Archive for November 9th, 2007
Krugman on Healthcare Reform
The United States spends far more on health care per person than any other nation. Yet we have lower life expectancy than most other rich countries. Furthermore, every other advanced country provides all its citizens with health insurance; only in America is a large fraction of the population uninsured or underinsured.
You might think that these facts would make the case for major reform of America’s health care system — reform that would involve, among other things, learning from other countries’ experience — irrefutable. Instead, however, apologists for the status quo offer a barrage of excuses for our system’s miserable performance.
So I thought it would be useful to offer a catalog of the most commonly heard apologies for American health care, and the reasons they won’t wash.
THIS IS VERY IMPORTANT
We’ve seen over and over again how Senators and Representatives simply sell their votes for campaign contributions. The Big Money buys the legislation they want. We must stop that:
The Fair Elections Action Week is coming up in just a few weeks! People are taking action now so that we can show Congress that Americans want an end to pay-to-play politics by instituting a system of public financing.
We are closer than ever to cleaning up Washington. The Fair Elections Now Act is gaining support in the Senate and we anticipate the introduction of the companion bill in the House to happen very soon! A voluntary system of public funding for congressional elections would allow members of Congress to serve without taking huge sums of special interest money. Elections should be about voters, not campaign cash.
Join us for the Fair Elections Action Week on November 12-16 when we will send a strong message to Congress that it’s time for public funding of elections! Actions and events will take place all over the country – some sponsored by Public Citizen and our coalition partners, others happening in the living rooms and kitchens of people ready for a change.
It’s easy to help make it a success by showing your support and spreading the word now!
A good example of how bad the Administration is
My God, they have no shame whatsoever—also, no ethics, no morals, no sense of public duty.
While parents were in panic over the lead paint on their children’s toys (like “Robot 2000“), what was the head of the government agency in charge of protecting us doing? Traveling – on the dime of the very industries she is supposed to be regulating.
Nancy Nord, the interim Chairwoman of the Consumer Product Safety Commission (CPSC), has not shied away from that fact that she accepts lavish trips from the industries she regulates and even claims that it is perfectly ethical.
The CPSC is charged with monitoring thousands of products that we use everyday, including toys, but has been systematically gutted by lack of funding and industry-friendly political appointees. A proposed bill, the CPSC Reform Act of 2007, would help fix that. It would more than double the agency’s funding, give it new powers to punish those who sell dangerous products, and offer protection to government whistleblowers who courageously report wrongdoing within the agency.
Guess who isn’t a fan?
Nord. She is also opposed to a bill that would make her agency more effective and better protect consumers from dangerous products. Could her position having anything to do with a recent free trip to New Orleans? Or maybe she is just more interested in protecting industry profits than consumers.
You can tell your senators to “RECALL” Nancy Nord and to PASS the CPSC Reform Action of 2007 with additional ethics reforms to prevent staff from accepting industry-sponsored travel.
Why US healthcare costs so much
Krugman pointed to this report (at the link are links to two PDF files: one the full report, one a synthesis). McKinsey states the following about the report:
The United States spends more of its income on health care than other developed countries and that share is rising. It is an arresting statistic that the U.S. now spends more on health care than it does on food.
In this new report MGI finds that the United States spends approximately $480 billion ($1,600 per capita) more on health care than other OECD countries and that additional spending is not explained by a higher disease burden; the research shows that the U.S. population is not significantly sicker than the other countries studied.
Instead, MGI found that the overriding cause of high U.S. health care costs is the failure of the intermediation system — payors, employers, and government — to provide sufficient incentives to patients and consumers to be value–conscious in their demand decisions, and to regulate the necessary incentives to promote rational use by providers and suppliers.
Given the less than optimal access for all U.S. citizens (relative to peer countries), MGI concludes that major opportunities for cost improvement —even if not the full $480 billion—are as possible as they are necessary although no single reform is likely to succeed in achieving the needed rebalancing. To be effective, reform in health care will need to apply sound principles on both the demand and supply side of the system.
