Why Are Politicians So Willing to Tell Outrageous, Easily Disproven Lies?

Recently, I’ve been writing (here and here) about the use of reconciliation in the Senate and the willingness of Republicans to lie about the history of prior use of reconciliation. Yet even after the E.J. Dionne demonstrated the falsity of Sen. Orrin Hatch’s claims about reconciliation, Republicans continue to ignore the truth and simply lie.

Here’s a video clip from last Sunday’s Face the Nation. First Sen. Evan Bayh (D-Indiana) talks about the healthcare bill. Then Sen. Lindsey Graham (R-South Carolina) talks about reconciliation. Pay particular attention to Sen. Graham’s comments.

Did you happen to notice this one particular statement from Sen. Graham:

We’ve had reconciliation votes, but all of them had received bipartisan support. The least was 12 when we did reconciliation with tax cuts.

Now go back and take a look at those previous posts that I linked to above. As you’ll see, Sen. Graham’s statement is a lie. Let me again quote from E.J. Dionne’s editorial in The Washington Post (emphasis added):

But surely the 2001 and 2003 Bush tax cuts, which were passed under reconciliation and increased the deficit by $1.7 trillion during his presidency, were "substantive legislation." The 2003 dividends tax cut could muster only 50 votes. Vice President Dick Cheney had to break the tie. Talk about "ramming through."

If you look at the chart that I posted, you’ll see that Republicans used reconciliation with less than Graham’s claimed 12 Democrats at least 6 times (Balanced Budget Act of 1995, 0 Democrats; Taxpayer Refund and Relief Act of 1999, 0 Democrats; Marriage Tax Penalty Relief Reconciliation Act of 2000, 7 Democrats; Jobs and Growth Tax Relief Reconciliation Act of 2003, 2 Democrats; Deficit Reduction Act of 2005, 0 Democrats; and Tax Increase Prevention and Reconciliation Act of 2005, 3 Democrats). In other words, there’s no other way to describe Graham’s comments than to say that he was lying; it wasn’t just hyperbole or an error in fact. It was a lie. He knows the history of reconciliation. But rather than admit that Republicans used reconciliation without any bipartisan support at least 3 times and that in 2003 Republicans used reconciliation to pass massive tax cuts and had to rely upon Vice President Cheney to break a tie, Graham simply lies. Tell me which is is worse for democracy: (a) The use of reconciliation to allow for a majority vote on a bill that has already passed with a super-majority or (b) a Senator that is willing to go on national TV, look right at the camera, and lie. It’s bad enough that Republicans are so opposed to trying to help American families, but that they are willing to lie to try to stop Democrats from passing legislation that could help sickens me (pun intended).

One more thing: If the mainstream media was, in fact, “liberal”, then don’t you think that lies like Graham’s would immediately be fact-checked, identified, and subject to editorial scorn?

Rachel Maddow Calls Out Republican Hypocrites and Liars (and the Washington Post)

Wow. Watch this video of Rachel Maddow calling out Republican hypocrites and liars (and going after The Washington Post for enabling the lies). Good stuff.

At least The Washington Post ran columnist E.J. Dionne’s response to Sen. Orrin Hatch’s op-ed (and for the record, am I the only one who finds statements by Republicans that majority rule is somehow a violation of the democratic process to be ridiculous, if not offensive?). Dionne makes a few additional points worth noting:

The health-care bill passed the Senate in December with 60 votes under the normal process. The only thing that would pass under a simple majority vote would be a series of amendments that fit comfortably under the "reconciliation" rules established to deal with money issues. Near the end of his column, Hatch conceded that reconciliation would be used for "only parts" of the bill. But why didn't he say that in the first place?

Hatch grandly cited "America's Founders" as wanting the Senate to be about "deliberation." But the Founders said nothing in the Constitution about the filibuster, let alone "reconciliation." Judging from what they put in the actual document, the Founders would be appalled at the idea that every major bill should need the votes of three-fifths of the Senate to pass.

Hatch quoted Sens. Robert Byrd and Kent Conrad, both Democrats, as opposing the use of reconciliation on health care. What he didn't say is that Byrd's comment from a year ago was about passing the entire bill under reconciliation, which no one is proposing. As for Conrad, he made clear to The Post's Ezra Klein this week that it's perfectly appropriate to use reconciliation "to improve or perfect the package," which is the only thing that Democrats have proposed doing through reconciliation.

Hatch said that reconciliation should not be used for "substantive legislation" unless the legislation has "significant bipartisan support." But surely the 2001 and 2003 Bush tax cuts, which were passed under reconciliation and increased the deficit by $1.7 trillion during his presidency, were "substantive legislation." The 2003 dividends tax cut could muster only 50 votes. Vice President Dick Cheney had to break the tie. Talk about "ramming through."

The underlying "principle" here seems to be that it's fine to pass tax cuts for the wealthy on narrow votes but an outrage to use reconciliation to help middle-income and poor people get health insurance.

Keeping Maddow’s and Dionne’s comments in mind, it’s also worth noting how The Indianapolis Star frames the issue. Today, the Star ran a front-page article (apparently not available on the Star’s website) sourced from McClatchy Newspapers that included a “Q-and-A on Reconciliation”. Among the questions and answers:

Q: Why do Republicans object so much? Haven’t they used this tactic before?

A: Yes, many times. However, they say the tactic is intended to be used only on budget-related matters, not to force through substantive policy legislation. While they’ve used reconciliation in the past to cut taxes and overhaul welfare, in many cases with bipartisan support, they say this is different.

Notice anything left out of that answer? The Q&A tells us what Republicans say but doesn’t tell us how Democrats respond or, more importantly, what the truth is. The Q&A cites the oft-repeated not for “substantive policy legislation” and “bipartisan support” talking points. But how ’bout, for example, those 2001 and 2003 tax cuts that increased the deficit by $1.7 trillion (and remember that according to a comparison of the various health reform proposals done by the Kaiser Family Foundation, the Congressional Budget Office estimates the cost of the Senate bill at $871 billion over ten years with a net reduction to the deficit of $132 billion over ten years), one of which required Vice President Cheney to break a tie? McClatchy doesn’t fact check Republican statements; they just reprint them and The Indianapolis Star goes along.

Maddow and Dionne are right and the “mainstream media” — despite cries of “liberal bias” — is letting Republicans control the debate with half-truths and lies.

Apparently I’m Not Eligible to Run for Office as a Republican; How About You?

