Republicans: No Party of Einsteins

A few days ago I compared the extent of Republican belief in Birther conspiracies to the overall delusional beliefs of Republicans. Charles Blow looked at this problem beginning with nonsense coming from Republicans on the health care debate and extended it to an overall view of the party:

Trapped in their vacuum of ideas, too many Republicans continue to display an astounding ability to believe utter nonsense, even when faced with facts that contradict it.

A Daily Kos/Research 2000 poll released last Friday found that 28 percent of Republicans don’t believe that Barack Obama was born in the United States and another 30 percent are still “not sure.” That’s nearly 6 out of 10 Republicans refusing to accept a basic truth. Then again, this shouldn’t surprise me. According to a Gallup poll released last summer, 6 in 10 Republicans also said they thought that humans were created, in their present form, 10,000 years ago.

Let’s face it: This is no party of Einsteins. Really, it isn’t. A Pew poll last month found that only 6 percent of scientists said that they were Republicans.

Blow also chastised Democrats for failing to do more to lead the discussion and allowing the debate to be “hijacked by hooligans.”

What If Republicans Win The Healthcare Fight?

David Frum has done something which few other conservatives have–question what it would mean if they actually won on healthcare:

What would it mean to “win” the healthcare fight?

For some, the answer is obvious: beat back the president’s proposals, defeat the House bill, stand back and wait for 1994 to repeat itself.

The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments.

We’ll have entrenched and perpetuated some of the most irrational features of a hugely costly and under-performing system, at the expense of entrepreneurs and risk-takers, exactly the people the Republican party exists to champion.

Not a good outcome.

Even worse will be the way this fight is won: basically by convincing older Americans already covered by a government health program, Medicare, that Obama’s reform plans will reduce their coverage. In other words, we’ll have sent a powerful message to the entire political system to avoid at all hazards any tinkering with Medicare except to make it more generous for the already covered.

If we win, we’ll trumpet the success as a great triumph for liberty and individualism. Really though it will be a triumph for inertia. To the extent that anybody in the conservative world still aspires to any kind of future reform and improvement of America’s ossified government, that should be a very ashy victory indeed.

I’m not sure if Frum realizes that most modern Republicans have no concept of governing. They are far better as an opposition party (greatly out performing the Democrats here) but, as we saw during the Bush years, actual governing is totally beyond them. For the Republicans the goal is simply to win political points and use this to increase how much power they have in government. This worked well for them after the collapse of HillaryCare allowed them to take control of Congress. Once in government their only real concern is attempting to maintain and expand their power without any real idea of what to do with it.

As for the consequences if the conservatives win, most likely this will mean an even bigger government program when the current system totally collapses. The longer we wait, I fear the worse the solution will be. Back in 2004 John Kerry ran with a health care plan which lacked any mandates and was very conservative compared to the plans under consideration this year. The Republicans opposed it, calling it a government takeover of health care. If they were smart they would have have taken this plan in order to prevent the plans which are being discussed this year from becoming necessary. This is also one reason why so many physicians, and so many in the insurance and pharmaceutical industries, are considering going along with this year’s plans. We realize that maintaining the status quo is not an option, and that to delay reform even longer will probably mean an even bigger government program than is now being proposed once the private insurance industry totally collapses.

A Proposal Which Perhaps Is Worse Than No Health Care Reform

I was just looking over some articles on the proposed bipartisan Senate Finance Committee health care bill. I don’t have much time now, and it might not really matter unless it looks like this bill is the one which makes it thorough the Senate, but it is worth a brief note to say that the bill is terrible. Realistically I don’t think this bill has much of a chance of passing once people see some of the problems such as how it will impact employers and how it will increase out of pocket expenses for Medicare beneficiaries.

Staying with the status quo is a poor option leading me to accept aspects of the House bill which I am not happy about, but if I had to choose I would likely vote against the Senate Finance Committee bill and gamble on a more sensible plan coming up. I have been critical in the past of some on the left who are threatening to make a litmus test of a public plan and vote against bills which might be good but not perfect,  but this bill creates too many problems while providing insufficient benefits.

