Gates Calls For Timetable For Withdrawal From Iraq

Few believed that the surge was anything more than a tactic to stall and avoid taking the blame for what will ultimately happen in Iraq. Democrats have taken the iniative to attempt to put an end to the war, while Bush continues to insist upon staying the course, regardless of how poorly his strategy is going. Democrats have been pushing for benchmarks and a timetable to leave, and Bush will not consider these ideas. Perhaps Bush should speak with his Secretary of Defense:

President Bush has mobilized his administration, including his top general in Iraq, in a major push to win more time and money for his war strategy. But one crucial voice has been missing from the chorus: Defense Secretary Robert M. Gates’.

In fact, Gates’ recent comments seem to run counter to the message from the White House. During a recent trip to the Middle East, Gates told the Iraqi government that time was running out and praised Democratic efforts in the U.S. Congress to set a timetable for withdrawal, saying it would help prod the Iraqis. He reiterated that point during a meeting with reporters last week.

A spokesman for Gates insisted there was no distance between the Defense secretary’s thinking on the timetable for Iraq and views held by the White House or Army Gen. David H. Petraeus, commander of U.S. troops in Iraq.

But his warnings to Iraqi Prime Minister Nouri Maliki are just the latest indications from Gates that he believes the window of opportunity for the administration to get Iraq right is closing sooner rather than later…

Gates was a member of the bipartisan Iraq Study Group, which recommended in its report last year that most combat troops withdraw by early 2008. Gates did not sign the report; he has said that formal deliberations did not start until after he left for the Pentagon. But several people who worked on the report said Gates was closely involved in early drafts and would have supported its eventual conclusions.

“Knowing how that group got along and how we shared our views, there remains no question in my mind that Bob Gates, had he not become secretary of Defense, would have supported those recommendations,” said Leon E. Panetta, a former Clinton White House chief of staff and a member of the Iraq panel.

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More Dead Than Republicans Predicted–No More Room on Memorial

Here’s one more sign of how far off the Republicans were on their pre-war predictions. They’ve run out of room to post the names of the dead on a memorial  in Washington, DC:

Congress already has run out of space on a memorial created last year to honor all of the U.S. service members killed in Iraq and Afghanistan.

In a grim sign of the times, the “Wall of the Fallen,” set up by House Republican leaders in June, is almost full. The mounting death toll from Iraq has forced U.S. House staffers to study how to reconfigure the display in the lobby of the Rayburn Building – the largest office building for members of Congress – to squeeze in more names.

According to the Defense Department, 3,736 U.S. service members died in the two wars by the end of April. New names are added to the display every few months, but none have been added since November. The last name listed is Lance Cpl. Luke Holler, 21-year-old Marine reservist from Bulverde, Texas, killed by an explosive device on Nov. 2.

In the current format, there is space for about 130 more names, but 506 Americans have died since mid-November. In April, 104 Americans were killed in the war’s sixth-deadliest month.

Insurance Problems Faced By Small Business

The New York Times gives an example of the difficulties faced by small business in providing insurance for employees:

To understand the challenges of insuring the health of the nation’s work force, consider Varney’s Book Store.

After a long bout with emphysema an employee at Varney’s, a family-owned business in Manhattan, Kan., died several years ago. But for Varney’s health insurer, her legacy lived on.

The next year, 2002, the insurer raised Varney’s premiums by 28 percent — even though most of the other three dozen employees were significantly younger and healthier than their departed colleague, who had been in her mid-70’s. And Varney’s premiums continued to climb.

“It was as if her medical history stayed on the books for an additional three years,” said Jeff Levin, 46, who runs Varney’s with his younger brother. “How can you justify projecting those costs forward?”

Such are the challenges for smaller businesses in Kansas and the many other states where laws permit insurers to raise health premiums substantially for small employers when one worker incurs significant medical bills.

Many governors see this as a problem, and one solution being promoted is government reinsurance of catastrophic cases, a part of John Kerry’s health care proposal in 2004:

“Almost any kind of situation where one employee has a serious health condition almost makes the group uninsurable, because of cost,” said the governor of Kansas, Kathleen Sebelius, a member of a group studying health care issues for the National Governors Association. “Affordable coverage for small-business owners and self-employed individuals is probably the biggest challenge that we have in Kansas and most states.”

Ms. Sebelius, a Democrat, is currently at work on a bipartisan proposal with the state’s Republican insurance commissioner that would insulate small groups by having the state provide backup insurance for the most expensive medical cases.