So the Republican National Committee is considering a “purity test” to determine which candidates will get party support in the 2010 elections. For those who’ve missed this, here is the full text of the resolution (sponsored by Indiana über-conservative James Bopp):

Proposed RNC Resolution on Reagan’s Unity Principle for Support of Candidates

WHEREAS, President Ronald Reagan believed that the Republican Party should support and espouse conservative principles and public policies; and

WHEREAS, President Ronald Reagan also believed the Republican Party should welcome those with diverse views; and

WHEREAS, President Ronald Reagan believed, as a result, that someone who agreed with him 8 out of 10 times was his friend, not his opponent; and

WHEREAS, Republican faithfulness to its conservative principles and public policies and Republican solidarity in opposition to Obama’s socialist agenda is necessary to preserve the security of our country, our economic and political freedoms, and our way of life; and

WHEREAS, Republican faithfulness to its conservative principles and public policies is necessary to restore the trust of the American people in the Republican Party and to lead to Republican electoral victories; and

WHEREAS, the Republican National Committee shares President Ronald Reagan’s belief that the Republican Party should espouse conservative principles and public policies and welcome persons of diverse views; and

WHEREAS, the Republican National Committee desires to implement President Reagan’s Unity Principle for Support of Candidates; and

WHEREAS, in addition to supporting candidates, the Republican National Committee provides financial support for Republican state and local parties for party building and federal election activities, which benefit all candidates and is not affected by this resolution; and

THEREFORE BE IT RESOLVED, that the Republican National Committee identifies ten (10) key public policy positions for the 2010 election cycle, which the Republican National Committee expects its public officials and candidates to support:

(1) We support smaller government, smaller national debt, lower deficits and lower taxes by opposing bills like Obama’s “stimulus” bill;

(2) We support market-based health care reform and oppose Obama-style government run healthcare;

(3) We support market-based energy reforms by opposing cap and trade legislation;

(4) We support workers’ right to secret ballot by opposing card check;

(5) We support legal immigration and assimilation into American society by opposing amnesty for illegal immigrants;

(6) We support victory in Iraq and Afghanistan by supporting military-recommended troop surges;

(7) We support containment of Iran and North Korea, particularly effective action to eliminate their nuclear weapons threat;

(8) We support retention of the Defense of Marriage Act;

(9) We support protecting the lives of vulnerable persons by opposing health care rationing and denial of health care and government funding of abortion; and

(10) We support the right to keep and bear arms by opposing government restrictions on gun ownership; and be further

RESOLVED, that a candidate who disagrees with three or more of the above stated public policy position of the Republican National Committee, as identified by the voting record, public statements and/or signed questionnaire of the candidate, shall not be eligible for financial support and endorsement by the Republican National Committee; and be further

RESOLVED, that upon the approval of this resolution the Republican National Committee shall deliver a copy of this resolution to each of Republican members of Congress, all Republican candidates for Congress, as they become known, and to each Republican state and territorial party office.

Chief Sponsor:
James Bopp, Jr. NCM IN
Sponsors:
Donna Cain NCW OR
Cindy Costa NCW SC
Demetra Demonte NCW IL
Peggy Lambert NCW TN
Carolyn McLarty NCW OK
Pete Rickets NCM NE
Steve Scheffler NCM IA
Helen Van Etten NCW KA
Solomon Yue NCM OR

I don’t want to waste time discussing whether a purity test is a smart idea or a bad idea; hey, it’s their party. But I do want to take on each of the ten themes expressed in the test itself.

(1) We support smaller government, smaller national debt, lower deficits and lower taxes by opposing bills like Obama’s “stimulus” bill;

OK. I get that Republicans were opposed to the stimulus bill. The problem is, I don’t recall hearing many Republican ideas to help prevent the economy from taking a nose dive into a true depression. One thing that Republicans don’t seem to grasp right now is that there is a huge difference between being opposed to something and offering up a viable alternative. Think of it this way: If you suggest eating Chinese for dinner, I could say, “Gee, I don’t feel like Chinese; why don’t we go for Italian, instead.” From there, we could have an open and honest debate about which would be a better meal choice. On the other hand, if I was a Republican, my response would be more like this: “Gee, I don’t feel like Chinese (after all, they’re communists!); so we’ll just skip dinner tonight.”

I also fail to understand the constant mantra about “smaller government” as if by simply making government “smaller” we make it better. I’m less worried about the size of the government than I am with the effectiveness of that government.

As to the national debt and deficits, I seem to recall these going up, not down, under a Republican administration. It seems that Republicans are firmly opposed to debt and deficits except for debt and deficits that they like. Finally, I’d like to be certain what Republicans mean when they say “lower taxes”; lower taxes on whom? The wealthiest Americans who can easily afford to pay a bit more from the money that they’re parking in illegal offshore bank accounts? Why is it that I doubt that “lower taxes” means repeal of regressive taxes like sales tax.

(2) We support market-based health care reform and oppose Obama-style government run healthcare;

First, does that mean that Republicans will support an end to the anti-trust exemption for insurance companies? After all, an anti-trust exemption doesn’t really seem consistent with market-based insurance reform. Second, when Republicans talk about “Obama-style government run healthcare” does that mean that they oppose Medicare, Medicaid, the VA, and military healthcare? Those programs are, of course, all government run. What about the insurance provided to members of Congress? Finally, what type of reform do Republicans support? Remember that the plan offered by Senate Republicans didn’t prohibit exclusion based on pre-existing conditions (among a host of other failings). We’ve had a largely “market based” system (with anti-trust exemptions) for years and look where that’s gotten us. And how exactly do Republicans plan to handle the millions of uninsured Americans? Insuring a measly 3 million additional Americans over 10 years (while leaving 30-50 million uninsured) doesn’t really seem to be a solution to the problem. Then again, so long as the “solution” is merely opposition and obstruction…

(3) We support market-based energy reforms by opposing cap and trade legislation;

I wonder how many Republicans can actually explain what cap and trade legislation means. And, for that matter, I wonder how many of the Republicans who oppose cap and trade also believe that global warming is a myth. The funniest part of this is that cap and trade is a market-based reform. That is the whole idea; allow the market to put a value on the right to pollute and provide cost incentives for reducing emissions. And again, note that as usual, what Republicans oppose is spelled out clearly (Obama’s stimulus bill, Obama-style government run healthcare, cap and trade) but what Republicans support is much, much more nebulous (smaller and market-based). Again, it is easy to be opposed to a particular, narrowly-defined policy; it is much more difficult to articulate an alternative.

(4) We support workers’ right to secret ballot by opposing card check;

In all honesty, I don’t know enough about card check to really get into this discussion. I will note, however, that it seems strange, in the entire universe of issues for Republicans to focus on, that card check makes the top ten.

(5) We support legal immigration and assimilation into American society by opposing amnesty for illegal immigrants;

This point is one of the most insidious of all of the points on the Republican purity test. Why? Did you note that Republicans don’t just support legal immigration, but also support assimilation? In other words, Republicans are telling immigrants to come in legally, but once here, they had better jettison their cultural (and religious?) heritage and assimilate into American society. And why is that I suspect that the Republican version of “American society” is the same thing as Glenn Beck’s “white culture”?

In addition, I’m not quite sure how supporting legal immigration and assimilation is accomplished “by opposing” amnesty. What does one have to do with the other? More importantly, what precisely is the Republican plan to deal with illegal immigration and the illegal immigrants who are already here? Again, they oppose a particular policy (amnesty) without offering a solution to the existing problem.