Sarah Palin and Other Republicans Spread False Claims Regarding “Death Panels” and Euthanasia

After the preceding two posts on misinformation being spread by the right with regards to health care reform we have a real whopper from Sarah Palin:

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.

The creation of a “death panel” is totally untrue. Steve Benen notes the irony in Sarah Palin making up a claim such as this after all her demands that journalists “quit making things up” about her. He also quotes Karen Tumulty:

Yes, such a system would indeed be downright evil. Which is why no one is proposing anything like it. Let’s repeat: No one is proposing anything like it.

There is a lot of similar disinformation being spread by the right by distorting items which are in the proposed bills. This includes scare tactics about end-of-life counseling sessions. PolitiFact sets them straight:

According to the bill, “such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.”

Medicare will cover one session every five years, the legislation states. If a patient becomes very ill in the interim, Medicare will cover additional sessions.

Jon Keyserling, general counsel and vice president of public policy for the National Hospice and Palliative Care Organization, which supports the provision, said the bill doesn’t encourage seniors to end their lives, it just allows some important counseling for decisions that take time and consideration.

“These are very serious conversations,” he said. “It needs to be an informative conversation from the medical side and it needs to be thought about carefully by the patient and their families.”

In no way would these sessions be designed to encourage patients to end their lives, said Jim Dau, national spokeman for AARP, a group that represents people over 50 that has lobbied in support of the advanced planning provision.

McCaughey’s comments are “not just wrong, they are cruel,” said Dau. “We want to make sure people are making the right decision. If some one wants to take every life-saving measure, that’s their call. Others will decide it’s not worth going through this trauma just for themselves and their families, and that’s their decision, too.”

Both Keyserling and Dau were particularly troubled that McCaughey insisted — three times, to be exact — that the sessions would be mandatory, which they are not.

For his part, Keyserling said he and outside counsel read the language carefully to make sure that was not the case.

“Neither of us can come to the conclusion that it’s mandatory.” he said. “This new consultation is just like all in Medicare: it’s voluntary.”

“The only thing mandatory is that Medicare will have to pay for the counseling,” said Dau. has also debunked conservative claims that the proposed bill will include forced euthanasia. Here is a small portion:

The accepted definition of end-of-life planning means thinking ahead about the care you would like to receive at the end of your life – which may include the choice to reject extraordinary measures of life support, or the choice to embrace them. For instance, the National Library of Medicine describes end-of-life services as “services [that] are available to help patients and their families deal with issues surrounding death.” This can include making decisions about treatment, designating a health care proxy, choosing a hospice program and putting together a living will, all of which the bill mentions explicitly as being part of an advance care planning consultation. In a 2003 study, the Agency for Healthcare Research and Quality found that “[p]atients who talked with their families or physicians about their preferences for end-of-life care had less fear and anxiety, felt they had more ability to influence and direct their medical care, believed that their physicians had a better understanding of their wishes, and indicated a greater understanding and comfort level than they had before the discussion.”

Furthermore, the bill would not make these sessions mandatory. It modifies section 1861(s)(2) of the Social Security Act, defining what services Medicare will pay for – if these definitions made treatments mandatory, seniors would all be required to get artificial legs and midwife services, too. In other words, this section of H.R. 3200 would require Medicare to pay doctors when they counsel their patients about such things as living wills, but no more frequently than once every five years, unless there’s a significant change in health status. “Both myself and our outside counsel have reviewed section 1233 of the House bill, and neither one of us can reach the conclusion that it is a mandatory consultation for Medicare and Medicaid beneficiaries,” Jon Keyserling, vice president of public policy at the National Hospice and Palliative Care Organization, told us. “The opportunity for the consultation is not only voluntary but patient-initiated.”