The media gets worse and worse
It’s one thing to not report the full story, to write “he said/she said” stories without working to find out the facts, to be gullible when given a press release, and all the sorry excuse for reporting we’ve come to expect. But when the media begin to actually edit quotations to create a false impression, it’s gone way beyond the line.
Bourbon sweet potatoes
I think you probably know that what your grocer calls “yams” are in fact sweet potatoes, which come in several varieties. Grocers early on worried that people would buy sweet potatoes expecting regular (white-fleshed) potatoes, so they decided to call sweet potatoes “yams.” The yam is a tropical vegetable with a thick, hairy skin, white flesh, tasteless, and of little food value. The sweet potato has edible skin, is orange, tasty, and full of food value. And here’s a good recipe:
Bourbon Sweet Potatoes
4 1/2 lbs mixed varieties of sweet potatoes
1/2 tsp salt
3/4 cup butter, softened
1/3 cup bourbon
2 Tbs butter
1/2 cup (or more) walnuts, coarsely chopped
Bake potatoes in jackets in a hot oven for 1 hour or until soft. Scoop out the meat and beat it with the soft butter, bourbon, and salt. Don’t overdo the bourbon—I did once and it tasted too strong. Put the mix in a shallow, greased baking dish. Dot with butter and walnuts. Bake at 350º for 20 minutes.
Pharmacists pick the prescriptions they refill
A federal judge has suspended controversial state rules requiring pharmacies to dispense so-called “Plan B” emergency contraceptives, saying the rules appear to unconstitutionally violate pharmacists’ freedom of religion.
The rules appear to force pharmacists to choose between their own religious beliefs and their livelihood, Judge Ronald B. Leighton of the U.S. District Court in Tacoma wrote Thursday.
Some pharmacists believe the emergency contraceptive pills, also called “morning-after pills,” are tantamount to abortion because they can in some cases prevent implantation of a fertilized egg.
“Whether or not Plan B … terminates a pregnancy, to those who believe that life begins at conception, the drug is designed to terminate a life,” the judge wrote in a 27-page order granting a preliminary injunction.
Thus, Leighton said, the current rules “appear designed to impose a Hobson’s choice for the majority of pharmacists who object to Plan B: dispense a drug that ends a life as defined by their religious teachings, or leave their present positions in the state of Washington.”
Under Leighton’s order, pharmacists may now refuse to dispense the medication but must refer a patient to “the nearest” or “a nearby” source for the drug.
State officials said it was too early to say whether they would appeal.
“This is a complex issue with a complex ruling,” said Donn Moyer, a state Department of Health spokesman. “We’re certainly going to talk to our lawyers.”
The injunction was issued in a federal lawsuit filed against the state in late July by pharmacists and the owner of Ralph’s Thriftway in Olympia, who objected to providing Plan B to customers. A trial is still scheduled to be heard before Leighton next October.
The state regulations, passed in July, required pharmacies to dispense Plan B and allowed individual pharmacists to opt out only if a co-worker on hand in the same pharmacy could do the job.
Those rules were meant as a compromise after long, contentious hearings and intervention by Gov. Christine Gregoire, who threatened to replace members of the Board of Pharmacy who didn’t vote to protect women’s rights.
Gregoire and other supporters said the rules were meant to keep pharmacists from imposing their personal religious or moral views upon patients by barring access to valid, legal prescriptions.
But opponents of the rules argued that pharmacists, like other health providers, should be able to refuse to provide a service that they object to on conscience or religious grounds.
At the core of the debate is a fundamental disagreement on whether Plan B can terminate a pregnancy.
If taken within 72 hours of unprotected sex, the drug usually works by preventing ovulation or fertilization. It won’t terminate an established pregnancy, but in some cases it could prevent implantation of a fertilized egg in the uterus.
That doesn’t constitute abortion under current law, but it does under some religious standards.
In his injunction, Leighton said no evidence has been presented that anyone in Washington has ever failed to obtain Plan B within the 72-hour window because of pharmacists’ or pharmacies’ refusals.
