bush 0.

Employment, of course, is closely related to the fourth of Forbes' measures of economic performance: unemployment. When Bill Clinton took office, in January 1993, unemployment stood at 6.9%. When he left office, it was at 4%, the lowest level since 1969.

When George Bush took office, he inherited Clinton's unemployment number, 4%. When he left office, in January 2009, the unemployment rate stood at 7.2% and was skyrocketing. The economy was hemorrhaging 600,000 jobs per month. Today, unofficial unemployment stands at 9.7%, the second highest rate since the Great Depression. Clinton 4: Bush 0.

Inflation is the fifth measure in Forbes' overall evaluation framework. Inflation can create the illusion of prosperity but it does so by debauching the purchasing power of money. So, it is routinely considered one of the most important gauges of economic performance. Lower numbers are better. Inflation averaged 2.54% per year under Bill Clinton and 2.83% per year under George Bush. Clinton 5: Bush 0.

The final measure of economic performance recommended by Forbes is reduction in the federal budget deficit. Deficits occur when the government spends more than it takes in in taxes. Like inflation, deficits create the illusion of prosperity by spending money borrowed from the future. They are a favored ruse of Republican presidents which have used them relentlessly to deliver fake prosperity over the past three Republican administrations. When the borrowing has to be repaid, which we're coming up on now, the effect will be devastating.

Here, the comparison is off the charts. Clinton inherited a $290 billion deficit from George H.W. Bush. He reversed Bush's and Reagan's trickle down economic policies, raising taxes on the wealthy, and reducing them on the working and middle classes. As a result, he was able to reduce the deficit every single year of his presidency. By 1997, the government was running budgetary surpluses, the first since 1969. He delivered a $230 billion surplus in 2000.

Bush reversed Clinton's policies, lowering taxes on the very wealthy - his "base" as he called them - and effectively raising them on everyone else. In his first full year at the helm of the economy, he delivered a $157 billion deficit, and he never looked back. By 2004, the deficits were topping $400 billion a year. While Clinton delivered surpluses, Bush's deficits totaled some $3.7 trillion over his eight-year term. Clinton 6: Bush 0.

There is no subtlety, no ambiguity about the data or the economic performance they reveal. By every single measure, Bush's policies and tenure were worse - much worse - for the American economy and the American people than those pursued by Bill Clinton. And we are still living today in the aftermath of the destruction they have wrought.

We could add any number of other measures as well, measures not offered up by Forbes but which are still straightforward indices of economic performance. Clinton reduced poverty, from 15.1% when he took office to 11.3% when he left. Bush increased it, from 11.3% when he started to 12.5% at the end of 2008.

The stock market more than tripled under Clinton's tenure. The Dow Jones Industrial Average went from 3,241 when he took office to 10,587 on the day he left. It actually declined under Bush's tenure, from 10,587 on the day he took office to 8,281 on the day he left. Between the recent stock market collapse and the housing crash, Bush destroyed more than $14 trillion in consumer wealth, a staggering, almost incomprehensible legacy of devastation that will haunt Americans for decades to come.

Confronted with such data, Republicans routinely cavil that the comparison is stacked to favor Democrats. But it can hardly be said of Forbes that it is a left-leaning publication. Quite the contrary. Forbes' framework is persuasive precisely because it comes from an unimpeachable Republican source.

And knowing all too well Bush's abysmal record, Republicans try to weasel away from it by claiming that presidents really don't have that much to do with economic performance. Forbes addressed this as well, stating directly, "Fairly or not, each president is judged by how much prosperity is delivered on his watch."

Donald Rumsfeld was fond of saying that people are entitled to their own opinions but they are not entitled to their own facts. The facts are undeniable: Bush's economic policies lose by every measure. He fails not just one but every single comparison. And the differences could not be more dramatic. His policies were a catastrophe for the American people, leaving them poorer, more indebted, and less economically secure.

As Republicans continue to bash Barack Obama it is important to remember that Obama is still trying to clean up the mess left by Bush. It's equally important to keep in mind that they almost never propose any alternative - witness the do-nothing whining about health care.

But when it comes to the economy, the alternative is known. It is specific, it is documented, and it is undeniable. It is the legacy of Bush II, the same enrich-the-wealthy policies that Bush I and Reagan pursued. They are a proven prescription for disaster. Let the buyer beware.


Robert Freeman writes on economics, history and education

Fox and Conservative Pundits Start False Rumors About 9-11 Rememberance Group

9/11 Anniversary, National Day Of Service
I finally understand what it really means when people say "no good deed goes unpunished."

About seven years ago, the 9/11 community came together to support the wonderful idea that the anniversary of the September 11, 2001, attacks on America ought to become a federally-observed, national day of service and remembrance, rather than become just another day on the calendar. Most would say it was a no-brainer.

I guess not.

This past August, a few months after the 9/11 community finally secured passage of bipartisan legislation that established 9/11 as a National Day of Service and Remembrance, a writer for the American Spectator published an article entitled "Obama's Plan to Desecrate 9/11."

The opening sentence read this way:

The Obama White House is behind a cynical, coldly calculated political effort to erase the meaning of the Sept. 11, 2001 terrorist attacks from the American psyche and convert Sept. 11 into a day of leftist celebration and statist idolatry.

An awful lot of people who read that article concluded that the 9/11 Day of Service and Remembrance was hatched by President Obama, not the 9/11 families at all, and furthermore, that our group, MyGoodDeed, was a front for "pinko commies." In an instant, what we had spent years building from scratch with the help of conservatives and liberals alike, not to mention very senior members of the Bush Administration, was transformed into a leftist political conspiracy to trick Americans into supporting President Obama's socialist agenda. Holy crap!

Not being one that reads the political media all that much -- I prefer the sports pages -- I had no idea what was about to happen next. First, a bunch of other blogs picked it up. And then Fox News got ahold of it. I'm sitting at home with a pizza watching TV one night, and all of a sudden there's Laura Ingraham blasting us for cavorting with guys like Van Jones and some other "commie" guy I never met or talked to in my life. What the heck?

Then our website, meant to be a peaceful place for well-meaning people to post their good deeds for the day and other service projects in tribute to the 9/11 victims, starts getting hammered with pretty scary comments from more than a few angry conservatives... things like:

"You BASTARDS. How Dare You!"