(6) We support victory in Iraq and Afghanistan by supporting military-recommended troop surges;

First, who doesn’t support “victory in Iraq and Afghanistan”? Do Republicans really think that either President Obama or Democrats support “defeat”? It seems to me that the real question is the definition of “victory”. More importantly, I find it quite odd that when the Republican purity test finally gets around to specific things that Republicans are supposed to support, the focus is on a particular strategy advocated by the military. The last time I checked, the military was overseen by civilian leadership. It is important to remember that the issues being looked at by military planners are almost exclusively military. We don’t ask or expect military planners to look at diplomatic consequences of a particular policy, the cost to implement that policy (what about that support for a smaller national debt…?), the cost in lives or impact upon military families (I suppose that the military might factor this in to the calculation, but I don’t really know), or the desire of the American electorate to engage in the particular military operation. I suspect that generals recommended attacks on the Soviet Union during the Cold War, but we allowed civilian leadership to decide what was in the best interest of the country. So too should civilian leadership decide what is in the best interests of America when it comes to Iraq and Afghanistan. If that means a surge, then so be it; but the decision needs to be made on the basis of all known information and should take into consideration all relevant matters, not just the matters relevant to the battlefield itself. Military strategy options should be developed by military planners but decisions regarding those strategic options should be made on the basis of national interest, not just military necessity.

(7) We support containment of Iran and North Korea, particularly effective action to eliminate their nuclear weapons threat;

This one leaves me a bit puzzled. First, the use of the word “containment” harkens back to the Cold War and fears of Soviet expansion. I suspect that the real issue being “supported” is limits on the ability of North Korea or Iran to export nuclear technology or terrorism. And again, who doesn’t support those ends? Do Republicans really think that President Obama or Democrats oppose “containment” of Iran or North Korea? More problematic is the phrase “effective action to eliminate their nuclear weapons threat”. What precisely does this mean. Again, I doubt that anybody supports ineffective actions. The real question, of course, is what action would be effective? So, for example, are harsh sanctions “effective”? Maybe I’m wrong, but when I read this particular point of the purity test, I take it to really be referring to military action as the “effective action”. Maybe I’m wrong. But if not, I’m troubled by the idea that Republicans are being asked to support a military action without necessarily considering either alternatives or consequences. Forget Iran for the moment; what would be the consequences of the use of force against North Korea? Do we really want to elect leaders who want war on the Korean peninsula?

(8) We support retention of the Defense of Marriage Act;

I’m not going to take the time in this particular post to explain why I oppose the Defense of Marriage Act (and why I believe it might be unconstitutional) or to explain why I support same sex marriage (or at least domestic partnerships that have all of the benefits and obligations of marriage). Instead, I’ll simply note that of the items that Republicans apparently view as the litmus test for whether a candidate is worthy, opposition to same sex marriage counts for 10%. I still don’t understand how the issue of whether a loving, committed couple can be allowed to enjoy the benefits of “marriage” can rise to this level of importance. And, for the record, I note that those states that have allowed same sex marriage have neither imploded, been struck by wave after wave of natural disasters, nor sunken into the bowels of the earth; moreover, I note that in those states the institution of heterosexual marriage remains alive and well.

(9) We support protecting the lives of vulnerable persons by opposing health care rationing and denial of health care and government funding of abortion; and

I’m glad that Republicans oppose health care rationing. I’m curious to know how they plan to stop insurance companies from continuing to ration care or, for that matter, how they intend to stop the effective rationing for those people who can’t afford health insurance. Republicans also oppose the denial of health care. That seems like a pretty clear blanket statement; yet last time that I checked, Republicans were set against health care for illegal immigrants (remember Rep. Joe Wilson’s “you lie” moment?). And recall, once again, that the Republican health care reform proposal did not prevent insurance companies from denying coverage based on pre-existing conditions.

With regard to the funding of abortions, first I note that it is a blanket opposition. There is no nuance or exception for matters of rape, incest, or life of the mother. “Gee, sorry, that you’re gonna die ma’am, but if you can’t pay for the abortion on your own, we can’t help you!” Talk about compassionate conservatism. I also have a problem with enshrining certain types of moral issues into federal funding policies. Why, for example, are Republicans opposed to funding abortion but not drugs for erectile dysfunction or hair replacement? More importantly, why are Republicans opposed to funding abortion but not opposed to funding the death penalty, wars, torture, and illegal wiretaps? If every issue to which a large group of voters objected on moral grounds were excepted out of government funding, I suspect that very little would be funded (then again, I suppose that Republicans would view that as good, so long as the military was still fully funded). I also have a problem with the exception for abortion given that other religious traditions come to the issue of abortion with a different understanding and mindset. Thus, while the denial of funding may satisfy a conservative Christian worldview, it may also run directly contrary to a Jewish understanding of when abortion is acceptable. If my religious tradition has a different understanding of the issue, why should someone else’s religious understanding determine how federal spending impacts upon my religious beliefs? (For a more in depth discussion of religious views of abortion, see my post Keep Your Religious Doctrine Out of My State’s Laws from January 2008). I get that conservatives don’t want their tax dollars to pay for abortions; I don’t want my tax dollars to pay for torture. Republicans will do almost anything to protect the “unborn”; but once a child is born, don’t look to the Republicans for help or protection, no sir!

(10) We support the right to keep and bear arms by opposing government restrictions on gun ownership;

Like abortion, I’ve written before about my thoughts on gun control and the Second Amendment and I won’t belabor the point here. But I do want to point out the fact that the opposition to “government restrictions on gun ownership” is another blanket statement. There is no exception for children, the mentally ill, or felons (or terrorists for that matter) and there is no exception for assault rifles or armor piercing bullets or rocket-propelled grenades (or nuclear weapons…). So it would seem to me than any Republican who supports even modest gun control legislation would not pass the party’s proposed purity test.

And what happened to honoring the tenets of this recitals from the preamble of the proposed resolution:

President Ronald Reagan also believed the Republican Party should welcome those with diverse views

Somehow the notion of welcoming diverse views doesn’t seem to come through in the proposed purity test.

As a counterpoint to the Republican purity test, take a look at this purity test for Democrats proposed by Devilstower on Daily Kos:

(1) We support the rights extended to Americans extended under the Constitution. All the rights. For all Americans.

(2) We support thoughtful, pragmatic solutions that protect American lives, American standards, and American pocketbooks. This includes finding solutions that don't require bombing anyone.

(3) We support an America that has diversity in race, thought, background, and religion not out of some hazy idealism, but because it is our nation's greatest strength.

(4) We oppose torture in any form, in any place, at any time, for any reason.

(5) We support American business, and recognize that an unregulated market is an unfair market, an unstable market, and a market doomed to failure.

(6) We support American workers, and know that when workers are allowed to organize they make their jobs, their companies, and their nation stronger.

(7) We believe that the reputation of our nation is valuable and must be zealously guarded against those who place expediency ahead of law.

(8) We believe in spreading democracy and human rights to the rest of the world by vigorously upholding those ideals here at home.

(9) We believe that access to our government is not for sale. Not in the courthouse, not in the White House, and not in the legislature.

(10) We believe that the health of our planet is not a zero-sum game, not a game of "you go first," and not a game.

