Democracy and Protests Against Health Care Reform

I’ve had numerous posts regarding the distortions being spread by those protesting health care reform. Opposing such spread of misinformation, and disagreeing on principles, should not translate into opposition to protests and questioning of government in principle. Ezra Klein writes that It Is Democracy, Not Health Reform, That Is Sick. He concludes:

What we’re seeing here is not merely distrust in the House health-care reform bill. It’s distrust in the political system. A healthy relationship does not require an explicit detailing of the “institutional checks” that will prevent one partner from beating or killing the other. In a healthy relationship, such madness is simply unthinkable. If it was not unthinkable, then no number of institutional checks could repair that relationship. Similarly, the relationship between the protesters and the government is not healthy. The protesters believe the government capable of madness. There is no evidence for that claim, which means that there is no answer for it, either. That claim is not about what is in this bill, or what government has done in Medicare and Medicaid and the VA. It is about what a certain slice of Americans think their government — and by extension, their fellow citizens — capable of.

The protesters are wrong in their facts on this case but a certain amount of distrust of the political system is a prudent thing. The founding fathers even advised this. Ezra doesn’t believe the government is capable of madness. Has he forgotten Vietnam, Watergate, Iraq, and the entire Bush years? Remember when we argued that protest was patriotic?

I also disagree with Ezra’s lack of respect for the importance of “institutional checks.” The breakdown of such checks is responsible for many of the horrors of the Bush years. In reforming health care, as in most government action, the devil is in the details and it is important that we institute the right institutional checks.

Ezra ends with mention of Medicare, Medicaid, and the VA. Government has been successful in one out of three here. Medicare does an excellent job of providing coverage for the elderly and the disabled and, with some tweaks, would be an excellent model for a public plan. Medicaid, due to limited funding to care for the poor, is a total disaster and ideally I would like to see it abolished with Medicaid patients instead transferred to the public plan if it survives. I have also discussed in previous posts how those outside of the medical profession such as Klein are misled by faulty data to believe the VA system is far better than it really is. While some liberal bloggers might be mislead by faulty data on the VA, many of those who have experienced its flaws first hand have legitimate reason to question those who promote this as a desirable system. Fortunately  a totally government run program such as the VA isn’t on the table.

There is a lot of misinformation being spread by the right, but there are also legitimate questions about health care reform. Questions about what types of “institutional checks” will prevent “madness” on the part of government is not unreasonable. Of course the protesters should also keep in mind that, while no government program will be perfect, there is also a lot of madness in our current system.

How The Current Health Insurance System Leaves Millions Behind

Opponents of health care reform are trying to distract discussion of the real issues with distortions of the facts and protests at town halls claiming that this is a government takeover of health care, “socialized medicine,” or would lead to euthanasia. When hearing all the invented horror stories from the right it is easy to lose track of the real horror stories which occur in our current health care system. While conservatives tell scare stories of rationing, we must remember how often those who either have insurance or are attempting to purchase insurance are denied health care. has put out a paper on Coverage Denied: How The Current Health Insurance System Leaves Millions Behind. Here is a portion:

“Pre-Existing Conditions” Affect Millions of Americans

A large proportion of Americans have health conditions that insurance companies can qualify as “pre-existing conditions.”

A pre-existing condition is a medical condition that existed before someone applies for or enrolls in a new health insurance policy. It can be something as prevalent as heart disease – which affects one in three adults1 – or something as life-changing as cancer, which affects 11 million Americans.2

But a pre-existing condition does not have to be a serious disease like cancer or heart disease. Even relatively minor conditions like hay fever, asthma, or previous sports injuries can trigger high premiums or denials of coverage.3

Unattainable Health Coverage

Insurance discrimination based on pre-existing conditions makes adequate health insurance unavailable to millions of Americans.

In 45 states across the country, insurance companies can discriminate against people based on their pre-existing conditions when they try to purchase health insurance directly from insurance companies in the individual insurance market.4 Insurers can deny them coverage, charge higher premiums, and/or refuse to cover that particular medical condition.

A recent national survey estimated that 12.6 million non-elderly adults5 – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years.6

In another survey, one in 10 people with cancer said they could not obtain health coverage, and six percent said they lost their coverage, because of being diagnosed with the disease.7

It is still legal in nine states for insurers to reject applicants who are survivors of domestic violence, citing the history of domestic violence as a pre-existing condition.8

Even when offering coverage, insurers can exclude whole categories of illnesses related to a pre-existing condition. For example, someone with a pre-existing condition of hay fever could have any respiratory system disease – such as bronchitis or pneumonia – excluded from coverage.9

Losing Coverage When You Need It Most

Thousands of Americans also lose health insurance each year through a practice called rescission.