"This is so disrespectful to the thousands of people who died on September 11th. How dare you try to co-op 9/11 from a National Day of Mourning to some cheesy Obamabot service day."

Up until that point, most of the posts were things like, "The Boys & Girls Clubs of Augusta will make cards of appreciation for the local veterans and distribute them on September 11th," and "I will be displaying two flags containing the names of the civilians that died on 911 along with the names of the firefighters and rescue workers..." Wow!

Now everyone is entitled to their opinion -- this is a free country. And we don't mind it if some people think that establishing 9/11 as a day of service and remembrance is the worst idea in the world. Although our view is that the 9/11 families themselves ought to be able to decide what the observance should be, people certainly can disagree. That's what makes America great.

But more was going on here than that. The real problem was that 9/11 Day of Service and Remembrance had become somebody's political ammo, in this case aimed at the Obama Administration. I felt a little like I'd walked into convenience store in the middle of a freakin' hold-up.

Apparently, we were in the wrong place at the wrong time.

I talked to the writer later and he explained what he was trying to do -- bring to light information that he said indicated that the president was orchestrating a plan to manipulate 9/11 for political gain. (We've been there before, BTW.) Later, in a subsequent post, he clarified his position and provided excellent and accurate information on our group and the 9/11 family origins of the observance, which thankfully stopped some of the more vociferous attacks.

But I sure learned that it's not a good thing to get into anyone's political cross-hairs these days.

Which is exactly why this observance is so important and right.

The whole idea is to encourage all of America to remember the way we were immediately after the attacks -- we weren't red states or blue states. We were Americans, and we were powerful. Because we were unified. Today, we are anything but. Ordinary citizens who might find themselves sharing coleslaw at a weekend BBQ are throwing punches at one another in the middle of town hall meetings on health care reform. Geez!

I'm not saying there aren't serious issues at hand. And people are going to disagree. But if 9/11 taught us anything, it was that we need to remember that we have so much more in common as human beings than we have differences. We have to find ways to debate our views, and solve our problems with the 9/11 spirit of unity in mind.

For the record, the 9/11 Day of Service and Remembrance is widely backed by the Left, Middle and Right and is not, in any way, a government led or funded initiative created by President Obama or any government agency. It was started by the 9/11 community eager to leave a lasting and positive legacy honoring their lost loved ones, and is supported by respected nonprofits such as the Points of Light Institute, founded with the help of former President George Bush Sr., AARP, America's Promise Alliance, City Year, ServiceNation, and many other wonderful and nonpartisan groups listed on our Web site at 911dayofservice.org.

Lest we all forget, almost eight years ago, 2,974 people were murdered. Forty percent of the families of these victims never recovered any remains. Nothing. They buried empty caskets. Since then, nearly 800 first responders who raced to the scene have died -- 27 percent from cancer. Thirty-one of the 800 committed suicide.

Needless to say, 9/11 is not a day that should ever be politicized or used to flame the fires of partisanship. Not by The American Spectator or Fox News. Or by supporters of the Obama Administration or MSNBC. It must always be a day of unity, patriotism, and reflection, along with remembrance. And yes, if a person chooses to do so, voluntary service as well. Let's honor the 9/11 heroes by putting the boxing gloves away, at least for one day.

Health Care Nazi Betsy McCaughey Spreads Another False rumor

Health Care Nazi Betsy McCaughey Spreads Another False rumor
On former Sen. Fred Thompson’s radio show, former lieutenant governor of New York Betsy McCaughey said that the House’s proposed health care bill contained a provision that would institute mandatory counseling sessions telling seniors how "to do what’s in society’s best interest … and cut your life short." House Minority Leader John Boehner made a slightly more measured statement, warning that the same provision "may start us down a treacherous path toward government-encouraged euthanasia if enacted into law."

In truth, that section of the bill would require Medicare to pay for voluntary counseling sessions helping seniors to plan for end-of-life medical care, including designating a health care proxy, choosing a hospice and making decisions about life-sustaining treatment. It would not require doctors to counsel that their patients refuse medical intervention.
Analysis

Our inboxes have exploded recently with worried queries from readers who have heard that the House’s proposed health care bill, H.R. 3200, contains a provision that would require that ailing seniors be pressed to consider suicide in order to save the taxpayers money on Medicare. Most messages mention that this clause appears on page 425 of the legislation. A sample e-mail forward:

Chain e-mail: On Page 425 of Obama’s health care bill, the Federal Government will require EVERYONE who is on Social Security to undergo a counseling session every 5 years with the objective being that they will explain to them just how to end their own life earlier. Yes…They are going to push SUICIDE to cut medicare spending!!!

Page 425 does deal with counseling sessions for seniors, but it is far from recommending a "Logan’s Run" approach to Medicare spending. In fact, it requires Medicare to cover counseling sessions for seniors who want to consider their end-of-life choices – including whether they want to refuse or, conversely, require certain types of care. The claim that the bill would "push suicide" is a falsehood.

10 of the Most Obscenely Stupid Right-Wing Conspiracy Theories and Attacks Against President Obama's Administration

10 of the Most Obscenely Stupid Right-Wing Conspiracy Theories and Attacks Against President Obama's Administration

Today, President Barack Obama is slated to give a speech urging America's schoolchildren to do their homework and stay in school.

Naturally, conservatives are extremely alarmed, because obviously the president is looking to create a vast army of adorable little zombies that will help him destroy America faster.

All last week, conservative bloggers and pundits gleefully accused the centrist president of plotting to force radical politics on America's impressionable youth, after Florida's Republican chairman Jim Greer said Obama's address would "indoctrinate" children and spread "socialist ideology."

The week of right-wing echo chamber freak-outs led to protests by conservative parents, which put school districts throughout the country in the unenviable position of having to deal with the "controversy": Some have decided not to air the president's address; others are requiring parental permission.

So, thanks to the right-wing saviors of America's youth, a bunch of kids will be shielded from the president's dangerous message that learning things is good.

Could this be the stupidest, most irrational way conservatives have tried to tear down Obama? Is it even possible to answer that question?

