I find the “What about people in the red states?” argument against an opt-out public option wholly unpersuasive. Yes, an opt-out public option could end up preventing millions of people from having access to quality affordable health care, but there’s a simple solution to that problem : Stop Voting For Republicans. If enough people do that, then you don’t have to worry about getting your heath care taken away by a bunch of wingnuts who think Barack Obama is the love child of Hitler and Malcolm X.

The main reason a robust public option is off the table at all is because conservative voices are over-represented in the Senate, yet we’re supposed to care because a bunch of ignorant, regressive, fools in the small states might take away a vital component from the compromise of a compromise of a compromise health care plan that Congress can barely pass? Cry me a frickin’ river.

I’m sick of seeing people suffer because the founders decided to give the representatives of small, states a de facto over anything even mildly progressive. Every major leap forward our nation has taken has been in spite of conservatives, so when I think about all of the progress still waiting to be done, I’d rather just get the best deal we can and let the rest of the country keep living in the dark ages. Better to lead by example and hope they catch up then let the tyranny of the minority keep screwing everyone over.

Obama’s High Bar

The problem for the addlebrained Obama-rejectionists is that the president, as far as they are concerned, couldn’t possibly do anything right, and thus is unworthy of any conceivable recognition. If Obama ended world hunger, they’d accuse him of promoting obesity. If he solved global warming, they’d complain it was getting chilly. If he got Mahmoud Abbas and Binyamin Netanyahu to join him around the campfire in a chorus of “Kumbaya,” the rejectionists would claim that his singing was out of tune.

What would actually work? Driving down the cost of health care

What provisions in a “health reform act” would actually drop costs in health care? Let’s leave aside for the moment all the myriad other arguments – some might be seen as too much government intrusion, some would destroy the health plan industry, some would be cripplingly difficult for providers, and so on – and just focus on cost. Given the real structure of health care markets in the United States at this moment, what could be written into federal law and regulation that would actually reduce cost?me of these changes are massive, some would be invisible to those outside the industry, but all could be legislated or regulated, and all would “bend the curve” toward lower costs.
. . .
Limiting medical loss ratios: Many European countries dictate that health plans must return 85% or 90% or 92.5% of the premium paid in as medical services paid out. U.S. health plans, in contrast, compete on (and brag to Wall Street analysts about) how low their medical loss ratio is. Some are as low as 60%.
. . .
Increasing subsidies for digitization, tied to productivity improvements: There are huge inefficiencies in the actual practice of medicine. No one can improve on them until the people running health care can actually track what they are doing, in detail. In something as complex as health care, that means total digitization, like any other business.

Subsidizing automation: Many things in health care would be done much more efficiently by automation, from lab work and pharmaceutical distribution to tracking inventory. Today’s system does little to encourage such automation – instead,it actually supports the inefficiency.

Standardization and checklists: Many parts of health care have established pathways that are clinically proven and widely published in the medical literature, yet followed only at the clinician’s whim. These are not matters for the doctor’s judgment, these are matters like washing your hands between patients, fully draping a patient for a central line placement, getting clear verbal confirmation from everyone in the surgical suite that they agree on who the patient is and what the operation is for. Standard pathways, and simple feedback mechanisms like checklists to make sure they are followed, are still not common practice in health care. If regulations made them mandatory, following them would save billions of dollars in fighting infections and having to re-admit patients to the hospital with problems that could have been prevented.

High Cost of Death Row

Perhaps the most extreme example is California, whose death row costs taxpayers $114 million a year beyond the cost of imprisoning convicts for life. The state has executed 13 people since 1976 for a total of about $250 million per execution. This is a state whose prisons are filled to bursting (unconstitutionally so, the courts say) and whose government has imposed doomsday-level cuts to social services, health care, schools and parks.

Money spent on death rows could be spent on police officers, courts, public defenders, legal service agencies and prison cells. Some lawmakers, heeding law-enforcement officials who have declared capital punishment a low priority, have introduced bills to abolish it.

A Smarter (and Cost-Efficient) Way to Fight Crime

Most crimes in the United States are committed by long-term repeat offenders, a majority of whom are eventually caught. One of every 100 adults in the United States is now behind bars; many are serving lengthy sentences. The crimes they committed clearly did not “pay” in any objective sense of the term.