What is interesting is that I don’t necessarily completely agree with each and every point in this “purity test” either (for example, I’m very hesitantly willing to consider torture in a true ticking time bomb case). Nevertheless, I think that the ideals espoused by this purity test are certainly worth considering, at least as a comparison to the proposed Republican purity test. Read both sets of positions and then ask yourself in which version of our country would you rather live?

Finally, ask yourself whether a purity test like that proposed by the Republicans makes sense. Which would you prefer: (a) party that has pre-determined how its members must think and how they must vote on certain issues; or (b) a party that tells its members to think for themselves, honor their ideals and values, and represent the voters that elected them, rather than the party to which they belong.

Oh, one more thing, as long as I’m looking at purity tests and lists of values and ideals. Charles Johnson, the founder of the right-leaning blog Little Green Footballs has announced that he is parting ways with the right because of:

1. Support for fascists, both in America (see: Pat Buchanan, Robert Stacy McCain, etc.) and in Europe (see: Vlaams Belang, BNP, SIOE, Pat Buchanan, etc.)

2. Support for bigotry, hatred, and white supremacism (see: Pat Buchanan, Ann Coulter, Robert Stacy McCain, Lew Rockwell, etc.)

3. Support for throwing women back into the Dark Ages, and general religious fanaticism (see: Operation Rescue, anti-abortion groups, James Dobson, Pat Robertson, Tony Perkins, the entire religious right, etc.)

4. Support for anti-science bad craziness (see: creationism, climate change denialism, Sarah Palin, Michele Bachmann, James Inhofe, etc.)

5. Support for homophobic bigotry (see: Sarah Palin, Dobson, the entire religious right, etc.)

6. Support for anti-government lunacy (see: tea parties, militias, Fox News, Glenn Beck, etc.)

7. Support for conspiracy theories and hate speech (see: Alex Jones, Rush Limbaugh, Glenn Beck, Birthers, creationists, climate deniers, etc.)

8. A right-wing blogosphere that is almost universally dominated by raging hate speech (see: Hot Air, Free Republic, Ace of Spades, etc.)

9. Anti-Islamic bigotry that goes far beyond simply criticizing radical Islam, into support for fascism, violence, and genocide (see: Pamela Geller, Robert Spencer, etc.)

10. Hatred for President Obama that goes far beyond simply criticizing his policies, into racism, hate speech, and bizarre conspiracy theories (see: witch doctor pictures, tea parties, Birthers, Michelle Malkin, Fox News, World Net Daily, Newsmax, and every other right wing source)

And much, much more. The American right wing has gone off the rails, into the bushes, and off the cliff.

I won’t be going over the cliff with them.

I disagree with Charles Johnson on many issues, but I’ve always found him to be reasonable and fair minded. When he takes a position, he almost always backs it up. Ever since I came across Little Green Footballs during the Israel-Lebanon war in 2006, I’ve found his site to be a destination to see what the rational right is thinking. As Johnson has frequently noted over the last several months, too often what the right is thinking isn’t rational at all.

So anyway, it looks like I won’t be eligible to run for office as a Republican in 2010. Shucks.

Why Competition Across State Lines May Not Really Be Such a Great Idea

One of the oft-repeated ideas in the current healthcare debate is that Americans should have the right to shop for health insurance across state lines. The argument is usually framed in terms of increased competition that will bring prices down and increase the quality of insurance packages available. And after all, who wouldn’t be in favor of increased competition?

Well, this is one of those issues that sounds great in a sound bite, but if you dig just a little bit below the surface, you will recognize some real problems and why this idea may not be so great after all.

Right now, insurance companies are regulated in the states in which they provide insurance. Thus, if you are a resident of Indiana, your insurance is provided by an insurer licensed by the Indiana Department of Insurance. Here is how Carol Cutter, the Commissioner of the Indiana Department of Insurance describes the Department’s role:

The purpose of the Indiana Department of Insurance is to protect Hoosiers as they purchase and use insurance products to keep their assets and their families from loss or harm. Consumers may need assistance with certain claim situations or just help in understanding how their policies work.  Our other primary obligation is to monitor the financial solvency of the insurance companies domiciled in Indiana so that the legal promises made in insurance policies are honored. To these ends, our Department staff is committed to providing exceptional customer service for both our consumers and our companies, and to maintain a fair and objective viewpoint as we examine each issue and circumstance within our jurisdiction.

I presume that other states have their own insurance departments that (again presumably) see their role in similar terms.

Now think about corporations for a minute. Have you ever noticed how many corporations are domiciled in Delaware? According to the Delaware Division of Corporations “More than 50% of all publicly-traded companies in the United States including 63% of the Fortune 500 have chosen Delaware as their legal home.” Why is that? After all, Delaware doesn’t have any large cities. The reason is simple: Delaware’s legislature made a conscious decision to enact laws that were seen as favorable to corporations (and in particular to corporate management, often at the expense of shareholders). Similarly, Delaware enacted less restrictive interest laws in order to make Delaware an attractive state of domicile for banks. At the end of the 19th Century, Delaware, New Jersey, and New York engaged in a race to attract corporate businesses. But when it comes to the protections given to shareholders, some might think of that race as a race to the bottom.

And that is what interstate insurance competition would lead to: A race to the bottom. States, in particular states with smaller populations or less homegrown industry, would be encouraged (don’t forget the strength of insurance lobbies) to enact laws that would be more favorable to the insurance companies. Those companies could then be domiciled in those states and offer their insurance packages across state lines into states with more rigorous consumer protection standards, greater solvency requirements, or more items that must be covered (mental  health or cancer screening, for example). So suddenly you, an Indiana resident, might be buying insurance from a company that the Indiana Department of Insurance has little or no ability to regulate but which is, instead, regulated by another state that has made the decision to lessen consumer safeguards to “drum up business”.

Let me offer one concrete example of how this might work and how it could impact a consumer. In Indiana, courts have ruled that when interpreting an insurance contract, any ambiguity is to be strictly construed against the insurer. (See, e.g., Cinergy Corp. v. Associated Elec. & Gas, 865 N.E.2d 571 (Ind. 2007)). In other words, if there is an ambiguity about what something means in an insurance policy, an Indiana Court will read that policy in a way that favors the insured rather than the insurance company. The basic reason for this presumption goes to unequal bargaining power and the fact that the insurance company drafted the policy and had the best opportunity to craft precise language. Insurance contracts (like most well-drafted contracts) include a “choice of law” provision, in which the parties agree as to which state’s laws will govern interpretation of the contract. Usually the chosen state will be the state that is the home (or principal place of business) one of the parties. So think how appealing it would be for an insurer to choose as its home or principal place of business a state that adopted the opposite presumption; that is, a presumption in favor of the insurer (as opposed to the insured). Or imagine how appealing it would be to an insurer to be domiciled in a state that does not require insurance policies to provide mental health coverage or cancer screenings to be included.