We've assembled the most absurd, logic-defying right-wing attacks on the president. Some you've undoubtedly encountered before, as all are incessantly blared by conservative pundits and shock jocks, while many are cynically embraced by GOP lawmakers.

Assembled together, they illustrate the absurd extremes to which right-wingers are trying to drive the public discourse in their efforts to thwart essential reforms in health care, energy policy and the economy.

The Advent of Socialism/Fascism

Most historians would agree that fascism and socialism represent vastly different ideologies and historical phenomena. But not the historians at Fox News! Since Obama took office, right-wing pundits have lobbed these smears interchangeably, not quite clarifying whether Obama is leading the proletariat to a glorious utopian future or trying to bring the master race to world dominion.

Obama's Nefarious Plan for the Nation's Genitals

When news leaked of a CDC report recommending that boys be circumcised as a preventative measure against HIV infection, right-winger conspiracy theorists began to fret that the federal government would mandate circumcision.

Since Patrick Henry isn’t around, it was up to Rush Limbaugh to sound the rallying cry against tyranny: "Leave our penises alone, too, Obama!" roared Limbaugh in a July 24 radio broadcast.

The next day, while discussing an unrelated dispute with Jay-Z, the talk show host said, "I would remind the rapper Jay Z; Mr. Z, it is President Obama who wants mandated circumcision. We had that yesterday. That means if we need to save our penises from anybody, it's Obama."

Needless to say, Obama had nothing to do with the CDC report, and doesn't appear to have ever publicly uttered the word "circumcision." Nor did he recommend the CDC promote circumcision.

None of this, of course, discouraged Limbaugh from running with the best metaphor for white male anxiety about a loss of power and masculinity in the age of Obama, ever.

The Birthers

Remember when the president invented a time machine and traveled back in time to plant his own birth announcement in a Hawaiian newspaper and forge a certificate of birth proving he was born in the States, all to hide the fact that he's a foreigner from a country filled with scary black people?

That, of course, appears to be the only explanation for why the birther nonsense continues to gurgle up online (even though certain idiots, who for mysterious reasons still have shows on CNN, have finally stopped giving this nonsense the patina of mainstream credibility).

Recently, some birthers on Free Republic argued that the only way to determine the president's birthplace for sure was by checking if he is circumcised. (It would seem that there needs to be a subcategory on this list for these patriots' obsession with the president's penis.)

The Deathers

In America in 2009 -- a time and place where most people have access to a high school education and can read -- a rumor emerged that the overhaul of our terrible health care system would allow the government to put old people to death. This rumor was stoked by the crazy people on Fox News and talk radio, then embraced and propagated by Republican lawmakers and others who are supposed to be sane adults.

"A lot of people are going to die. This program of government option that‘s being touted as being this panacea, the savior of allowing people to have quality health care at an affordable price, is going to kill people." said Rep. Paul Broun, R-Ga, said.

Then there was almost-a-heartbeat-away-from-the-presidency Sarah Palin, who contributed to the discussion by saying that under a reformed health system, the government would have killed her child Trig because he has Down syndrome. (Palin took back the comments after much outcry, but that didn't stop the vocal minority of town hall protesters from screaming about Obama killing old and disabled people all summer).

The End of the Internet?

Cass Sunstein, currently awaiting confirmation to head the Office of Information an Regulatory Affairs, is apparently doing Obama's dirty work on this one. Someone enterprising at crackpot site World Net Daily cherrypicked from a long-ago Sunstein statement, making it sound like he wants government regulation forcing blogs to link to opposing viewpoints.

In fact, as Julian Sanchez writes, in the statement in question Sunstein floated the theory as "food for thought." And then he noted the free-speech issues involved. And then he called the idea stupid and unconstitutional.

Czars

Obama has "czars" in his administration. The word "czar" is Russian, which of course is scary ("Too Russian!" said former Oklahoma Rep. Ernest Istook. "Why not call somebody the Big Boss?").

One of Glenn Beck's favorite things to do is list off and rail against the czars in Obama's administration. Neil Cavuto, Mike Huckabee and others on Fox and like-minded media are also pretty excited about it and have made lots of puns (czar wars!) and wild accusations about Obama's alleged czar shadow army.

Somehow, their balanced take on this threatening phenomena fails to mention that George W. Bush was pretty fond of czars himself, overseeing the creation of a "food-safety czar," a "cybersecurity czar," a "regulatory czar," an "AIDS czar," a "manufacturing czar," an "intelligence czar," a "bird-flu czar" and a "Katrina czar," according to Steve Benen in Washington Monthly.

Our Half-White President Has a Problem With White People?

One would think Obama is pretty OK with white people, since he is half white and was raised by a white mother and grandparents. Beck would disagree.

In July, Beck bizarrely accused the president of having a deep-seated hatred for white people and "white culture," an attention-grubbing overreach that has led to a successful boycott campaign that has cost Beck 57 advertisers.

Beck's offensive statement was only the most extreme iteration of a conservative strategy to sneakily accuse the president of undermining the interests of whites. One other example is the absurd claim that the president is trying to trick white Americans into paying reparations through health reform.

Snitch Site?

A few months ago, the White House made a valiant attempt to help steer the health care debate toward existing things like policy, rather than totally made up crap like death panels. They did so by setting up a Web site where people could submit questions about the wild conspiracy theories circulating about reform.

Naturally, the fringe decided that Obama was asking people to report on their neighbors. And, of course, Republican lawmakers irresponsibly and shamelessly joined the fray, with Texas Sen. John Cornyn, for example, accusing Obama of compiling an "enemies list" and demanding the site be shut down.

An Expansion of AmeriCorps. The Horror!

And finally, what does Obama plan to do with all those kids he brainwashes during his speech today?

Wait, with diabolical patience, until their teeny little arms grow strong enough to wield heavy weaponry so he can draft them into his massive domestic paramilitary force. At least that appears to be a fear held by Beck, who has said Obama's "civilian national security force" is like Hitler's SS, or something Saddam Hussein would do.

Michelle Bachmann warned of a massive effort to herd kids into re-education camps. What were they talking about? The expansion of AmeriCorps and the Peace Corps.

And there you have it: Public discourse in 2009.

Tana Ganeva is an associate editor at AlterNet.