Why, then, did they commit them? The short answer is that most criminals are not the dispassionate rational actors who populate standard economic models. They are more like impulsive children, blinded by the temptation of immediate reward and largely untroubled by the possibility of delayed or uncertain punishment.

The evidence suggests that when hardened criminals are reasonably sure that they will be caught and punished swiftly, even mild sanctions deter them. But not even the prospect of severe punishment is effective if offenders think they can get away with their crimes.

One way to make apprehension and punishment more likely is to spend substantially more money on law enforcement. In a time of chronic budget shortfalls, however, that won’t happen.

But Mr. Kleiman suggests that smarter enforcement strategies can make existing budgets go further. The important step, he says, is to view enforcement as a dynamic game in which strategically chosen deterrence policies become self-reinforcing. If offense rates fall enough, a tipping point is reached. And once that happens, even modest enforcement resources can hold offenders in check.

The Republican party just redesigned their website to be a red version of Barack Obama’s campaign site. Knowing their primary goal should be to convince the rest of the country they’re not just a bunch of bitter old white dudes, they updated the logo to replace the “O” with a bunch of yearbook photos. Since your time is valuable, I’ll save you the strain of hitting reload a bunch of times. Here’s all of them :

I’ll leave it to others to analyze the demographic breakdown of these images and what it says (if anything) about the type of voters the Republican Party is trying to attract, though I’d be willing to bet if the GOP was really as diverse as the images here suggest, we’d have a much more civil discourse in this country.

While conservatives are laughing themselves silly over Chicago’s failed bid to host the 2016 Olympics, deluding themselves into seeing their own rabid hatred of Barack Obama reflected in the eyes of the IOC, let’s take a step back here. Putting aside for the moment that Rio is an excellent choice to host the 2016 games, if I was on the International Olympic Committee, I dunno if I’d be so keen on hosting the Olympics in the America either. I don’t know how much American news the Swiss receive, but if they saw one of the gun-toting mobs of tea baggers holding signs of the President’s face Photoshopped with a Hitler mustache, it probably wouldn’t do much to help them forget that the last time the United States hosted the Summer Olympics, a right-wing domestic terrorist planted a bomb in the middle of the Centennial Olympic Park.

If you take a look at Eric Rudolph’s statement on the Olympic Bombing, it looks like something that could have been written yesterday :

Even though the conception and purpose of the so-called Olympic movement is to promote the values of global socialism, as perfectly expressed in the song Imagine by John Lennon, which was the theme of the 1996 Games even though the purpose of the Olympics is to promote these despicable ideals, the purpose of the attack on July 27 was to confound, anger and embarrass the Washington government in the eyes of the world for its abominable sanctioning of abortion on demand.

I’m not saying this is why the IOC didn’t chose Chicago, but if I had to chose a venue for the Olympics, the recent explosion in right-wing lunacy would certainly make me think twice about whether or not it’s safe for the United States to host another Olympic Games.

Y’know that hilarious Protect Insurance Companies video that every other person was posting on Facebook yesterday? Well, prepare yourself to take back those chuckles because Jim Geraghty at the National Review (with an approving link from Andrew Sullivan) has an epic takedown of the fake-PSA :

Because $10 a Head To Watch ‘Land of the Lost’ Wasn’t Greed

The greed of health insurance company executives is the topic of satire in this video from Will Ferrell, who is by some accounts the highest paid star in Hollywood; Forbes said this year he was merely the 20th highest paid actor in Hollywood.
.

Get it? If you’ve made a lot of money pumping out absurdist comedies, then you’re a hypocrite for even suggesting that letting insurance companies profit off the deaths of their customers is a bad thing. This kind of argument is simplistic and ridiculous. It’s like saying “Michael Pollan doesn’t want people to eat junk food, but he eats three meals every single day.”

We really live in a golden age for race-baiting. Back in the day, there was a spectrum of racism of sorts. You knew something racist fell somewhere between Al Jolson in blackface, zip-a-de-doo-dah racism and the move your wallet to your front pocket because you see a black guy walking down the street racism. It was a simpler time.