When a person is diagnosed with an expensive condition such as cancer, some insurance companies review his/her initial health status questionnaire. In most states’ individual insurance market, insurance companies can retroactively cancel the entire policy if any condition was missed – even if the medical condition is unrelated, and even if the person was not aware of the condition at the time. Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition.10

A recent Congressional investigation into this practice found nearly 20,000 rescissions from three large insurers over five years, saving them $300 million in medical claims11 – $300 million that instead had to come out of the pockets of people who thought they were insured, or became bad debt for health care providers.

At least one insurance company has been found to evaluate employee performance based in part on the amount of money an employee saved the company through rescissions.12 Simply put, these insurance company employees are encouraged to revoke sick people’s health coverage.

Mike Madden has some examples of people who have been left behind by the current health insurance system at Salon. Here is just the first of their horror stories:

In June 2008, Robin Beaton, a retired nurse from Waxahachie, Texas, found out she had breast cancer and needed a double mastectomy. Two days before her surgery, her insurance company, Blue Cross, flagged her chart and told the hospital they wouldn’t allow the procedure to go forward until they finished an examination of five years of her medical history — which could take three months. It turned out that a month before the cancer diagnosis, Beaton had gone to a dermatologist for acne treatment, and Blue Cross incorrectly interpreted a word on her chart to mean that the acne was precancerous.

Not long into the investigation, the insurer canceled her policy. Beaton, they said, had listed her weight incorrectly when she bought it, and had also failed to disclose that she’d once taken medicine for a heart condition — which she hadn’t been taking at the time she filled out the application. By October, thanks to an intervention from her member of Congress, Blue Cross reinstated Beaton’s insurance coverage. But the tumor she had removed had grown 2 centimeters in the meantime, and she had to have her lymph nodes removed as well as her breasts amputated because of the delay.

Further Fact Checking of False Conservative Claims on End of Life Decisions

For the conservative misinformation campaign turns out to be counterproductive, as discussed in the previous post, it is necessary for the actual facts to get out. Fortunately there has been a lot of debunking of the right wing misinformation in the media. I gave previous examples of fact checking here and here, with more appearing.

It is no surprise to see Keith Olbermann debunk the right wing misinformation but it is more helpful when the mainstream news broadcasts also present the truth.  ABC News has addressed the claims about euthanasia (video available here):

“Right now it seems there is an intentional effort to distort what’s in the legislation and that’s confusing the public debate,” AARP executive vice president of policy John Rother said.

At issue is a 10-page section of a 1,000-page House health care reform bill on “advanced care planning consultations.”

These consultations would reimburse a doctor for talking with a patient once every five years about what kind of care they want near the end of life.

Sarah Palin, the former governor of Alaska, called this “downright evil,” and asserted the elderly would have to stand in front of a “death panel so [President Obama’s] bureaucrats can decide … whether they are worthy of health care.”

So what are the facts?

The provision would create no such panel. It calls only for a “consultation between the individual and a practitioner.”

The story discussed how the misinformation began and then looked at the facts:

In fact, the intent of the measure is not for doctors to tell patients what to do, but to give doctors more incentives to talk to patients about all of their options.

Opponents of the House bill argue that any focus on cost-cutting will push people toward decisions to limit care.

“There should never be any doubt as to whether your end-of-life decisions are influenced by its affect on the United States Treasury,” said Rep. Thaddeus McCotter, R-Mich.

But proponents of this measure — and there are Republicans among them — say that’s a false argument because these are patient-driven consultations. They would be available to anyone but not mandatory, and patients would dictate what they want done, not the cost of the procedures.

Two dozen physicians were interviewed by ABC News’ medical unit, and each said these kinds of consultations help families and they are happening already. This provision, they say, would only make them more widespread.

Is Conservative Strategy on Health Care Counterproductive?

At this point it is possible that the current health care reform legislation might pass or be defeated. There are a number of articles around, both from opponents of reform and some pessimistic supporters, already writing reasons as to why Obama was unsuccessful. The coverage of Obama’s strategy will change dramatically should he be successful in passing health care reform when so many before him have failed.