When will Conservative Silliness End

Republicans have a Record of Trying To Kill Medicare

Dr. Rafal, Part-time Conservative Nut, Fulltime Doctor Makes Fool of Himself - Making the Case for Socializing the legal system. Lawyers, Judges and Prosecutors.

Health-care Reform is constitutional. No where in the constitution of the U.S. does it mention medicine, television, telephones or X-ray machines, but we regulate all those things because....1. The commerce clause. 2. Common sense. The Founding fathers wrote the Constitution at a time when there were no transistors, electricity, or even steam engines. They left it up to future generations to make wise decisions about policy decisions like health-care - something that many modern Americans would consider something necessary for the "common good".

Conservative media take note: Reagan preached tax cut gospel to America’s students

Putting aside possible ulterior motives, the conservative freak-out over President Obama’s planned speech to students urging them to stay in school and work hard is due to fears that Obama will use his platform as an opportunity to push his agenda on unsuspecting students. Ironically, that’s exactly what President Reagan did two decades ago.

On November 14, 1988, Reagan addressed and took questions from students from four area middle schools in the Old Executive Office Building. According to press secretary Marlin Fitzwater, the speech was broadcast live and rebroadcast by C-Span, and Instructional Television Network fed the program “t o schools nationwide on three different days.” Much of Reagan’s speech that day covered the American “vision of self-government” and the need “to keep faith with the unfinished vision of the greatness and wonder of America” but in the middle of the speech, the president went off on a tangent about the importance of low taxes:

Conservatives Ranting about "Socialized Medicine" Go To Govt. Hospital

Conservatives Ranting about "Socialized Medicine" Go To Govt. Hospital
Republicans in Congress have raised the specter of a bloated, "socialized," bureaucrat-run nightmare of a health care system as a means of undermining the White House's effort at a systematic overhaul. And yet, as Democratic sources are now pointing out, when medical crisis hit close to home, many of these same officials turned to a government-run hospital for their own intensive care and difficult surgeries.

Take, for instance, Senate Minority Leader Mitch McConnell (R-Ky.), who warned that "a government takeover of health care" would "take away the care that people already have [and] are perfectly satisfied with." In its place, the senator said, would be "a system in which care and treatment will be either delayed or denied."

That was July 2009. In February 2003, McConnell actually went to one of those government-run institutions (where treatment is, apparently, "either delayed or denied") for a procedure of his own. The Kentucky Republican traveled to the National Naval Medical Center in Bethesda, Maryland, to have an elective coronary artery bypass surgery after it had been revealed that he had arterial blockages.

Also known as Bethesda Naval Hospital, the National Naval Medical Center is the premier branch of the United States Navy's system of medical centers -- as in, the government runs it. It's also the place where elected officials of all ideological stripes and political branches often go get surgery performed. Indeed, members of Congress pay an annual fee for the privilege of getting treatment at Bethesda Naval Hospital or, for that matter, Walter Reed Army Medical Center. It is, as longtime Democrat Martin Frost wrote for Politico, "like belonging to an HMO." Only, in these cases, the surgery is conducted at a public facility.

None of this has stopped some of the same officials who have taken advantage of this congressional perk from railing against the intrusiveness and inefficiencies of a health care system with greater government involvement.

Senator John McCain, (R-Ariz.) for instance, recently applauded the town hall protesters who were, in his words, revolting "against a government-run health system." That was August 2009. In May of 2000, McCain had surgery at the Bethesda Naval Hospital to remove a potentially lethal melanoma from his left temple.

Senator Kit Bond (R-Mo.), meanwhile, has warned of the rationing of care, expensive costs, and reduced quality that would come under a government-run health care plan. In April 2003, however, he traveled to Bethesda Naval Hospital to undergo hip replacement surgery in an attempt to alleviate degenerative arthritis in his left hip.

Senator George Voinovich, (R-Ohio), has declared that a "bureaucratic Washington-run government plan is not the answer" to the nation's health care needs. In June 2003, the Ohio Republican (who is retiring from the Senate in 2010) went to Bethesda Naval Hospital to have a pacemaker installed.
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The best example of this double standard, however, may be Rep. Roy Blunt, (R-Mo.) who compared government-run health care to an elephant, stomping on and killing off the mice of the private insurance industry.

Blunt has had two procedures done at Bethesda Naval Hospital. The first came in July 2002, when he underwent surgery to remove his left kidney. The second came a year later, when he underwent prostate surgery after being diagnosed with early-stage prostate cancer.

To be strictly accurate, there is an important distinction between a government-run hospital and a government-run health insurance agency. The public plan, which is the focus of much of the GOP's ire, is the latter. Bethesda Naval Hospital is the former.

But conservatives have long used the notion of "socialized medicine" to defeat health care reform efforts -- even though when it comes to the flagship Naval Hospital just miles away, the worries about bureaucratic nightmares, low quality care, and long lines seem to be wiped away.

via Sam Stein at huffingtonpost.com

Twenty-six Conservative Lies About Health-care Reform

Twenty-six Conservative Lies About Health-care Reform

Our inbox has been overrun with messages asking us to weigh in on a mammoth list of claims about the House health care bill. The chain e-mail purports to give "a few highlights" from the first half of the bill, but the list of 48 assertions is filled with falsehoods, exaggerations and misinterpretations. We examined each of the e-mail’s claims, finding 26 of them to be false and 18 to be misleading, only partly true or half true. Only four are accurate. A few of our "highlights":

* The e-mail claims that page 30 of the bill says that "a government committee will decide what treatments … you get," but that page refers to a "private-public advisory committee" that would "recommend" what minimum benefits would be included in basic, enhanced and premium insurance plans.
* The e-mail says that "non-US citizens, illegal or not, will be provided with free healthcare services" but points to a provision that prohibits discrimination in health care based on "personal characteristics." Another provision explicity forbids "federal payment for undocumented aliens."
* It says "[g]overnment will restrict enrollment of SPECIAL NEEDS individuals." This provision isn’t about children with learning disabilities; instead, it pertains to restricted enrollment in "special needs" plans, a category of Medicare Advantage plans. Enrollment is already restricted. The bill extends the ability to do that.
* It claims that a section about "Community-based Home Medical Services" means "more payoffs for ACORN." ACORN does not provide medical home services. The e-mail interprets any reference to the word "community" to be some kind of payoff for ACORN. That’s nonsense.