Nonetheless, women’s-rights advocates quickly condemned Leighton’s decision.
“I think this is another step on the assault on women’s rights to control our own bodies,” said Helen Gilbert, an activist with the group Radical Women. “If [pharmacists’] beliefs are in conflict with doing this job, then they should do a different job.”
State Sen. Karen Keiser, D-Kent, vowed that the Democrat-controlled Legislature would take up a bill to require pharmacists to dispense the pills.
“It is unconscionable that we would allow pharmacists to deny women access to a legal form of birth control,” Keiser said. “We need to take this issue out of the courts and into state law.”
But C.J. Kahler, a longtime independent pharmacy owner and former president of the Washington State Pharmacy Association, a private trade group, said the judge was right to suspend the current rules.
“I think the rules that the Board of Pharmacy enacted made pharmacists choose between their livelihoods and their deeply held moral and religious beliefs,” Kahler said. In most cases, the rules worked well, but in smaller, owner-operated pharmacies, where only one pharmacist was employed, “he was pushed into the corner,” Kahler said.
Rod Shafer, the current CEO of the trade group, said that allowing pharmacists or pharmacies to refer patients to other pharmacies protects the rights of both patient and pharmacist.
“I thought [the judge] did a great job, reviewing all the legal precedents, looking at the issue not only from the pharmacists’ viewpoint but the patient’s viewpoint,” Shafer said.
But others were not so sure the injunction would have any real immediate effect.
The “vast majority” of pharmacists in the state are “ardent supporters” of Plan B access, said Don Downing, an associate professor of pharmacy at the University of Washington.
And because Plan B can now be sold over the counter to most women and men 18 or older, he said, most people can get it without a pharmacist.
More on the Democratic “opposition” to Mukasey
Mr. Smith has left Washington and Mr. Orwell has arrived.
First, let’s be crystal-clear about how the Democrats threw a vote they would have won on Michael Mukasey and torture and let’s be clear about why this happened.
Others and I were privately advocating a filibuster against Mukasey’s attorney general confirmation bid, and would have needed 41 votes to prevail. At a minimum the filibuster could have forced Bush to accept a waterboarding and torture ban as a condition of confirmation.
Democrats had 40 votes against confirmation last night plus the four presidential candidates who did not vote. Democrats had 43 or 44 “no” votes adding the presidential candidates and, had these senators had the conviction to filibuster, would have won.
As of Thursday morning the vote would have been taken next week with some talk of delay until December. Once it became apparent that there were 43 to 44 “no” votes if the presidential candidates were present, with the weekend coming to increase pressure, the vote was jammed through late at night, a week ahead of schedule.
Of course, by late last night, the BBC World Service was correctly broadcasting to the world that the Senate had confirmed Mukasey with all of the objections to his position on torture that were stated, but surrendered, yet again, by Democrats.
George Washington spoke with fury against torture. Commanders of every military service, throughout every generation of Americans, during every war ever fought, were adamantly against torture. Military JAG lawyers have defied higher authorities in opposition to torture. Gen. Taguba defied higher authorities to courageously speak out against the continuing cover-up of Abu Ghraib.
Yet the Senate’s contribution to our troops on Veterans Day is to create more harm for them, as messages are beamed to the world, that even the Democratic Senate cannot make a stand against torture, even when 70 percent of America agrees, even when they had the votes to win.
Meanwhile, Sen. Joe Lieberman (I-Conn.), one of the leading neoconservative advocates of the catastrophic Iraq war, who only recently succeeded in defining the Senate’s position on Iran, is now attacking Democrats for having too much principle, and fighting too hard.
What is incredible about Lieberman is his lack of modesty considering how much carnage, chaos and bloodshed has resulted from his catastrophically bad judgment on Iraq and his arrogance in attacking those who have been the most right.
Yesterday was a new low for Democrats, who surrendered the fight they would have won and were morally obligated to make, on torture, and for Lieberman, who attacks Democrats for being too strong, at the exact moment of their weakest of many surrenders.
