Trust in Government and Belief In Health Care Distortions

August 29, 2009 — Ron Chusid

Charles Blowattributes the widespread belief in many of the false claims about health care reform being spread by Republicans on increased distrust in government, arguing that “it stands to reason that many people probably don’t trust Washington on health care reform because, right now at least, they just don’t trust Washington.”

There is logic to distrusting Washington. While the Democrats are far from perfect here, the dishonesty coming from government increased tremendously during the Bush years. If Blow is right, Democrats are now suffering from the distrust in government which increased during the Bush years.

Blow also writes:

These fluctuations highlight a peculiar quirk of recent American politics — according to an analysis of The New York Times/CBS News polls from the past 33 years, Americans seem to trust the government substantially more after a Republican president is elected than they do after a Democratic one is elected — at least at the outset.

The comment about “at the onset” is key. Americans trusted government when Republicans were elected but often have been burned by this trust. Therefore it makes sense that they showed distrust of government at the same time as they voted in Democrats.

Blow repeats a common but erroneous stereotype in writing:

It seems curious that the same party that believes in big government doesn’t trust that government to do the right thing when Democratic leaders control it. But Democrats are a curious lot.

Republicans are actually the party of big government at least as much as the Democrats.  Despite the tremendous amount of growth in government under Republicans, they have fooled some into thinking of them as opposing big government because of their rhetoric, not their actions.

People vote for Democrats for a variety of reasons–not necessarily because of support for government programs. The differences in Democratic voters are similar to the differences among liberals which I have previously discussed. There are certainly some liberals and Democrats who tend to support big government, but there are also many liberals and those who vote Democratic because of concern over civil liberties and restoring the checks and balances on government which were eroded under the Republicans.

With health care reform, assuming can still be passed, it might come down to getting the program through first and then earning trust. Once people see that the actual plan is nothing like it is being misrepresented by Republicans their view of it will change.

Campaigns based upon such distortion have become standard operating procedure for the Republicans in recent years. The big question is whether Americans will figure this out, forcing Republicans to stop relying on such tactics.

Posted in Democrats, Health Care, Op-eds, Republicans. Tags: , , , , , , , . 2 Comments »

Huckabee Pulls a Palin

August 28, 2009 — Ron Chusid

Thursday morning, Mike Huckabee criticized Democrats for using Ted Kennedy’s memory to promote health care reform:

“Sen. Ted Kennedy’s death had barely hit the news before we started hearing calls that Congress must hurry and pass the health care reform bill and do it in his memory,” said Huckabee. “That not only defies good taste, it defies logic. We certainly can and should respect his years of advocacy and work for the things that he truly believed in. But there is no good reason to rush through a giant unread bill that would transform American health care and impact every citizen.”

Huckabee didn’t have any qualms about using Kennedy’s name to spread misinformation:

The 2008 Republican presidential candidate suggested during his radio show, “The Huckabee Report,” on Thursday that, under President Obama’s health care plan, Kennedy would have been told to “go home to take pain pills and die” during his last year of life.

“[I]t was President Obama himself who suggested that seniors who don’t have as long to live might want to consider just taking a pain pill instead of getting an expensive operation to cure them,” said Huckabee. “Yet when Sen. Kennedy was diagnosed with terminal brain cancer at 77, did he give up on life and go home to take pain pills and die? Of course not. He freely did what most of us would do. He choose an expensive operation and painful follow up treatments. He saw his work as vitally important and so he fought for every minute he could stay on this earth doing it. He would be a very fortunate man if his heroic last few months were what future generations remember him most for.”

Of course this is totally untrue. The proposed legislation prohibits discrimination based upon age and Kennedy would receive the same care regardless of his age.

George Stephanopoulos considered the political aspects of this:

One thing’s for sure: by joining the debate in this time in this way, Huckabee is showing how determined he is not to be outmaneuvered by Sarah Palin in the early 2012 bidding for the GOP’s conservative base.