Analysis

This chain e-mail claims to give a run-down of what’s in the House health care bill, H.R. 3200. Instead, it shows evidence of a reading comprehension problem on the part of the author. Some of our more enterprising readers have even taken it upon themselves to debunk a few of the assertions, sending us their notes and encouraging us to write about it. We applaud your fact-checking skills and your skepticism. And skepticism is warranted.

Chain e-mail: Subject: A few highlights from the first 500 pages of the Healthcare bill in congress Contact your Representatives and let them know how you feel about this. We, as a country, cannot afford another 1000 page bill to go through congress without being read. Another 500 pages to go. I have highlighted a few of the items that are down right unconstitutional. ? Click to expand/collapse the full text ?
• Page 22: Mandates audits of all employers that self-insure! • Page 29: Admission: your health care will be rationed! • Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)• Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.• Page 58: Every person will be issued a National ID Healthcard. • Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer. • Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (read: SEIU, UAW and ACORN) • Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange. • Page 84: All private healthcare plans must participate in the Health care Exchange (i.e., total government control of private plans) • Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens • Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan. • Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter. • Page 124: No company can sue the government for price-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed. • Page 127: The AMA sold doctors out: the government will set wages. • Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives. • Page 146: Employers MUST pay healthcare bills for part-time employees AND their families. • Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll • Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll • Page 167: Any individual who doesn’t’ have acceptable health care (according to the government) will be taxed 2.5% of income. • Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them). • Page 195: Officers and employees of Government Health care Bureaucracy will have access to ALL American financial and personal records. • Page 203: "The tax imposed under this section shall not be treated as tax." Yes, it really says that. • Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected." • Page 241: Doctors: no matter what specialty you have, you’ll all be paid the same (thanks, AMA!) • Page 253: Government sets value of doctors’ time, their professional judgment, etc. • Page 265: Government mandates and controls productivity for private healthcare industries. • Page 268: Government regulates rental and purchase of power-driven wheelchairs. • Page 272: Cancer patients: welcome to the wonderful world of rationing! • Page 280: Hospitals will be penalized for what the government deems preventable re-admissions. • Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government. • Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies! • Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval. • Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN. • Page 335: Government mandates establishment of outcome-based measures: i.e., rationing. • Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc. • Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals. • Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone). • Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia? • Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time. • Page 425: Government provides approved list of end-of-life resources, guiding you in death. • Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends. • Page 429: Advance Care Planning Consult will be used to dictate treatment as patient’s health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT. • Page 430: Government will decide what level of treatments you may have at end-of-life. • Page 469: Community-based Home Medical Services: more payoffs for ACORN. • Page 472: Payments to Community-based organizations: more payoffs for ACORN. • Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage. • Page 494: Government will cover mental health services: defining, creating and rationing those services.

A few readers alerted us to the fact that a state representative in North Carolina, Rep. Curtis Blackwood, published a version of the e-mail in a newsletter to constituents, telling them that while going through e-mail, he came across "some interesting information on the Democrats’ big health care bill, H.R. 3200. … While this is federal legislation and not state, the topic is of enough significance that I thought many of you would be interested in reading it." We’d refer Rep. Blackwood to our special report on viral messages titled, "That Chain E-mail Your Friend Sent to You Is (Likely) Bogus. Seriously."

We can trace the origins of this collection of claims to a conservative blogger who issued his instant and mostly mistaken analyses as brief "tweets" sent via Twitter as he was paging through the 1,017-page bill. The claims have been embraced as true and posted on hundreds of Web sites, and forwarded in the form of chain e-mails countless times. But there’s hardly any truth in them. We’ll go through each of the claims in this message:

Claim: Page 22: Mandates audits of all employers that self-insure!

False: This section merely requires a study of “the large group insured and self-insured employer health care markets.” There’s no mention of auditing employers, only of studying “markets.” The purpose of the study is to produce “recommendations” to make sure the new law “does not provide incentives for small and mid-size employers to self-insure.”

Claim: Page 29: Admission: your health care will be rationed!

False: This section says nothing whatsoever about “rationing” or anything of the sort. Actually, it’s favorable to families and individuals, placing an annual cap on what they could pay out of pocket if covered by a basic, “essential benefits package.” The limits would be $5,000 for an individual, $10,000 for a family.

Claim: Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)

False: Actually, the section starting on page 30 sets up a “private-public advisory committee” headed by the U.S. surgeon general and made up of mostly private sector “medical and other experts” selected by the president and the comptroller general. The advisory committee would have only the power “to recommend” what benefits are included in basic, enhanced and premium insurance plans. It would have no power to decide what treatments anybody will get. Its recommendations on benefits might or might not be adopted.

Claim: Page 42: The “Health Choices Commissioner” will decide health benefits for you. You will have no choice. None.

False: The new Health Choices Commissioner will oversee a variety of choices to be offered through new insurance exchanges. The bill itself specifies the “minimum services to be covered” in a basic plan, including prescription drugs, mental health services, maternity and well-baby care and certain vaccines and preventive services (pages 27-28). We find nothing in the bill that prevents insurance companies from offering benefits that exceed the minimums. In fact, the legislation allows (page 84) any company that offers an approved basic plan to offer also an “enhanced” plan, a “premium” plan and even a “premium plus” plan that could include vision and dental benefits.

Claim: Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.

False. That’s simply not what the bill says at all. This page includes "SEC. 152. PROHIBITING DISCRIMINATION IN HEALTH CARE," which says that "[e]xcept as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services." However, the bill does explicitly say that illegal immigrants can’t get any government money to pay for health care. Page 143 states: "Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States." And as we’ve said before, current law prohibits illegal immigrants from participating in government health care programs.

Claim: Page 58: Every person will be issued a National ID Healthcard.

False. There is no mention of any “National ID Healthcard” anywhere in the bill. Page 58 says that government standards for electronic medical transactions "may include utilization of a machine-readable health plan beneficiary identification card,” to show eligibility for services. Insurance companies typically issue such cards already, but if such a standard were issued the cards would need to be in a standard form readable by computers. The word “may” is used to permit such a standard, but it does not require one.

Claim: Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.