In the last two years, however, Republicans have been so angry they’ve had to invent new ways to be racist. No longer can we judge racist sentiment simply by its degree of offensiveness. Now there are multiple varieties of racism which have become almost like an ingredient the cupboard of conservative hate speech that’s used to flavor every utterance the way a great Italian chef might finish off a dish with a drizzle of their finest extra virgin olive oil.

You’ve got the birther crowd with their “Faked the moon landing” racism. The Fox News saying Michelle is Barack’s “Baby Mamma” which is more of an “Oh my god, you’ve never really met a black person before have you?” racism. The “Fiscal conservative” / Tea Party “Complain about high taxes while comparing the President to a monkey” racism. The Matt Drudge “Ominously link to a story that incidentally involves people of different races as if to imply there’s racial backlash against caucasians” racism. And the religious extremist “Don’t blame me if the Bible says Obama is the anti-Christ” racism.

Then there’s Rush Limbaugh and Glenn Beck, who are like the Thomas Edison and Nicola Tesla of racist bullshit. These guys aren’t just content to be the “Telling a racist joke, but it’s cool because everyone knows I’m not racist” guys. Oh no. They’re innovators. They went out there, saw that America elected a black guy, and said “The old ways being a racist asshole aren’t good enough”.  In the process they’ve erected multimedia empires, doing for the “Aggrieved white guy cries reverse-discrimination” racism what Henry Ford did for auto manufacturing (or, not to change the subject, anti-semitism).

Now if the right wing’s artisans of racial hatred could only devote this uniquely American spirit of ingenuity into endeavors that don’t…well…threaten to destroy the social and political fabric of our nation, then we might get somewhere.

I’ve always had a soft spot in my heart for the Presidential Prayer Team. After all, they were the ones who gave us my favorite bit of post-9/11 kitsch :

On a lark, I decided to check in on the organization whose self-described mission was to “pray for our national leaders in accordance with biblical principles, regardless of political persuasion“, but it seems like the election of Barack Obama has dampened the enthusiasm quite a bit. Here’s what the PPT site looked like back in 2006 :



And here’s what the Presidential Prayer Team site looks like today :



Funny how a “non-partisan organization” would go out of its way to avoid using the current President’s name or photo. It’s almost as if members of the Presidential Prayer Team are less likely to pray for President Obama than President Bush. I wonder why that is?

Bonus detail : Notice the site no longer references a Bible quote in the masthead. Is 1 Timothy 2:1-2 not as popular now as it was when Republicans ran the country?

I urge, then, first of all, that requests, prayers, intercession and thanksgiving be made for everyone— for kings and all those in authority, that we may live peaceful and quiet lives in all godliness and holiness.

Roy Edroso’s round-up of wingnut reaction to Joe “You lie!” Wilson contains this hilarious gem (via Tom Tomorrow) :

Riehl World View rushed to interview the Congressman, and though they only repeated one word of his responses (“appalling,” regarding the President’s assertion), they characterized him as open-minded (“he went into the speech hoping Obama would genuinely reach out both to the people and across the aisle to address their concerns”), sensitive to the needs of his constituents (“Wilson also stressed his concern for the existing high unemployment in South Carolina”), and a man of even temperament, at least on most occasions (“Other than the single, short impromptu blurt, Wilson said he was in complete control of himself at all times”).

True. Wilson was “in complete control of himself”, except when he wasn’t. And if you really think about it, with the exception of a few interviews, Sarah Palin has spent the majority of her life NOT sounding like a complete dumbass. Like when she’s sleeping or eating or waiting for others to stop talking.

Add this to the long list of reasons why I will never, ever, ever vote Republican :

It turns out that in eight states, plus the District of Columbia, getting beaten up by your spouse is a pre-existing condition.

Under the cold logic of the insurance industry, it makes perfect sense: If you are in a marriage with someone who has beaten you in the past, you’re more likely to get beaten again than the average person and are therefore more expensive to insure.

In human terms, it’s a second punishment for a victim of domestic violence.

In 2006, Democrats tried to end the practice. An amendment introduced by Sen. Patty Murray (D-Wash.), now a member of leadership, split the Health Education Labor & Pensions Committee 10-10. The tie meant that the measure failed.