In other words, to appeal to the conservative base it is necessary to invent false claims as ridiculous as those being spread by Sarah Palin.

Posted in Health Care, Mike Huckabee, Sarah Palin. Tags: , , , , . 1 Comment »

Villians and Rationing in Health Care

August 28, 2009 — Ron Chusid

With the insurance companies coming under a considerable amount of criticism, The New York Times looks at insurance company executives. A project manager for Humana says, “I’m certainly not villainous or immoral in any way.”

Maybe, or maybe not. The real issue here isn’t the individuals involved but what the insurance companies have turned into. As business executives their goal becomes to maximize profits for their company, and in the case of health insurance this has serious deleterious effects. The ways insurance companies maximize profits were discussed in many previous posts, such as here and here. The more services they can deny, the greater their profits.

A comment from another executive at Humana touches on this:

“I believe we’re getting the pushback because we are standing up for what we believe in,” said Cheryl Tidwell, 45, Humana’s director of commercial sales training. “We believe there’s a better way to control costs by controlling utilization and getting people involved in their health care.”

“Controlling utilization.” If the government was doing this, conservatives would scream about rationing. Controlling utilization to reduce payment for unnecessary services makes sense. The problem is that the insurance companies have financial incentives to find deny services whether they are needed or not. They increase their profits even more if they can find ways to drop people who develop expensive medical problems.

This strategy is effective. It the early 1990’s, 95 cents of  every dollar received in premiums went to paying claims. Now that figure is down to just over 80 cents. Whether the insurance executives who came up with these ways to increase their profits are villains or brilliant businessmen is not the issue. What is important is changing the policies which lead to denial of coverage to increase insurance company profits.

Posted in Health Care. Tags: , . 3 Comments »

Ted Kennedy on Separation of Church and State at Liberty University

August 28, 2009 — Ron Chusid

There are many news stories lately on the life of Ted Kennedy. One of the more unusual events occurred in 1983.  Kennedy received a membership card from the Moral Majority and an invitation to join the organization as part of a mass mailing. Kennedy declined the membership but did offer to speak at Liberty Baptist College (now Liberty University) and Jerry Falwell did accept this offer.  Kennedy spoke on separation of church and state. Above is a clip from his speech. The full transcript is here (leaving off the introductory remarks which do appear at in the above clip).

Posted in Democrats, Religion, Separation of Church and State. Tags: . No Comments »

Hoekstra Criticized By Former National Security Officials For Scare Tactics

August 27, 2009 — Ron Chusid

My Congressman is once again up to resorting to scare tactics. Pete Hoekstra already destroyed his credibility with discredited claims of finding WMD in Iraq. Now that he hopes to run for Governor of Michigan, he is trying to find new ways to scare people into voting for him. This time he is using fear of terrorism to attack possible plans to move prisoners from Guantanamo Bay to Standish, Michigan. The Michigan Messenger reports opposition to his claims:

A group of former national security officials and military officers who have worked on the Guantanamo Bay military tribunals have written a letter to Rep. Pete Hoekstra criticizing him for “politicizing” the debate over a possible plan to transfer Gitmo detainees to a maximum security prison in Standish, Michigan.

Here is the letter sent to Hoekstra:

As military and national security officials who have spent our entire careers fighting to protect the American people and the defend country from attack, we all agree that the prison facility at Guantanamo Bay needs to be closed-as do five former Secretaries of State, Gen. David Petraeus, Joint Chiefs of Staff Chairman Adm. Mike Mullen, and Defense Secretary Robert Gates. We also agree with you that the discussion over closing Guantanamo and moving the detainees to a new facility needs to occur, as you have said, in a “civil and rational way.” That is why we were disappointed last week-during a town hall meeting in Standish, MI, whose prison is a possible site to detain terror suspects -to hear you politicize such a critical national security issue and disseminate misrepresentations and exaggerations about closing Guantanamo and the possibility of housing terrorist suspects on American soil. In doing so, you spread fear in order to score political points, and perpetuate the Bush/Cheney era strategy of seeking political victories instead of doing what’s right to protect the country.