Don’t think for a moment that I’m just making up this worry or that the idea had never crossed the minds of those advocating for interstate insurance competition. The Republican healthcare reform bill [pdf], which does allow for interstate competition (and which also, by the way, does nothing to prevent insurers from denying coverage to those with pre-existing conditions…) requires that the fine print of an insurance policy include the following language (emphasis added):

THIS POLICY IS ISSUED BY _____ AND IS GOVERNED BY THE LAWS AND REGULATIONS OF THE STATE OF _____, AND IT HAS MET ALL THE LAWS OF THAT STATE AS DETERMINED BY THAT STATE’S DEPARTMENT OF INSURANCE. THIS POLICY MAY BE LESS EXPENSIVE THAN OTHERS BECAUSE IT IS NOT SUBJECT TO ALL OF THE NSURANCE LAWS AND REGULATIONS OF THE STATE OF _____, INCLUDING COVERAGE OF SOME SERVICES OR BENEFITS MANDATED BY THE LAW OF THE STATE OF _____. ADDITIONALLY, THIS POLICY IS NOT SUBJECT TO ALL OF THE CONSUMER PROTECTION LAWS OR RESTRICTIONS ON RATE CHANGES OF THE STATE OF _____. AS WITH ALL INSURANCE PRODUCTS, BEFORE PURCHASING THIS POLICY, YOU SHOULD CAREFULLY REVIEW THE POLICY AND DETERMINE WHAT HEALTH CARE SERVICES THE POLICY COVERS AND WHAT BENEFITS IT PROVIDES, INCLUDING ANY EXCLUSIONS, LIMITATIONS, OR CONDITIONS FOR SUCH SERVICES OR BENEFITS.

(See page 130.) Have you ever read the fine print of your insurance policy? Did you understand it?

Essentially, those who propose allowing interstate competition for health insurance packages already recognize that states may engage in a regulatory race to the bottom to encourage insurers to become domiciled in their state (think fees and taxes, not to mention the possibility of jobs).

Oh, one more thing about that Republican bill. When it comes to which state an insurance company could choose for “headquarters”, the bill specifically includes Guam, American Samoa, and the Northern Mariana Islands (see page 121-122). Just imagine having to travel to Guam, American Samoa, or the Northern Mariana Islands to engage in litigation with your insurer! (Most contracts include a choice of jurisdiction and venue as well; so long as one of the parties is domiciled or has a principal place of business in that “state”, most courts will recognize and enforce that choice of jurisdiction and venue.)

I’m sure that there are many, many other issues to consider in the debate about whether it is a good idea to allow for interstate competition in health insurance plans. But be sure to recognize that there is a downside to what, on its face, sounds like a great idea.

Tea Party Idiots Are Back ... and Just as Vile

I don't have time for a full discussion of today's tea party protest (or is that a "press conference" as Republican staffers were apparently told to day) organized by none other than Rep. Michelle Bachmann (R-Minnesota). But I did want to take a brief moment to post photos of a sign being prominently displayed in front of the Capitol today:

And a close-up:

The misguided or hate-filled mind that would create and carry that sign is what rational Americans have to fight against.

Oh, and did you hear the joke about the Republican healthcare reform proposal? You know, the bill that doesn’t stop insurance companies from denying coverage for pre-existing conditions and that would, by 2019, only reduce the number of people without health insurance by 3 million. Oops. Sorry. That wasn’t a joke. But it sure sounds like one.

[Update: I tried to correct a typo on this post and now, for some reason, the date of the post has changed from November 5, 2009, to March 16, 2010. I'll try to fix that.]

IN Touch: Sick Kids in Class (update)

Last Friday, I posted my most recent entry on The Indianapolis Star's IN Touch blog. The good news is that my post was published in today's print edition of The Indianapolis Star. The bad news is that, once again, my post was been edited in a way that removes part of the point that I was trying to make (note the entire last paragraph that was omitted). So, just for the hell of it, below is my original post. I've lined through the parts that were omitted from the printed version and underlined additions made by the Star’s editorial staff. What do you think? Were the changes made by the Star's editorial staff appropriate? Do they change the meaning?

As we go through the process of debating the merits of various proposals for health-care reform, we should also take the time to examine certain hidden health-care-related societal costs.

We hope that, when faced with a sick child, most parents would keep that a sick child home from school and take the child to see a doctor. But how many parents can't do this keep their child home because they don't have alternate child-care arrangements? And what are the ramifications of sick children being sent to school because a parent can't stay home with the child? ¶ Similarly, how many children stay sicker longer or return to school earlier than they should because the family cannot afford to see the doctor or pay for medicines? And what is the cost to society for sick children attending school and no doubt sickening other children?

We teach our children not to steal or cheat. When it comes to their classmates, we teach them not to fight or hurt one another. But how many parents extend that teaching to include a responsibility not to expose a classmate to germs?

As a society, we don't tolerate violent children. So why do we tolerate parents who send sick children to school? And what can we, as a society, do to help those parents and their children learn right from wrong and be in a position where the child can be safely kept home from school when necessary without forcing the family to make unacceptable sacrifices?

And what can we do to help schools with budgets determined by the number of children in attendance? Schools should not be encouraging sick children to attend classes so that the school can receive additional funds.

IN Touch: Sick Kids in Class

My eleventh post on The Indianapolis Star's IN Touch blog is now online. I took the themes that I addressed here on Wednesday and re-worked them in a post for the Star. As I've said previously, I'm going to keep re-posting those entries here (at least until someone from the Star asks me to stop). Go ahead and visit the post on the IN Touch site, anyway.

As we go through the process of debating the merits of various proposals for health-care reform, we should also take the time to examine certain hidden health-care-related societal costs.

We hope that, when faced with a sick child, most parents would keep that child home from school and take the child to see a doctor. But how many parents can't keep their child home because they don't have alternate child-care arrangements? And what are the ramifications of sick children being sent to school because a parent can't stay home with the child? Similarly, how many children stay sicker longer or return to school earlier than they should because the family cannot afford to see the doctor or pay for medicines? And what is the cost to society for sick children attending school and no doubt sickening other children?

We teach our children not to steal or cheat. When it comes to their classmates, we teach them not to fight or hurt one another. But how many parents extend that teaching to include a responsibility not to expose a classmate to germs?

As a society, we don't tolerate violent children. So why do we tolerate parents who send sick children to school? And what can we, as a society, do to help those parents and their children learn right from wrong and be in a position where the child can be safely kept home from school when necessary without forcing the family to make unacceptable sacrifices?

And what can we do to help schools with budgets determined by the number of children in attendance? Schools should not be encouraging sick children to attend classes so that the school can receive additional funds.

The Costs of Sick School Children

I want to tease out a little scenario. Little Billy is a 3rd grader at Clinton Bush elementary school. One morning Billy wakes up with a fever. His mother, always concerned for Little Billy, keeps him home from school and takes him to see the doctor. Billy is given an antibiotic and stays home from school for a few days while his mother takes loving care of him. At least that is how it should work.