Mr. Smith has left Washington, George Orwell has arrived, and 70 percent of the nation must now consider what to do, with Washington in such overwhelming disrepute directed at both sides of the aisle.
New approach to fighting malaria
Researchers at the National Institute of Standards and Technology (NIST) used their expertise in radiation science to help a young company create weakened, harmless versions of the malaria-causing parasite. These parasites, in turn, are being used to create a new type of vaccine that shows promise of being more effective than current malaria vaccines.
The new vaccine is a departure from previous approaches, which have usually depended on proteins derived from only part of the parasite Plasmodium falciparum, the most dangerous species of parasite that causes malaria. Using vaccines based on whole living parasites had been on scientists’ minds for several decades, after they discovered that volunteers built up high levels of protection to malaria after being exposed to mosquitoes containing live, radiation-weakened parasites. But manufacturing technology only recently has been developed to the point where it is possible to efficiently extract weakened parasites from their mosquito carriers in order to make a vaccine.
With their knowledge of measuring radiation doses for industrial processes such as medical equipment sterilization, NIST researchers have been lending their expertise for several years to Maryland-based biotech firm Sanaria Inc., which is creating the new vaccine. In the manufacturing process, live mosquitoes containing the parasite are exposed to gamma rays. To ensure that the parasites are sufficiently weakened for the vaccine, yet remain alive, they must be exposed to a radiation dose of at least 150 gray, but not much more. Coincidentally, this is also the dose used to delay sprouting in potatoes and onions.
One critical design issue is ensuring a relatively uniform radiation dose regardless of where the mosquito is in the chamber. Using radiation-sensitive test materials inside the chamber as well as sophisticated measuring equipment, NIST researchers mapped out the radiation dose at different parts of the chamber. They initially found there was a variation in dose within the chamber, but by suggesting that the manufacturer change the position of the chamber relative to the radiation source they were able to significantly reduce this variation in dose. This not only increases the speed of the process, but more importantly improves the quality of the process. To be safe for human trials all mosquitoes in the chamber must get their minimum dose of 150 gray.
The vaccine is currently being manufactured for the anticipated human clinical trials. NIST researchers will continue to be active in the manufacturing process by doing regularly scheduled quality-assurance tests that ensure the desired dose is being delivered to the mosquitoes.
The first paragraph says it all
House Democrats on Friday pushed through an $80 billion bill to block the spread of a dreaded tax on middle-income people. The White House and Republicans, protesting tax increases in the bill affecting mainly investment fund managers, maintained that it would never become law.
The investment fund managers, you’ll recall, are those guys whose annual salary can hit $1.6 BILLION dollars, and who are taxed at 15% tops. Of course they need protection, and the middle-income people do not—or so the GOP sees it.
Read the whole story…
Greenwald asks, “What happened to the 60-vote rule?”
You know how everything in the Senate now requires 60 votes (because of the GOP threat of filibuster)? Well, guess what: Mukasy was confirmed by less than 60 votes. Any Democrat who truly opposed Mukasey could have threatened filibuster, requiring 60 votes for the nomination to succeed. But, alas, no Democrats truly opposed the Mukasey. Read Greenwald’s column. As a result of that column, I just sent this email to Senator Boxer:
The US Healthcare system: “greatest in the world”
Via Kevin Drum, this story on how a health insurer in LA tied bonuses to dropping policies when people got sick:
Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed.
….Health Net had sought to keep the documents secret even after it was forced to produce them for the hearing, arguing that they contained proprietary information and could embarrass the company. But….at a hearing on the motion, the judge said, “This clearly involves very significant public interest, and my view is the arbitration proceedings should not be confidential.”
The documents show that in 2002, the company’s goal for Barbara Fowler, Health Net’s senior analyst in charge of rescission reviews, was 15 cancellations a month. She exceeded that, rescinding 275 policies that year — a monthly average of 22.9.