According to reports, you said there was “much to fear” if the detainees came to Standish. Standish tavern owner Dave Munson stated your comments “scared the heck out [him]…soft targets and safe zones, that if they came to this country they would have rights, visitors and friends would come who could be jihadists.” But you also acknowledged that the Supermax Facility in Florence, CO-which houses terrorists like Ramzi Yousef, mastermind of the first World Trade Center attack who was captured in Pakistan, Zacharias Moussaoui, convicted in connection to the attacks on 9/11, as well as the East Africa Embassy bombers-has never had a major incident or attempted jailbreak. And indeed American prison facilities-and the men and women who work there-have proven themselves extremely capable of protecting American lives while also imprisoning dangerous terrorists; even after decades, we have never had a major incident tied to the domestic imprisonment of terrorists.

The former warden of the Supermax facility said prisoners “spend up to 23 hours a day in their cells, every minute, every meal. The window in their cell is blocked so they can’t see the mountains.” Yet you stated that detainees housed in America “would have greater opportunities to command and control their networks through outsiders and to spread radical jihadist ideology.” The Supermax warden also stated that Ramzi Yousef has never left his cell. If the same-if not stricter-standards are applied to Guantanamo detainees held domestically, then how exactly would they command terrorist networks overseas?

You also said in the past that you “have no doubt that we could move these folks into a prison in Michigan. We could move them into a maximum security prison perhaps anywhere around the country. And there’s no doubt in my mind that we could probably contain them and hold them and they wouldn’t escape.” Do you still believe this to be the case?

You also stated in testimony to the Michigan Senate Judiciary Committee that “making Michigan home to the world’s most dangerous terrorists will not make it more attractive for tourists, families or potential job providers.” We ask if you can say with certainty that Colorado’s economy has been negatively affected by housing terrorists in the Florence facility-or the economies of Illinois, New York City, or North Carolina, for that matter-which have all held or detained some of the world’s most dangerous terrorists?

The bottom line is while the Administration should provide a clear plan for closing Guantanamo and transferring detainees, we should also not allow the destructive politics of fear, which tarnish America’s national security imperatives, to dictate the debate. By stirring up panic and distorting reality for political purposes, you do a disservice to the people of Michigan and the United States. Politicizing national security for partisan gain has dangerous consequences for effectively defending this country and protecting American lives.

You yourself once demanded that “partisan political games have no place when it comes to national security.” We ask you to live up to your own standards when it comes to discussing Guantanamo Bay and detainees. Whether it’s in Standish Michigan or the halls of Congress, politicizing national security is always dangerous. We ask you to return the debate to the “civil and rational” in order to stop the spreading of fear that plays into the very hands of the enemies we are trying to defeat.

Sincerely,

Lt. Col. Stephen Abraham (US Army Res. Ret.), Office for the Administrative Review of the Detention of Enemy Combatants at Guantanamo Bay, 2004-2005
Maj. Gen. Paul D. Eaton (USA, Ret.), National Security Network Senior Adviser
Lt. Gen. Robert Gard, Jr. (USA Ret.)
Vice Admiral Lee Gunn (USN, Ret.)
Lt. Gen. Donald Kerrick (USA, Ret.), Former Deputy National Security Adviser
Richard Clarke, Former head of counterterrorism at the National Security Council
Margaret Henoch, Retired Senior Officer, Central Intelligence Agency
Jonathan Winer, Former Deputy Assistant Sec. of State for International Law Enforcement
Vic Comras, Former State Department Minister Counselor
Michael Kraft, Former Senior Advisor, State Department Counterterrorism Office

Posted in Michigan News, Republicans, Terrorism. Tags: , , , , , , . 2 Comments »

Romney Not Interested in Senate Run

August 27, 2009 — Ron Chusid

After Ted Kennedy’s death there was speculation that Mitt Romney might run for his seat. The arguments were that a Senate seat might increase his chances for the 2012 presidential nomination and that the candidate would have to be able to laregely self-finance a Senate race due to the limited time available to raise money. I was not at all surprised to see that Romney is saying he is not interested.