False. This section aims to simplify electronic payments for health services, the same sort of electronic payments that already are common for such things as utility bills or mortgage payments. The bill calls for the secretary of Health and Human Services to set standards for electronic administrative transactions that would "enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice." There is no mention of "individual bank accounts" nor of any new government authority over them. Also, the section does not say that electronic payments from consumers is required.

Claim: Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (read: SEIU, UAW and ACORN)

Misleading. Page 65 is the start of a section (SEC. 164. REINSURANCE PROGRAM FOR RETIREES) that would set up a new federal reinsurance plan to benefit retirees and spouses covered by any employer plan, not just those run by labor unions or nonprofit groups. Specifically, it covers “retirees and . . . spouses, surviving spouses and dependents of such retirees” who are covered by “employment-based plans” that provide health benefits. It’s open to any “group health benefits plan that . . . is maintained by one or more employers, former employers or employee associations,” as well as voluntary employees’ beneficiary associations (page 66). Furthermore, the aim of the fund is to cut premiums, copays and deductibles for the retirees. Payment “shall not be used to reduce the costs of an employer.”

Claim: Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.

True. This page begins a section setting up a new, national Health Insurance Exchange through which individuals and employers may choose from a variety of private insurance plans, much like the system that now covers millions of federal workers. Any private insurance plans offered through this exchange must meet new federal standards. For example, such plans can’t deny coverage for preexisting medical conditions (page 19).

Claim: Page 84: All private healthcare plans must participate in the Health care Exchange (i.e., total government control of private plans)

Partly true. Nothing like this appears on page 84. No insurance company is required to sell plans through the exchange if it doesn’t want to. Any employer may choose to buy coverage elsewhere. In fact, the vast majority of employers will still be buying private plans through the normal marketplace, because only employers with 10 or fewer employees are even allowed to buy through the exchange in the first year. The limit rises to 20 employees in the second year. However, new plans sold directly to individuals will only be sold through the exchange. Individuals who currently buy their own coverage can keep those plans if they wish, and if the insurance company continues to offer them.

Claim: Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens

Misleading. It’s true that page 91 says that insurance companies selling plans through the new exchange “shall provide for culturally and linguistically appropriate communication and health services.” The author’s “translation,” however, assumes that anyone speaking a foreign language or from another culture is an illegal immigrant, which is false.

Claim: Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.

False: This page is the start of “SEC. 205. OUTREACH AND ENROLLMENT OF EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS IN EXCHANGE-PARTICIPATING HEALTH BENEFITS PLAN.” It says a newly established Health Choices Commissioner “shall conduct outreach activities” to get people covered by private or government health insurance plans. The section says on page 97 that the Commissioner “may work with other appropriate entities to facilitate … provision of information.” But there is no authorization anywhere in the entire section for the Commissioner to pay money to any group to engage in outreach.

Claim: Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.

Partly true. Page 102 says certain Medicaid-eligible persons will be “automatically enrolled” in Medicaid (which is the state-federal program to provide insurance to low-income workers and families) IF they are not already covered by private insurance. That would happen only if they had “not elected to enroll” in one of the private plans offered through the new insurance exchanges, however. So on paper at least, they would have a choice. Also, it’s estimated that one in four persons who lacks health insurance is already eligible for Medicaid or its offshoot, the state Children’s Health Insurance Program, but simply haven’t signed up or been enrolled by their parents.

Claim: Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed.

Half true. It’s true that page 124 forbids any review by the courts of rates the government would pay to doctors and hospitals under the new “public option” insurance plan. But there’s no mention of “price fixing” in the bill; that’s the e-mail author’s phrase. It also remains to be seen if the “public option” plan would grow to become a “government monopoly,” as the author predicts.

Claim: Page 127: The AMA sold doctors out: the government will set wages.

Misleading. Nothing in the bill would “set wages” for doctors in general. Page 127 says the government would ask doctors to accept below-market rates set by the government for their patients who are covered by a new “public health insurance option,” just as they now are asked to do so for patients covered by Medicare. Physicians would still be free to charge what they wish for other patients, and free not to accept patients covered by the new program just as they are now free to refuse Medicare patients. That’s not a choice many doctors make, however, so as a practical matter the government would be setting rates (not “wages”) for many patients. On the other hand, the new “public” plan is aimed mainly at covering people who have no insurance now and can afford to pay doctors little if anything.

Claim: Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.

False. It’s true that employers would be required to sign up their workers for coverage automatically, but it doesn’t have to be the “public plan.” It would be the employer-offered plan “with the lowest applicable employee premium” (pages 147- 148). This would only be the "public option" if the employer was eligible to buy coverage through the Health Insurance Exchange (not likely, at least during the first two years when only small businesses would have access), and the "public option" was the cheapest plan (which would be likely). Furthermore, while the employer isn’t given an alternative, the workers are. They may reject auto-enrollment under an opt-out provision (page 148).

Claim: Page 146: Employers MUST pay healthcare bills for part-time employees AND their families.

Half true. There’s nothing in this section about part-time employees’ families, but this provision does call for employers to contribute toward part-time employees’ health insurance. The bill says that “for an employee who is not a full-time employee … the amount of the minimum employer contribution” will be a proportion of the minimum contribution for full-time employees. This proportion will depend on the average weekly hours of part-time employees compared with the minimum weekly hours required to be a full-time employee, as specified by the Health Choices Commissioner. (For a point of reference: The minimum contribution for individual plans of full-time employees is not less than 72.5 percent of the premium of the cheapest plan the employer offers.)

Claim: Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll Claim: Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll.

Both Partly True. The bill requires employers either to offer private health insurance coverage or pay a percentage of their payroll expenses to help finance a public plan. The 8 percent payment would indeed apply to employers with payrolls over $400,000 in the previous year, and lesser amounts would apply to smaller firms. Those with payrolls of $250,000 or less would pay nothing. But the penalty isn’t incurred if an employer "does not offer the public option," as the e-mail claims. Rather, it’s a penalty for not offering health insurance to employees.

Claim: Page 167: Any individual who doesn’t have acceptable health care (according to the government) will be taxed 2.5% of income.