“If the insurer was guaranteed never to have to pay out over $100,000, for example, it could be a much more stable situation,” she said.

Patients Conned Into Inferior, But More Expensive, Coverage In Bush’s Medicare Program

I’ve frequently written about one of the consequences of George Bush’s Medicare changes which gets less attention than the prescription plan. The same act provided for additional payments to private insurance companies to cover Medicare patients under Medicare Advantage plans. The New York Times questions these plans. I’ve found that patients often wind up in these plans without understanding what they signed, and this problem is also noted in this report:

Insurance companies have used improper hard-sell tactics to persuade Medicare recipients to sign up for private health plans that cost the government far more than the traditional Medicare program, federal and state officials and consumer advocates say.

Insurance agents, spurred in some cases by incentives like trips to Las Vegas, have aggressively marketed the private plans, known as Medicare Advantage plans. Enrollment in them has skyrocketed in the last year, and Medicare officials foresee continued rapid growth in the next decade.

Many patients wind up with poorer coverage than they had under Medicare, with increased out of pocket expenses. I had one patient complain to the person who sold him the insurance policy that his copays are higher. He was told that this shouldn’t matter as his doctor didn’t have to charge him the copay. While exceptions can be made for financial hardship. routinely failing to collect Medicare copays is in violation of Medicare rules.

Besides costing patients more, these plans also cost the government more, even though Medicare Advantage typically cherry pick the healthiest Medicare patients in order to maximize their profits:

Moreover, those plans may be more expensive than traditional Medicare for some patients, because the co-payments for some services may be higher. The Medicare Payment Advisory Commission says that the cost to the government is also higher because it pays the private fee-for-service plans, on average, 19 percent more than the cost of traditional Medicare.

Richard S. Foster, chief actuary for the Medicare program, said “the additional payments to Medicare Advantage plans, above and beyond the costs” of traditional Medicare, were causing higher premiums for all beneficiaries and speeding the depletion of the Hospital Insurance Trust Fund for Medicare.

There can be additional problems if a patient requires nursing home care:

Private plans generally provide all the services of traditional Medicare, and many offer extra benefits, but the co-payments may be different. Thus, Mr. Slabach said, under traditional Medicare, a beneficiary does not have any co-payment for the first 20 days in a skilled nursing home, but some private fee-for-service plans charge $100 a day, and that charge comes as a shock to some patients.

I have one patient who is having increased problems since he lost his Medicaid when he got signed up for a Medicare Advantage plan. He’s now in a sort of limbo, unable to get into the nursing home he desires which is closer to his family due to being in a Medicare Advantage plan, but would not have had these problems if he remained in traditional Medicare and Medicaid.

Doctor Who: The Lazarus Experiment

Despite my initial error in SciFi Friday, this week’s episode of Doctor Who, The Lazarus Experiment, aired as scheduled (with next week’s episode to be postponed one week). We got to see Martha’s sister and mother, as well as seeing The Doctor and Martha dressed for a black tie reception. The story itself was only average, but it was also part of what is presumably a continuing story line for the season as we saw Mr. Saxon, who many suspect will turn out to be The Master. It is ironic that Lazarus worked hard to achieve what two of those present could already do, assuming that Saxon, as well as The Doctor, is a Timelord with the ability to regenerate.

Republican Children and the Fertility Gap

Last year there were stories on the fertility gap, warning that conservatives would outnumber liberals in the future since conservatives typically have more children than liberals. Despite the data supporting this data, I had little fear, feeling confident that humanity would move forward as historically “the overall trend has been for liberty to win out over tyranny and reason to be victorious over superstition.”

While not intended as commentary on the fertility gap, an article in Newsweek provides grounds for hope. The children of prominent Republicans are leaving the party and considering voting Democratic. That really isn’t surprising considering that today’s Republican party is far to the right of the party of their parents. While I could detail the ideological differences, the real difference, as The Moderate Voice points out, is that the party has abandoned principle for “a kind of new Republicanism where loyalty to the party’s leader (and adjusting and if necessary discarding previous beliefs as he adjusts them and a group of loyal talk show hosts help keep the troops intellectually in line) and to gaining and retaining power is the key goal.”

Seeing the children of Republican leaders abandon the party is just one of many stories about Republicans who do not support the far right beliefs and authoritarian tendencies of the current Republican leadership. Just recently there have been similar stories about New Hampshire residents and Lee Iacocca. I’m sure we’ll see similar stories about many other groups as Republican support increasingly becomes limited to the south and handfuls of fanatics elsewhere.