But let’s look at how things work in the real world. First of all, for a lot of Little Billys, there isn’t a mother who can stay home to care for him or take him to the doctor. She has to work to put food on the table. So instead of staying home, Little Billy, even though he is sick, goes to school. Chances are good that within a few days, several of Billy’s school mates will also be sick and their families will be in the same position as Billy’s. What are the costs to the families and community for all of those other sick kids? And what are the costs to the school itself for the days of missed attendance (especially in states where school funding programs are based on the number of children in attendance on any given day or ability to achieve certain test scores)?

And even for the Billys who are able to stay home from school, how many of them aren’t making a doctor visit? For too many families, there may be no insurance (or limited insurance) to pay for the doctor visit. Others may have insurance but need to self-ration their own healthcare because of inability to afford co-pays or deductibles, let alone medicines. In these cases, Billy may get worse or may miss more school than he should or return to school too early. In some cases, Billy may have insurance (through programs like CHIP), but his family may be unaware of the availability; even if that insurance is available, the family may not be able to take the necessary time to care for Billy.

Sure there is a cost to insuring Little Billy. But what is the true cost of Billy being sick for longer, of going back to school too soon and getting other kids sick, of additional children missing additional days of school, of parents having to weigh the importance of work versus caring for a sick child or medicine versus food? What are those costs to our society?

When my kids have a fever, they stay home. My wife can stay home with them. We keep them home for their own well being and so that every other child in their class is not exposed to their germs. But the number of times that I’ve heard about another child being sent to school with a fever or severe cough or runny nose and sneezing, is almost mind-boggling. What is the cost to my family when my children get sick because another parent either couldn’t or wouldn’t keep their child home? If another child pushes and injures my child, I can look that that family’s insurance to pay for the medical costs that my child will incur; if another child goes to school sick and gets my child sick, should I be able to look to that family’s healthcare insurance? (And if not, why not? Before answering, consider the following: If you are in an automobile accident with an uninsured motorist, you can usually look to a state pool that is funded by a premium for uninsured motorists that you pay as a part of your own insurance…)

The health of our children is our responsibility as parents. But the health of our children’s school mates is also our responsibility to the extent that our children are sick. That is a shared responsibility that we have as members of a community and civil society. We all recognize that our children shouldn’t hit one another; so why are so many parents unwilling to recognize their responsibility to be sure that their children don’t sicken others?

All of these costs impact our families and our communities. All of these costs impact the overall cost of healthcare in America. Yet I’m not sure that these sorts of “hidden” costs are being considered in the ongoing debate over reforming America’s healthcare system.

Public Service Announcement: Protect Insurance Companies!

 

As a bonus, here’s a very interesting clip of CNN’s Rick Sanchez taking Fox News to task. Watch the whole clip so that you don’t miss the surprise “in your face” ending.

Why the Visceral Hatred? (update) - And a Bonus Discussion of Healthcare

On August 5 I wrote a post entitled Why the Visceral Hatred? which began with the following:

Why do so many (presumably mostly on the right) have such a visceral hatred for President Obama? It is one thing to disagree with his policies ("I don't like his healthcare proposal because..." or "I don't think that the government should have bailed out the automakers"). I understand those sentiments; they lend themselves to discussion of the issues which is, of course, how the democratic process is supposed to work. But in the case of President Obama, there seems to be something else going on, something dangerous.

I answered my own question, in part:

I think that the answer really can be found in that little nugget that I decided to ignore when I began this post. Those who hate President Obama never seem to fail to use his middle name. Why is that so important to them? I wonder how many of them can even tell you the middle names of the last handful of Presidents, including what the "Dubya" stands for .... I think that the name "Hussein" reminds people that President Obama is "different" and maybe, just maybe, too much a name used by "the enemy" (I doubt that Richard Nixon would have been elected has his middle name been Stalin or Kruschev, but who knows). Add to that the obvious fact that President Obama is different (remember that whole, "first African-American elected to the Presidency" thing?) and I think you've found the real reason that many people hate him. Who he is, what he looks like, and where he comes from is the proverbial elephant in the room.

I think that many people who may claim not be racist are, in fact, racist, and whether they'll admit it to themselves or not, cannot stand the idea of a "black" in the White House (never mind that he's half-white); nor can they stand the idea that a man whose father was not an African-American, but rather an actual African, and who has a "funny" name that includes a common Arabic or Muslim name associated with a principal US adversary of the past 18 years (remember Saddam Hussein...?).

I think what we've seen over the last few days makes my initial question ever more relevant. And it makes me believe that my answer was, at least to some extent, on target.

 

Consider for a moment the seething anger at the idea of President Obama addressing schoolchildren (never mind that both Ronald Reagan and George H.W. Bush did the same thing; never mind that George W. Bush was reading to schoolchildren when the planes hit the World Trade Center on 9/11). What could President Obama have possibly said to our children that could have "indoctrinated" them (presuming of course, that indoctrination was his subversive goal)? Please, somebody, write the sentence that he could have used that would have turned our nation's children into a phalanx of little Marxists. And, before you do so, go back and read the text of President Reagan's speech where he did talk economic politics to kids.

Some have pointed to the proposed lesson plan for teachers from the Department of Education, focusing on the suggestion that children write a letter discussing "how they could help President Obama". Note that the question does not ask the children how they could help President Obama do __________ (insert your favorite Marxist-Socialist-Fascist-Terrorist goal), but rather, simply how they could help the President. I guess that the fear here may go back to Rush Limbaugh's statement that he wants President Obama to fail. I suppose that parents who support that viewpoint would be upset at their children being asked to talk about how they might help the President rather than how they might hinder the President. I've written before about how cynical that viewpoint is, but think of the lesson that we're teaching our children when we tell them that they should want the President to fail. That is the inverse of teaching patriotism and civic spirit, but it seems that the right only believes in patriotism sometimes.

Remember, too, that we're talking about kids. Do we really worry that some 3rd grader is going to be swayed such that he'll write a letter suggesting he'll help the President by joining the proletariat to throw off the reigns of the bourgeoisie; do we really worry that some 5th grader will be emboldened to write to the government to report that his parents failed to pay the appropriate taxes on their domestic help or illegally downloaded an MP3; and do we really worry that a 9th grader will suddenly become a supporter of publicly-financed abortions for illegal immigrants and ask to sit on a "death panel" to help euthanize grandma? I mean, really. Think about it. If people are so afraid that President Obama could have that kind of influence over their children in the course of a 15-minute speech, what does it say about the influence those people have over their own children?

Which of course leads me back to the initial question. What is it about this President, in particular, that creates this degree of hysteria, fear, and hatred? Why would people presume, on the basis of nothing more than the fact that President Obama planned to speak to schoolchildren and the suggestion that children be asked how they could help the President, that President Obama's speech was some secret plan to indoctrinate children? Why do people presume evil intent?

And then consider the heckling outburst from Rep. Joe Wilson (R-South Carolina) during President Obama's speech to a joint session of Congress last night.

I make it a point to try to watch the State of the Union every year, to watch every Presidential speech to a joint session of Congress, and to watch the inaugural address every four years. And I don't recall ever hearing the President of the United States heckled during one of those speeches by anyone, let alone a member of Congress! So what precisely is it about President Obama that led Rep. Wilson to be so consumed by outrage that he shouted "You lie!" as the President sought to debunk lies being espoused by those on the right? (And, for what it's worth, PolitiFact rated Rep. Wilson's statement "False".)