More recently, her goals were expressed in financial terms. Her supervisor described 2003 as a “banner year” for Fowler because the company avoided about “$6 million in unnecessary health care expenses” through her rescission of 301 policies — one more than her performance goal.
In 2005, her goal was to save Health Net at least $6.5 million. Through nearly 300 rescissions, Fowler ended up saving an estimated $7 million, prompting her supervisor to write: “Barbara’s successful execution of her job responsibilities have been vital to the profitability” of individual and family policies.
Quote of the day
Kevin Drum rightly calls this “Quote of the Day”:
From waitress Anita Esterday on press corps fascination over whether Hillary Clinton left her a tip during a campaign stop:
You people are really nuts. There’s kids dying in the war, the price of oil right now — there’s better things in this world to be thinking about than who served Hillary Clinton at Maid-Rite and who got a tip and who didn’t get a tip.
Journalists today are pathetic.
FEMA protects itself, not the public
Last year, a report found that 94 percent of emergency housing trailers for Katrina victims contained “hazardous levels of formaldehyde.” CBS News reports that while “50,000 families along the Gulf Coast” are still forced to live in these trailers, FEMA has prohibited “its own staff from even briefly stepping inside trailers once residents have moved out” because of safety concerns:
In an Oct 19 email, a worker asks if there is “any safety reason you know of that says we can’t go into a [deactivated or previously used] trailer quickly to shut a vent.”
The response from the director of the Baton Rouge office, Jon Byrd, said, “the issue is formaldehyde.”
Then, on Oct. 22, this final answer from FEMA’s head of safety in Washington, David Chawaga: “Please reinforce … FEMA employees do not enter stored TTs until further notice…”
Protecting torture
Today, a House Judiciary subcommittee is holding an oversight hearing on the “effectiveness and consequences of ‘enhanced’ interrogation.” The Committee had invited Lt. Col. Stuart Couch, a former Guantanamo Bay prosecutor, to testify about his experiences. The Wall Street Journal reports, “Asked last week to appear before the panel, Col. Couch says he informed his superiors and that none had any objection.” But Counch’s appearance was blocked by Cheney-backed Pentagon counsel William Haynes:
Yesterday, however, [Couch] was advised by email that the Pentagon general counsel, William J. Haynes II, “has determined that as a sitting judge and former prosecutor, it is improper for you to testify about matters still pending in the military court system, and you are not to appear before the Committee to testify tomorrow.“
Haynes has been a forceful advocate and key architect for the administration’s harsh interrogation techniques. Couch’s potential testimony posed a serious danger to Haynes’ work.
As a Gitmo prosecutor, Couch had been assigned to prosecute accused al Qaeda operative Mohamedou Ould Slahi, one of fourteen “high value” prisoners. “Of the cases I had seen, he was the one with the most blood on his hands,” Couch said of Slahi. Yet Couch determined he could not prosecute Slahi because his incriminating statements “had been taken through torture, rendering them inadmissible under U.S. and international law.”
In a lengthy Wall Street Journal profile published in March, Couch revealed evidence of torture he witnessed at Guantanamo Bay — images that captured his conscience and forced him to become a critic of the administration’s interrogation system. Couch reported that Slahi “had been beaten and exposed to psychological torture, including death threats and intimations that his mother would be raped in custody unless he cooperated.” Here’s what happened when Couch announced his decision not to prosecute:
In May 2004, at a meeting with the then-chief prosecutor, Army Col. Bob Swann, Col. Couch dropped his bombshell. He told Col. Swann that in addition to legal reasons, he was “morally opposed” to the interrogation techniques “and for that reason alone refused to participate in [the Slahi] prosecution in any manner.”
Col. Swann was indignant, Col. Couch says, replying: “What makes you think you’re so much better than the rest of us around here?”
Col. Couch says he slammed his hand on Col. Swann’s desk and replied: “That’s not the issue at all, that’s not the point!”
An impassioned debate followed, the prosecutor recalls. Col. Swann said the Torture Convention didn’t apply to military commissions. Col. Couch asked his superior to cite legal precedent that would allow the president to disregard a treaty.