All ten no votes were Republicans, including Sen. Mike Enzi (R-Wyoming), a member of the “Gang of Six” on the Finance Committee who are hashing out a bipartisan bill.

It’s a shame that the only chance of getting a “bipartisan” bill is to work with the party that voted en masse to defend insurance companies against battered wives.

I remember those days immediately following 9/11, when we were overcome by a patriotic spirit uniting every American, regardless of party, in the belief that universal healthcare is a socialist plot to kill your grandma.

I guess it makes sense that somebody who would evoke the revolutionary mantra of taxation without representation would be ignorant and self-righteous enough to co-opt everything they can get their hands on. Here’s the logo to Glenn Beck’s “9/12 Project”

Needless to say, conservatives’ Photoshop skills are about as good as their historical analysis in this case. The original (which I love) :



Of course the great flaw that undercuts most of the Revolutionary rubbish that Beck and his teabaggin’ allies casually name-drop is that the Founding Fathers were fighting a monarchy which is, for those who prefer a democracy, tyrannical. For modern conservatives, who waited mere weeks after losing a fair election to carelessly accuse Obama et. al. of a burgeoning despotism, wrapping themselves in the accomplishments of the revolutionary movement don’t make them look like the second coming of Thomas Paine, it makes them look like a bunch of friggin’ babies.

I’ve got a lot of conservative friends and family who sincerely believe that we’re in serious need of health care reform and that it’s unconscionable for the richest country in the world to let people die because they’re too poor to go to the doctor. Though I may vocally disagree with their positions, I won’t second-guess their stated motives for opposing the current plan. Indeed, I could see why a Republican would oppose Democratic health care efforts in the hopes that a more conservative plan emerges at some point in the future.

But here’s the deal : Republican politicians don’t care about heath care reform. They may talk a good game, but look at the past four decades. Ronald Reagan swept into office in 1980 and re-invigorated conservatism. He never tried to achieve universal health care. In 1994, Republicans took back the Congress promising reform in their “Contract with America”. They also never tried to ensure every American had access to quality affordable health care. In 2000, George W. Bush “won” the election and presided over six years in which Republicans had de facto control of the legislative and executive branches. Once again, solving our health care crisis wasn’t part of the agenda.

Seeing a pattern here?

Honestly, I’d rather the health care debate be about reforming a Republican health care bill that has already passed, but the last Republican President to even attempt to insure every American was Richard Nixon. No other Republican President or Congress has made a serious effort to ensure access to health care is a right afforded to everyone regardless of income.

I wish this wasn’t the case. I wish both sides could at least agree that there’s a problem requiring a solution, but the lack of interest among Republicans in Congress has made consensus impossible. At this point, conservatives should stop holding their breath hoping for something better to come along. Republicans have drawn a line in the sand between the various flavors of Democratic health care reform and no bill at all. If that is unacceptable to you, then should probably ask why the GOP hasn’t even bothered trying to protect the uninsured.

“This is the cause of my life. New hope that we will break the old gridlock and guarantee that every American – north, south, east, west, young, old – will have decent, quality health care as a fundamental right and not a privilege.”

- Ted Kennedy, exactly one year ago today

We’ve got a poorly-regulated economy that’s stuck in an endless boom-bust cycle, which means we spend a majority of our time either in an economic downturn or slowly coming out of one.

We’ve also got a political system that’s so fractured by partisan rancor that it’s impossible to get anything meaningful done in an even-numbered year due to the overwhelming pressures of midterm and presidential elections.

Something to keep in mind when you hear “sensible” Democrats like Joe Lieberman say things like “I’m afraid we’ve got to think about putting a lot of that off until the economy is out of recession.” If not now, when?

David Kurtz at TPM found this revealing bit from a Politico article on health care :

And this week, he returned to an argument Democratic strategists said shouldn’t be part of the pitch this year — trying to convince Americans they have a “moral obligation” to help people without insurance, a discredited argument from the reform effort under President Bill Clinton.

Yes, if the failure to achieve healthcare reform in 1993 taught us anything, it’s that there’s nothing wrong with letting people die because they’re too poor to go to the doctor. Thanks, Politico!