True. This is the mechanism in the bill to enforce the individual mandate requiring everyone to have insurance. A person who doesn’t have insurance that meets minimum benefit standards (or other acceptable coverage, such as a plan that was grandfathered in) would pay a penalty of 2.5 percent of modified adjusted gross income for the year. The total penalty can’t exceed a national average premium for individual coverage, or family coverage if applicable.

Claim: Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).

False. “Non-resident aliens” are generally those who have spent less than 31 days in the U.S. during the year. The claim that “Americans will pay for them” assumes that such visitors would somehow be getting federal benefits that would cost taxpayers money. In any case, they are not “exempt from individual taxes” at all. Under current law, the Internal Revenue Service says: “If you are a nonresident alien, you must file Form 1040NR (PDF) or Form 1040NR-EZ (PDF) if you are engaged in a trade or business in the United States, or have any other U.S. source income on which the tax was not fully paid by the amount withheld.” All that page 170 says is that non-resident aliens who don’t obtain health coverage don’t have to pay an additional 2.5 percent federal tax that would apply to U.S. workers who fail to get coverage, or to immigrants who are working here legally under green cards and who fail to obtain coverage. The tax is spelled out in subsection (a) starting on page 167.

Claim: Page 195: Officers and employees of Government Health care Bureaucracy will have access to ALL American financial and personal records.

False. This section of the bill discusses “Disclosures To Carry Out Health Insurance Exchange Subsidies.” It says that government employees of the health insurance exchange will have access to federal tax information for purposes of determining eligibility for affordability credits available for low- and moderate-income Americans. In other words, in order to qualify for a government subsidy to purchase health insurance, the government needs to confirm your income. And, no surprise, the government already has access to your federal tax information. The bill also says nothing about “ALL … financial and personal records.” Instead it says “Such return information shall be limited to—(i) taxpayer identity information with respect to such taxpayer, (ii) the filing status of such taxpayer, (iii) the modified adjusted gross income of such taxpayer (as defined in section 59B(e)(5)), (iv) the number of dependents of the taxpayer, (v) such other information as is prescribed by the Secretary by regulation as might indicate whether the taxpayer is eligible for such affordability credits (and the amount thereof).” The bill goes on to limit use of this information “only for the purposes of, and to the extent necessary in, establishing and verifying the appropriate amount of any affordability credit … and providing for the repayment of any such credit which was in excess of such appropriate amount.”

Claim: Page 203: “The tax imposed under this section shall not be treated as tax.” Yes, it really says that.

Misleading. What this actually says is: “The tax imposed under this section shall not be treated as tax imposed by this chapter for purposes of determining the amount of any credit under this chapter or for purposes of section 55,” which deals with the Alternative Minimum Tax. It would limit the ripple effects of the new taxes the bill would impose on individuals making over $350,000 a year.

Claim: Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected. Claim: Page 241: Doctors: no matter what specialty you have, you’ll all be paid the same (thanks, AMA!)

Both False. Both of these claims pertain to Section 1121, which updates the physician fee schedule for 2010 for Medicare. It doesn’t "reduce physician services for Medicaid" (which wouldn’t pertain to seniors anyway); instead it modifies a section of the Social Security Act that defines physicians’ services. The section also doesn’t say that doctors will be paid the same “no matter what specialty you have.” Instead it sets up two categories of physician services with different growth rates for fees under those categories. As the Kaiser Family Foundation says of this section of the bill: "Allows the revised formula to be updated by the gross domestic product (GDP) plus 2% for evaluation and management services and GDP plus 1% for all other services." The measure will cost $228.5 billion over 10 years, according to the Congressional Budget Office and Joint Committee on Taxation.

Claim: Page 253: Government sets value of doctors’ time, their professional judgment, etc.

Misleading. It’s true that page 253 refers to “relative value units” to be used when determining payment rates for doctor’s services, and that such RVUs would weigh factors “such as time, mental effort and professional judgment, technical skill and physical effort, and stress due to risk.” But this is nothing new; the government already uses RVUs when setting rates it will pay under Medicare. For example, the RVUs assigned to a colonoscopy are currently double the RVUs assigned to an intermediate office visit. In fact, page 253 is part of a section (Sec. 1122) that sets up a process for correcting existing but “potentially misvalued” rates.

Claim: Page 265: Government mandates and controls productivity for private healthcare industries.

Misleading. This claim doesn’t even make sense. How can anyone "mandate” that somebody else be productive, or “control” how productive they are? The author has simply misunderstood what this controversial item would do. In fact, page 265 is the start of a section (Sec. 1131) that is among several designed to slow future growth of Medicare payments to help offset the cost of the bill. It would require that “productivity improvements” be taken into account when setting annual “market basket” updates to Medicare rates for hospital-based services. The hospital industry has estimated this would translate into a 1.3 percent cut next year and a total of $150 billion in reduced payments over 10 years, and is opposed to it.

Claim: Page 268: Government regulates rental and purchase of power-driven wheelchairs.

Misleading. What page 268 does is to stop Medicare for paying for “mobility scooters,” which have been widely marketed as a Medicare-financed benefit, leading to ballooning costs to the program. They would no longer qualify as a “power-driven wheelchair.” Only a "complex rehabilitative power-driven wheel chair recognized by the Secretary” would be covered. The Congressional Budget Office estimates this will save the government $800 million over 10 years (see page 2).

Claim: Page 272: Cancer patients: welcome to the wonderful world of rationing!

False. This page merely calls for a study of whether a certain class of hospitals incur higher costs than some others for the cancer care they deliver. It also says the secretary of HHS “shall provide for an appropriate adjustment” in payments “to reflect those higher costs.” It’s hardly “rationing” to pay hospitals more to compensate for higher costs.

Claim: Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.

True: This does say that “the Secretary shall reduce the payments” to hospitals with too many “potentially preventable” readmissions of patients that they previously had discharged.

Claim: Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.

False. That section is part of a list of potential physician-centered approaches to reducing excess hospital readmissions. The bill states that the secretary of Health and Human Services will conduct a study on the best ways to enforce readmissions policies with physicians. One of the approaches the secretary must consider is the option to reduce payments to physicians whose treatment results in a hospital readmission. Another is the option to increase payments to physicians who check up on recently released patients. Neither of these approaches is mandated in the bill – what’s mandated is that the secretary consider them, among others.