While in theory a Senate seat might improve Romney’s credentials, the downside of running far exceeds the potential benefits. In general Republicans run for the Senate in Massachusetts not to win but to improve their name recognition. Romney is already well known and there is no benefit for him to be seen going down to defeat.

Even if he won it is questionable how much this would help  him. In the age of Obama it is not necessary to have extensive Senate experience, and in the age of Bush and Palin it is not even necessary to understand the issues to run as a Republican.

Being in the Senate could also be counterproductive for Romney as he would be forced to vote and take a stand on controversial issues. He would have to commit to positons now when I bet he would prefer to hold off on choosing his current political philosophy until he sees how the wind is blowing in 2011-2. I bet he will just continue to lay low for a while and let other Republicans take all the hits.

Posted in Congress, Mitt Romney. Tags: , . 1 Comment »

The Congressional Budget Office And Cost Savings

August 26, 2009 — Ron Chusid

Conservatives have an amazing skill for picking and choosing which facts to use to support their beliefs, and have absolutely no difficulty promoting contradictory claims if it supports their cause. Conservatives ignore the predictions of the Congressional Budget Office which show that the public plan would not be a threat to private insurance companies. They had no concern about their predictions as to the cost of the Iraq war.  They certainly don’t pay any attention to their predictions that tort reform would not significantly reduce health care costs. On the other hand they promote the report which says that savings will not fund health care reform.

Besides the contradiction of picking and choosing which CBO reports to pay attention to, conservatives fail to realize that one reason the CBO minimizes savings is that the bill does not give the government all that much power to lower costs. In other words, endorsing the CBO report contradicts conservative claims that the proposed health care reform would amount to a government take over of health care or socialized medicine. Conservatives oppose those measures which would lead to greater savings.

The other problem with the report is that the methodology used by the CBO under-estimates savings because they can only include savings which clearly can be measured and coded. Jon R. Gabel, a senior fellow at the National Opinion Research Center of the University of Chicago,  has reviewed the track record of the CBO and has showed that their methodology routinely underestimates savings. After giving some examples he concludes:

The Congressional Budget Office’s consistent forecasting errors arose not from any partisan bias, but from its methods of projection. In analyzing initiatives meant to save money, it helps to be able to refer to similar initiatives in the past that saved money. When there aren’t enough good historical examples to go by, the estimated savings based on past experience is essentially considered to be unknown. Too often, “unknown” becomes zero — even though zero is not a logical estimate.

The budget office has particular difficulty estimating savings when it considers more than one change at once. For example, last December the office reported that it found no consistent evidence that changes in medical malpractice laws would have a measurable effect on health care spending. It also reported that increased spending on studies comparing the effectiveness of different drugs and medical treatments would yield no net savings for 10 years. Yet if both malpractice reform and comparative effectiveness studies were instituted simultaneously, they might work together to yield substantial savings; doctors would gain more confidence in the effectiveness of less aggressive treatments and, at the same time, could use those treatments with less to fear from lawsuits.

The budget office’s cautious methods may have unintended consequences in the current health care reform effort. By underestimating the savings that can come from improved Medicare payment procedures and other cost-control initiatives, the budget office leads Congress to think that politically unpopular cost-cutting initiatives will have, at best, only modest effects. This, in turn, forces Congress to believe it can pay for reform only by raising taxes, which then makes reform legislation more difficult to pass.

The most likely reality is somewhere between the CBO report and the overly optimistic claims of the Obama administration. The CBO’s methodology has prevented them from considering health care savings from the proposed legislation–just as their methodology prevents them from recognizing savings which might come from tort reform–as there is no way to accurately measure the savings at this time. The proposed measures will ultimately save money, but it will also be necessary to spend more at first for measures like expanding preventive care and promoting computerization of medical records. Health care reform will probably save money, but I do not believe the savings will pay for the proposed measures.