“As I understand it, the intent of the provision is to have patients be provided an opportunity to discuss with their own health care professional, probably the one they have been seeing for the past many years, what their treatment wishes might be as they approach the end of life,” said Keyserling, who stressed that consultations like this are treatment-neutral. Comparing this to forced euthanasia is like saying that a bill making retirement planning easier would force Americans to quit their jobs.

I can attest to the value to patients of open discussion of end of life issues. This comes both from experience with my patients and now to an even greater degree after seeing how my father handled this situation, having decided to discontinue life support eight days ago.

Obama Speaks Out Against Misinformation On Health Care Reform

Along the lines of the previous post on fighting misinformation on health care reform, Barack Obama has devoted this week’s address (video above) to the topic. Here is a portion:

…let me explain what reform will mean for you. And let me start by dispelling the outlandish rumors that reform will promote euthanasia, cut Medicaid, or bring about a government takeover of health care. That’s simply not true. This isn’t about putting government in charge of your health insurance; it’s about putting you in charge of your health insurance. Under the reforms we seek, if you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan.

And while reform is obviously essential for the 46 million Americans who don’t have health insurance, it will also provide more stability and security to the hundreds of millions who do. Right now, we have a system that works well for the insurance industry, but that doesn’t always work well for you. What we need, and what we will have when we pass health insurance reform, are consumer protections to make sure that those who have insurance are treated fairly and that insurance companies are held accountable.

We will require insurance companies to cover routine checkups and preventive care, like mammograms, colonoscopies, or eye and foot exams for diabetics, so we can avoid chronic illnesses that cost too many lives and too much money.

We will stop insurance companies from denying coverage because of a person’s medical history. I will never forget watching my own mother, as she fought cancer in her final days, worrying about whether her insurer would claim her illness was a preexisting condition. I have met so many Americans who worry about the same thing. That’s why, under these reforms, insurance companies will no longer be able to deny coverage because of a previous illness or injury. And insurance companies will no longer be allowed to drop or water down coverage for someone who has become seriously ill. Your health insurance ought to be there for you when it counts – and reform will make sure it is.

With reform, insurance companies will also have to limit how much you can be charged for out-of-pocket expenses. And we will stop insurance companies from placing arbitrary caps on the amount of coverage you can receive in a given year or a lifetime because no one in America should go broke because of illness.

In the end, the debate about health insurance reform boils down to a choice between two approaches. The first is almost guaranteed to double health costs over the next decade, make millions more Americans uninsured, leave those with insurance vulnerable to arbitrary denials of coverage, and bankrupt state and federal governments. That’s the status quo. That’s the health care system we have right now.

So, we can either continue this approach, or we can choose another one – one that will protect people against unfair insurance practices; provide quality, affordable insurance to every American; and bring down rising costs that are swamping families, businesses, and our budgets. That’s the health care system we can bring about with reform.

There are certainly areas for disagreement with his plan but instead of engaging in honest debate the Republicans have concentrated on fighting by making outrageous claims which are simply untrue.

One portion of Obama’s argument has been open criticism because it is generally but not one hundred percent true. When Obama speaks about the ability to keep one’s own doctor or insurance he is highlighting the fact that his plan is based upon offering opportunities for those who do not have coverage or are unhappy with their current coverage. The plan will not automatically take away any one’s current coverage as some conservatives claim.

It is not a one hundred percent guarantee that nobody will wind up having to make changes. Some employers will change or drop  their current insurance in the future, but many companies are dropping coverage now. At present if a company drops coverage employees are forced to buy on the individual market, which is often difficult or impossible for those who are older or have medical problems. With this health care reform proposal, employees will have options for coverage.

It is always possible that a doctor will not participate with an individual plan. Today patients often have to change doctors because either their employer changes to a plan their doctor does not accept or because their doctor stops accepting a plan. Such situations might also continue if Obama’s plan is passed but individuals will have more options in health care coverage which will make it easier to find plans which their doctor participates in. Elimination of the more outrageous policies of health care plans will also reduce the chances that doctors will refuse to accept certain plans.