In a similar vein (though a bit off topic...), consider what the Republicans in Congress did and did not cheer during President Obama's speech. Most importantly, I noted that few if any Republicans applauded when President Obama talked about the fallacy of the "death panel" allegation. Query: Why would anybody not applaud the President for confronting a malicious fabrication that has served to scare elderly Americans? The debunking of this fallacy takes nothing away from legitimate arguments against President Obama's healthcare proposal, so why wouldn't Republicans welcome his efforts to "clear the air" and allow the debate to focus on real issues? The only reason that I can think of is that Republicans don't want to focus on real issues and have relied upon lies and distortions as their only means of combating healthcare reform.

As I was taking a break before finishing this post, I came across a statement from former Gov. Sarah Palin about President Obama's speech that left me ... well ... dumbfounded (that seems an appropriate word given the source):

In his speech the President directly responded to concerns I’ve raised about unelected bureaucrats being given power to make decisions affecting life or death health care matters. He called these concerns “bogus,” “irresponsible,” and “a lie” -- so much for civility.

Let's not forget that Palin was one of the early proponents of the "death panel" lie:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

And she wants to criticize President Obama for a lack of civility because he pointed out that she and others of her ilk lied? I'm sorry, but pointing out that a false "concern" -- raised for the sole purpose of scaring people and scoring political points -- is bogus and a lie and calling those who spread these lies irresponsible is not uncivil; no, it is patriotic and democratic. As I've noted repeatedly, our system requires a full and open exchange of ideas, but must be based on honest debate. Incivility can be laid at the footsteps of people like Gov. Palin for suggesting that then Sen. Obama "palled around with terrorists," allowing supporters to go unchallenged when they called then Sen. Obama a "terrorist" or shouted "kill him", and for scaring people on the basis of complete falsehoods.

 

Plus, for what it's worth, I would remind Gov. Palin that "unelected bureaucrats" are already (in her words) "given power to make decisions affecting life or death health care matters": They are the faceless, nameless claims adjusters sitting in cubicles for the insurance companies deciding which patients should not be insured, which patients should be dropped when they become ill, which claims should be rejected (whether for pre-existing conditions or cost or the experimental nature of the treatment or any of a myriad of other bullshit reasons). My wife and I have to deal with these unelected bureaucrats making life or death healthcare decisions relating to my wife's illness and medical regimen. I don't see Gov. Palin or the Republicans making much effort to be sure that those bureaucrats don't have such power; apparently, private bureaucrats seeking to make a profit should be encouraged to make these kinds of life and death decisions; insurance company based "death panels" are just fine. It's OK for an insurance company to kill grandma; just don't let the big bad government and evil President get involved. What a sick, twisted, and cynical view of our society.

 

Thus, I am left to ponder what the future holds for a society that holds so little regard for the truth, that is so willing to believe the worst about anyone, let alone the President, and that allows visceral hatred and malicious lies to replace reasoned debate and discourse. On that note, I strongly encourage people to read Pierre Atlas' terrific essay "Beware extreme rhetoric" published today in The Indianapolis Star in which he reflects on the consequences of political rhetoric of the sort that we're seeing today.

 

I understand a general distrust of government, but I don't understand the hatred and belief that President Obama is evil.

Using Lies to Whip Mobs into Anti-Democratic Frenzies (update 2)

Earlier today, I wrote (twice, actually) about the vile lie being used to scare the elderly so that they will oppose healthcare reform. Well, another Republican "leader" has now picked up that lie and has begun to use it. Here is what Sarah Palin (I like not having to call her Governor anymore) said on her Facebook page today:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Yes, such a system is downright evil. That's why it is not being considered by anyone. It is also downright evil to use a lie like this to try to scare people. But that is where today's Republican party lives. (By the way, in the statement from which I've pulled the above-quote, Palin also commends Rep. Michelle Bachmann for her stance against healthcare reform. Yes, that Rep. Bachmann...)

Oh, did you see the video of Glenn Beck saying that he'd like to poison Nancy Pelosi? And laughing about it? Or did you hear about Rush Limbaugh comparing President Obama to Adolph Hitler and, when called on that by Jewish groups and even some Republicans, he affirmed the comparison? Did you see the video of the Republican Congressman joking about constituents wanting to lynch their Democratic representatives and getting a big laugh from his constituents?

I'm afraid that civil discourse is dead.

The real question has become this: Does the right wing want a new civil war?

Using Lies to Whip Mobs into Anti-Democratic Frenzies (update)

As a follow-up to today's earlier post, I wanted to offer this terrific expose on the subject by Rachel Maddow.

I also thought this video was illustrative of the point that I made about trying to scare people. Listen to the big guy in the red hat (wait until about :25 before he really gets going):

Does he really say that Sen. Chris Dodd "would not be allowed to have surgery under the new healthcare plan" because he's 65-years old? I'd like to see the part of the bill that says that! (And don't forget that Sen. Dodd is already in a government healthcare plan...)

Videos like this are popping up all over the Internet. Some show people shouting at their representatives and some show pushing and shoving and fistfights. To paraphrase another blogger (I can't find the link right now) who posted a video of an apparent fight outside a town hall meeting: Our political system has crossed the Rubicon.

Since early on in my blogging days, I've been warning about the slippery slope into political violence. Sen. McCain and Gov. Palin allowed the unleashing of mob mentality (remember the shouts of "terrorist" and "kill him"). Well, I'm afraid that violent rhetoric and action have now become part of our political process. That slippery slope that I was worried we were approaching? Well, I'm afraid that we're there and we're sliding downhill.

Healthcare, Healthcare, Healthcare

Unless you’ve been living under a rock, you’ve probably noticed that, of late, a huge percentage of the political discussion (whether in Congress or the media) has focused on healthcare. That’s a good thing. Sorta. The problem is that, when most of us are truly honest with ourselves, the issues are so complex that most of us have nothing more than a superficial understanding of the real issues or the implications of the competing policy ideas. Add to this the fact that so many of the “experts” that we hear talking about healthcare have their own agenda, sometimes disclosed, oftentimes not. And of course the role of politics cannot be discounted (and query whether most of the members of Congress truly understand the issues either, beyond the talking points from their respective parties and lobbyists spending vast sums of money to secure their votes). Unfortunately, due to the complexity of the issues, the healthcare debate has been ripe for politicians to distort facts and mischaracterize ideas, sometimes due to a lack of understanding, but sometimes with true intent to deceive or mislead.

Thus, as we continue to the listen to the ongoing debate, there are few things that we, as voters and, more importantly, as the individual recipients of actual healthcare, must keep in mind.