On his first day in Guantanamo, Couch said he saw treatment of a prisoner that “resembled the abuse he had been trained to resist if captured.” Couch’s willingness to tell the truth posed such a threat to the administration that they have prevented him from speaking to Congress. The subcommittee chairman, Rep. Jerrold Nadler (D-NY), said he would consider seeking a subpoena for Couch if the Pentagon maintained its stand.
Same song, second verse
Gareth Porter of Inter Press Service reports that Vice President Cheney has been thwarting the release of a long-overdue National Intelligence Estimate on Iran because it doesn’t deliver the casus belli for war:
A National Intelligence Estimate (NIE) on Iran has been held up for more than a year in an effort to force the intelligence community to remove dissenting judgments on the Iranian nuclear program, and thus make the document more supportive of U.S. Vice President Dick Cheney’s militarily aggressive policy toward Iran, according to accounts of the process provided by participants to two former Central Intelligence Agency officers.
The current dispute over the Iran NIE bears striking resemblance to the controversies that played out over pre-war Iraq intelligence in at least two important ways:
1) Administration Stifling Dissent
NOW: According to IPS, the draft Iran NIE was reportedly completed a year ago, but the White House rejected it because it contained dissenting views. A former intelligence officer said, “They refused to come out with a version that had dissenting views in it.”
THEN: Prior to the Iraq war, the Air Force, Energy Department, and State Department all issued dissenting views on the state of Iraq’s progress towards a nuclear program. Those dissenting views later turned out to be correct, and in the process, greatly undermined the administration’s credibility. The lesson learned by the White House apparently is that this time they need to demolish dissent.
2) Administration Pressuring Analysts
NOW: Former CIA officer Philip Giraldi told IPS that “intelligence analysts have had to review and rewrite their findings three times, because of pressure from the White House.” The draft Iran NIE, for example, did not conclude that there was confirming evidence that Iran was arming the Shiite insurgents in Iraq, according to Giraldi.
THEN: Prior to the Iraq war, Cheney and his chief of staff Scooter Libby visited the CIA headquarters approximately a dozen times to engage the CIA analysts directly on the issue of Iraq’s nuclear development, “creating an environment in which some analysts felt they were being pressured to make their assessments fit with the Bush administration’s policy objectives.”
The New Yorker’s Seymour Hersh has reported that, despite there being very little evidence that Iran is developing a nuclear bomb, the White House is “stovepiping” intelligence and hiding information from the CIA that makes a case for war.
In February, the intelligence community released a National Intelligence Estimate on Iraq that reported Iran was not “a major driver of violence” inside Iraq, disputing administration claims to the contrary. Former CIA officer Giraldi says the the White House is looking for “a document that it can use as evidence for its Iran policy.” Fortunately, not all analysts are willing to “fix the facts around the policy.”
Another who underwent waterboarding calls it torture
It really seems pretty clear that waterboarding is torture—clear, that is, to all but a few: Cheney, Fox News, Bush, Judge Mukasey, … From Dan Froomkin today:
Josh White writes in The Washington Post: “A former Navy survival instructor subjected to waterboarding as part of his military training told Congress yesterday that the controversial tactic should plainly be considered torture and that such a method was never intended for use by U.S. interrogators because it is a relic of abusive totalitarian governments.
“Malcolm Wrightson Nance, a counterterrorism specialist who taught at the Navy’s Survival, Evasion, Resistance and Escape (SERE) school in California, likened waterboarding to drowning and said those who experience it will say or do anything to make it stop, rendering the information they give nearly useless. . . .
“Unlike attorney general nominee Michael B. Mukasey, who called the technique repugnant but declined to say whether it is torture, Nance said unequivocally that waterboarding is a long-standing form of torture used by history’s most brutal governments, including those of Nazi Germany, Imperial Japan, North Korea, Iraq, the Soviet Union and the Khmer Rouge of Cambodia.”