Claim: Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!

False. It’s already illegal, with certain exceptions, for doctors to refer Medicare patients to hospitals, labs, medical imaging facilities or other such medical businesses in which they hold a financial interest. Page 317 would modify an exception to that “self-referral prohibition” for rural providers, and says doctors can’t increase their stake in an exempt hospital after the bill becomes law.

Claim: Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.

False. Expansion is forbidden only for rural, doctor-owned hospitals that have been given a waiver from the general prohibition on self-referral. It does not apply to hospitals in general. The bill provides for exceptions to even this limited expansion ban (page 321).

Claim: Page 321: Hospital expansion hinges on “community” input: in other words, yet another payoff for ACORN.

False. Page 321 says rural, doctor-owned hospitals that are exempt from the Medicaid self-referral prohibition can ask to be allowed to expand under rules that must allow “input” from “persons or entities in the community.” Under that language, anybody in the community could offer their opinion, but nobody – not ACORN or anybody else – would be paid for it.

Claim: Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.

Misleading. This section does deal with establishing quality measures for Medicare. It does not make any recommendations for treatment, or empower anyone to make treatment recommendations based on those measures. The only effect of these outcome-based measures established in the bill would be ranking and potential disqualification of underperforming Medicare Advantage plans – that’s disqualification of the plans, not of any medical procedures.

Claim: Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.

True. The bill allows for the possibility of disqualifying underperforming Medicare Advantage plans, which include Medicare HMOs. Medicare Advantage plans are private health plans that provide Medicare benefits. Under the bill, the secretary of Health and Human Services has the authority to disallow plans that are providing low-quality care under the new quality measures (which include evaluations of patient health, mortality, safety and quality of life). If a plan is disqualified, this will not leave seniors without care. The Kaiser Family Foundation reports that “virtually all” Medicare beneficiaries have access to at least two Medicare Advantage plans, and most have access to three or more. In 2008, 82 percent of beneficiaries had access to six or more private fee-for-service plans, one type of Medicare Advantage plan (along with HMOs, PPOs and medical spending accounts). Beneficiaries are also always free to return to the regular Medicare fee-for-service program.

Claim: Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.

Misleading. Insurance companies already restrict enrollment in so-called “special needs” plans, a special category of Medicare Advantage plans that were created in 2003. Page 354 merely extends the authority to do that beyond the end of next year, when it was set to expire. Furthermore, what’s being restricted isn’t the number of patients, but the type of patients. Plans can be restricted to accepting only those patients who fall into in one or more special categories. These include those who are institutionalized (think, nursing homes), those who qualify both for Medicare and Medicaid (think, both low-income and over age 65) and those with severe or disabling chronic conditions such as diabetes, emphysema, chronic heart failure or dementia. And of course, this has nothing to do with children with learning problems.

Claim: Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).

Misleading. The advisory committee would not be a “bureaucracy” or have any administrative functions, but instead would bring together experts from the private sector to give advice on how Medicare and Medicaid should treat the practice of medicine via telecommunication, something used in rural hospitals and such places as cruise ships, battlefield settings and even on NASA space missions. Pages 380-381 call for the committee to consist of five “practicing physicians,” two “practicing non-physician health care workers” and two “administrators of telehealth programs.”

Claim: Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia? Claim: Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time. Claim: Page 425: Government provides approved list of end-of-life resources, guiding you in death Claim: Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends. Claim: Page 429: Advance Care Planning Consult will be used to dictate treatment as patient’s health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT. Claim: Page 430: Government will decide what level of treatments you may have at end-of-life.

All False. These six claims are a twisted interpretation of a provision in the bill that says Medicare will cover voluntary counseling sessions between seniors and their doctors to discuss end-of-life care. Medicare doesn’t pay for such sessions now; it would under the bill. End-of-life care discussions include talking about a living will, hospice care, designating a health care proxy and making decisions on what care you want to receive at the end of your life. Doctors do the consulting, not the "government" or a "bureaucracy." The e-mail author’s assertion that the bill calls for "an ORDER from the GOVERNMENT" for end-of-life plans rests on language about a patient drawing up such an order stipulating their wishes, and having that order signed by a physician. There’s nothing about "an order from the government." The bill defines an order for life-sustaining treatment as a document that "is signed and dated by a physician …[and] effectively communicates the individual’s preferences regarding life sustaining treatment." See our article "False Euthanasia Claims" for more on such assertions.

Claim: Page 469: Community-based Home Medical Services: more payoffs for ACORN.

False. This section defines the term "community-based medical home" as a "nonprofit community-based or State-based organization" that "provides beneficiaries with medical home services." ACORN does not provide medical home services. The section goes on to say such a medical service is one that "employs community health workers, including nurses or other non-physician practitioners, lay health workers, or other persons as determined appropriate by the Secretary, that assist the primary or principal care physician or nurse practitioner in chronic care management activities." The only thing ACORN has in common with that description is the word "community." It’s a community organization that offers services such as free tax preparation help and first-time home buyer counseling for low- and moderate-income people. It also works to register people to vote, and a few of its canvassers have been investigated for registration fraud, a point of concern during the presidential campaign.

Claim: Page 472: Payments to Community-based organizations: more payoffs for ACORN.

False. This section is referring to community-based medical homes.

Claim: Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.

Half true. It’s true that pages 489 and 490 make state-licensed “marriage and family therapist” services a covered expense “for the diagnosis and treatment of mental illnesses.” But the therapists wouldn’t be employed by the government, and there’s no requirement for anybody to receive their help. So the claim that this would mean that “government intervenes in your marriage” is false.

Claim: Page 494: Government will cover mental health services: defining, creating and rationing those services.

Misleading. The provision amends Section 1861 of the Social Security Act laying out what services Medicare will cover. It expands coverage for mental health services, stipulating that a "mental health counselor" who can perform mental health counseling is someone with a master’s or doctorate degree, a state license, and two years of practice as a counselor. Is this the government "defining" mental health services? Well, it’s certainly the government defining what government programs will cover.

– by Brooks Jackson, Lori Robertson and Jess Henig, with D’Angelo Gore

Posted by Brooks Jackson, Jess Henig and Lori Robertson on Friday, August 28, 2009 by Factcheck