Should those predicting defeat for health reform turn out to be wrong ,  Mark Ambinder provides an argument as to why the GOP strategy with the town halls is counterproductive:

They ramped up much too quickly. When smaller, conservative groups Astroturfed, they inevitably brought to the meetings the type of Republican activist who was itching for a fight and who would use the format to vent frustrations at President Obama himself. There were plenty of activists who really wanted to know about health care, and some who were probably misinformed — scared out of their chairs — to some degree, but the loudest voices tended to be the craziest, the most extreme, the least sensible, and the most easy to mock.

The American people remain anxious and confused about health care reform. That is an underlying reality that Republican activists are so eager to exploit. But doing so required a certain restraint — and a willingness to traffic in at least approximate truths — and an ability to make distinctions within their own ranks about which tactics were valid and which tactics were venomous…
Remember, the target audience for Republicans is Blue Dog Democrats in Congress. They won’t panic unless they perceive organic anxiety.  The White House’s goal was to prevent the Blue Dogs from panicking. The swing constituents in these congressional districts aren’t angry Republicans, and the Blue Dogs know this.  They’re political independents for whom the sanctity of the process is important. These are the type of voters who like President Obama because he appears willing to bring people together even though they don’t agree with their policies…
Unrestrained, these town hall meetings are going to turn off the type of voters Republicans most need to pressure Blue Dog Democrats — independents who don’t have red genes or blue genes.  Both Fox and MSNBC televised Sen. Arlen Specter’s raucous town hall meeting live. It was full of confrontation and protest. There were boos when Specter reaffirmed his president’s Americanness.
He has a good point. We see the right wing reinforcing their own talking points but conservative Democratic Congressmen know the difference between those on the far right who will not vote for them and moderates. The question is whether the conservatives strategy is failing as Ambinder says. My fear is that a portion of the misinformation they are spreading is fooling even moderates who repeatedly hear the false claims coming from the right.

230 MPG Electric-Drive Car Announced by GM

If General Motors is to recover from the stigma of bankruptcy and government majority ownership they are going to have to impress consumers with something significant. The Detroit Free Press reports on a new car which might help GM in its recovery. General Motors has announced the Chevrolet Volt, an electric-drive car which they clam gets 230 miles per gallon in the city.

The m.p.g. estimates are calculated under the U.S. Environmental Protection Agency’s draft procedure for plug-in electric vehicles. Henderson added that GM believes it will also get triple digit m.p.g. for a combination of city and highway driving. He didn’t give a highway m.p.g.

“From the data we’ve seen, most drivers could operate purely on grid electricity in a Chevy Volt,” Henderson said in a statement. “A car that gets more than 100 miles per gallon is a significant step in the reinvention of the auto industry and GM is and will continue to be a leader in that reinvention.”

Mileage ratings are tricky to calculate with the Volt. In theory, some drivers would burn no gas for extended periods of time.

It is an electric-drive vehicle, not a hybrid. GM has said it wants the Volt to have a 40-mile range on an electrical charge alone.

The car will have an on-board generator to recharge the batteries after 40 miles, and the generator will be powered by gasoline.

Update: More from The New York Times

Levi Johnston Cites Marital Problems As Reason For Palin Resignation

In the latest installment in the Palin Place soap opera, Levi Johnston has told Radar Online that he believes that martial problems were behind Palin’s resignation but he does not believe that having affairs was a factor as was recently rumored:

Sarah Palin’s marriage has been in trouble from the beginning, says Levi Johnston, the father of their grandson Tripp and ex-fiance of daughter Bristol.

What’s more Levi told in an exclusive video interview that he believes marital problems were behind Palin’s decision to resign as governor of Alaska.

When we asked if the couple had marital problems, Levi responded: “Oh yeah. There have been from day one.” then asked if Levi thought marital problems were the reason she stepped down from political office. Levi answered, “Oh yeah I do.”

He didn’t stop there. He also told that he thinks Palin will be chasing an even bigger paycheck now that she’s out of public office and on the speaker circuit.  “She took the money,” he said. “That’s what she’s talked about, that’s what I’m gathering and I think that’s what she’s doing.”

He did add that he did not believe cheating was a factor in Sarah and Todd’s marriage.

Quote of the Day

“I personally have not seen any results for the DNA test, but I can tell you 100 percent John Edwards is the father of my sister’s child.”–Roxanne Druck (the sister of Edwards’ mistress Rielle Hunter, on Entertainment Tonight)

Bonus Quote:

“They definitely communicate. They have a daughter. They definitely communicate.”