1. The “talking head” being interviewed on the evening news (or any other program) may be an “expert” but chances are that the person has an agenda, whether as an employee or “consultant” for an interested company or organization or as a lobbyist. We should demand that news outlets (and entertainment channels like FOX News) be more candid and forthcoming with any relationships that a featured expert has with an interested company (or whether the person lobbies on behalf of an interested party). Moreover, when we hear that expert voice an opinion, we must consider whether that opinion is being offered for the benefit of one side or the other. Thus, when an expert says, “Policy X will mean Y,” stop to consider whether Y would be good or bad for those with whom the expert may be involved. And consider whether the news (or FOX) are being balanced in the presentation of expert opinions. If not, ask yourself why.
2. When you hear your member of Congress talking about healthcare, ask yourself whether that member of Congress actually understands the issues or is just parroting party-line talking points. And then ask yourself whether the opinions being voiced by that member of Congress will be of benefit to you or whether someone else stands to be the primary beneficiary. And, when you hear a member of Congress tell you what a particular bill says, don’t take their word for it; instead, take some time, go find the bill, and try to read it yourself. Or at least take the time to see if others have done a fact check on the claim. A few days ago a member of Congress gave a speech saying that page X of the House healthcare plan said that in 5 years, private plans would be eliminated (or something to that effect; the particulars aren’t important for this discussion). Simply reading the designated page revealed no such provision; yet many people will probably believe the “fact” set forth in her speech. We should also demand that our representatives cease using truly harmful rhetoric in their debates. A Georgia Congressman declared earlier this month that adoption of the House healthcare plan would “kill” Americans. How is that kind of rhetoric constructive to the debate? Finally, don’t forget that members of Congress presently participate in a government run health plan that is, by all accounts, excellent.
3. Remember the influence of lobbyists. How much money have drug companies spent lobbying on the healthcare issue? And why have they spent that money? Obviously, the drug companies have a vested interest in shaping any healthcare reform in a way that will be financially beneficial to them; why else spend the money (and let’s don’t forget that many drug companies aren’t even American companies…). How much money have insurance companies spent lobbying? How about medical groups or trial lawyers? Compare your answers to those questions with the following: How much money have you spent lobbying? How much time have you spent talking to your elected representatives? Doesn’t seem quite equitable, does it?
4. Insurance companies make money from the premiums that people pay. They lose money by paying hospitals and physicians to provide care to the people who paid the premiums. In other words, the more medical care we get, the less insurance companies earn. So, next time you hear a representative of an insurance company suggest that insurance companies are “working for consumers” or are on the “consumers’ side” recognize this falsehood for what it is. Moreover, if insurance companies are really so good at protecting consumers and offers such good products and services, why are they concerned with a government-sponsored plan?

I don’t know what healthcare reform should look like. But here are a few ideas:

1. Every American should be able to access high quality, reasonably affordable, basic healthcare. During one of the Presidential debates a question was posed to Sen. Obama and Sen. McCain, asking whether healthcare was a right or a privilege. In a modern, technologically advanced nation like ours, one that strives to be the exemplar for the world, I agree with Sen. Obama’s answer that healthcare should be viewed as a right. And using the emergency room is not an acceptable substitute for quality, basic healthcare.
2. Patients and their doctors should make healthcare decisions, not insurance companies. This issue is important to my family. My wife, as you may know from previous posts, has a rare illness that is treated by just a handful of doctors in the country. Many doctors, let alone insurers, have never heard of her illness. In fact, those time that we’ve were forced to seek treatment at the emergency room (before we knew what her illness was), the treatment given turned out to be wrong because, while the illness presented in a particular way, unless the doctor understood what the illness really was, the standard approach to treat the particular symptoms did not really help (it would make a good episode for House). So her doctor (who, until recently practiced at the University of Michigan and is now moving to Harvard) prescribed a course of medication that has largely kept her illness in check. But he has instructed her, when her symptoms do trigger, to take an extra dose of her medicine. The problem is that frequently, as the end of the month approaches, she doesn’t have enough medicine left and our insurance company refuses to pay for any extra medication because that would exceed their formulary guidelines, even though they don’t have any real understanding of her illness. The doctor isn’t some quack and the drugs are not hyper-expensive or experimental. Yet the insurance company is trying to dictate the medical care or drug treatment that my wife should receive notwithstanding: (a) the doctor’s prescription and (b) the fact that the drug treatment works. I and others like me should not have to fight with insurance companies when they disagree with the diagnosis or prescription of the treating physician.
3. People should be able to choose their doctor.
4. People who like their current health insurance should not be forced to terminate their coverage.
5. Insurance companies should not be able to refuse coverage based on a pre-existing condition. One of the reasons that my wife and I haven’t found alternate coverage is that no insurer will cover her now that we know about her illness. Her only option besides keeping our current coverage would be to enroll in the state “high risk” pool.
6. Even though I’m a lawyer, I do support limits on malpractice claims. Too many malpractice actions are without real merit and too many doctors seem to practice defensive medicine to avoid malpractice actions. That said, doctors should be competent in the services they perform and, if they aren’t, they should be held liable.
7. Healthcare coverage should pay for reasonable preventative, wellness, and pre-natal care. If we work to make ourselves healthier in the first place (not exactly one of my great strengths), it will benefit our society in the long run, financially and otherwise.
8. Every child should be entitled to the best quality healthcare. The health of a child should not suffer because the parent is poor or made bad decisions or is an illegal immigrant or for any other reason. We need to recognize that children are the future and we need to do what we can, as a society, to ensure (insure?) their health.

Well, I could probably go on and on about my thoughts for healthcare reform. I’ve listed a number of things that I think should be done, but, as I said from the outset, I don’t know how to get there. I do know that we, as taxpayers and consumers of healthcare need to demand more from our elected representatives as they debate the issue: more clarity, more intellectual honesty, and less political grandstanding.

One final thought. In our representative democracy, it is people who vote. Our nation was founded by “We the People” and we often talk about “government of the people, by the people, and for the people”. And it is people who need healthcare. Insurance companies don’t get cancer, drug companies don’t get diabetes, and hospitals don’t get the flu. People do. When we think about healthcare in America, we need to keep forefront in our minds, that what we are talking about is the health of people; the “health” of insurance companies, drug companies, hospitals, or others may be considered, but not at the expense of the health of the American people.

IN Touch: Germ Factory Lessons

My eighth post on The Indianapolis Star's IN Touch blog is now online. I'm going to keep re-posting those entries here (at least until someone from the Star asks me to stop). Go ahead and visit the post on the IN Touch site, anyway.

This week I've received two notices from the Carmel-Clay Public Schools providing information about the swine flu (oops, the H1N1 flu), including reminders about hand-washing and the school district's policy on when children should be kept home from school (fever of 100 degrees or higher).

We've made sure that our children understand that the flu is serious and that simple precautions can help keep them healthy.

What I don't understand, however, is why, if the school district is concerned enough to send numerous emails to parents, no attention is being paid to the flu by teachers. When I asked my children if any teachers had told them about the flu or reminded them to wash their hands or cover their mouths if they coughed or sneezed, they told me that the teachers hadn't said anything.

It seems to me that the schools need to make a concerted effort to be sure that the germ factories (also known as children) in their charge remember take those simple steps that can help prevent the spread of illness.

Update (May 2, 2009): This post was printed in The Indianapolis Star on May 2, 2009.