Posted in Congress, Health Care, Op-eds. Tags: , , , , , , . 10 Comments »

American Diabetes Association Backs Health Care Reform

August 26, 2009 — Ron Chusid

The American Diabetes Association has put out a fact sheet on why health care reform benefits those with diabetes and they debunk many of the false conservative claims:

Separating Myth from Fact: The Truth about Diabetes and Health Care Reform

The American Diabetes Association recognizes there is a lot of information and opinions on health care reform. There are also a number of myths that need to be addressed and understood so that everyone can move on to the most important issue of expanding access to quality, affordable health care for people with diabetes. Some of the top myths are discussed below.

MYTH: Health care reform will lead to negative changes in diabetes coverage and care.

FACT: Health care reform will protect people with diabetes by requiring all health insurance companies to accept all applicants for health coverage regardless of pre-existing conditions. Under health care reform, if you are happy with your current health care team and wish to keep your health insurance plan, you can do so. Otherwise, you can purchase health insurance in the individual market without fear of being denied coverage due to your diabetes.

MYTH: Health care reform aims to ration access to health care, including diabetes services and supplies and care for Medicare seniors.

FACT: Health care reform will not lead to rationing access to health care including diabetes services and supplies. Currently the U.S. spends the largest amount (and highest percentage of GDP) on health care in the world, yet we have some of the worst health outcomes. Health care reform does not aim to cut health care costs by rationing care, rather health care reform focuses on ensuring that the money we do spend on health care goes to high quality and appropriate care. Health care reform attempts to redirect spending to high quality care and reducing unnecessary, poor quality expensive sick care.

Health care reform will protect Medicare patients’ access to their health care providers and reduce the costs of preventive care to help seniors live healthy lives. Health care reform will not cut Medicare benefits, reduce access to Medicare services or give the government the power to make treatment decisions for anyone regardless of age.

MYTH: Health care reform will lead to government-run health care and enable the government to decide which treatments people with diabetes receive.

FACT: Under health care reform, neither the government nor a government committee will be responsible for determining which health care treatments people receive from their health care providers. Decisions on how to treat and manage one’s diabetes will still be made by the person with diabetes and his/her health care providers. Under health care reform, the government will work to ensure that information about the quality and effectiveness of treatment and care options are readily available and properly disseminated to health care providers and patients.

MYTH: Health care reform will make health insurance more expensive, especially for people with diabetes.

FACT: By prohibiting the current health insurance practice of charging higher premiums to people with diabetes and other health conditions, health care reform will actually help make health insurance more affordable for people with diabetes. Health insurers will no longer be able to charge individuals higher premiums based on health status, race or gender; nor would be they be able to target people with illnesses or their employers for premium increases based on health status. Health care reform will also limit annual out-of-pocket costs for covered benefits, with currently proposed limits of to $5,000 for an individual and $10,000 for a family.

MYTH: Health care reform won’t benefit people like me who already have health insurance.

FACT: Health care reform will reduce swelling health care costs for all Americans, improve the quality of care all patients particularly people with diabetes receive by rewarding better care, prohibit insurance companies from denying coverage based on pre-existing conditions, limit the out-of-pocket spending on health care for individuals and families so that they do not go bankrupt trying to pay for necessary medical care, and provide consumers with more choice in health insurance coverage.

Posted in Health Care. Tags: , , . 4 Comments »

Ted Kennedy Dies at 77

August 26, 2009 — Ron Chusid

Kennedy

Ted Kennedy has died at age 77, over a year after being diagnosed with malignant cancer of the brain. Kennedy was first elected to the Senate in 1962 at the age of 30–a year before the assassination of his brother. During a Senate career of that length Kennedy has played a part in many issues of the past few decades but he is probably most associated with health care reform.

Kennedy’s endorsement of Barack Obama contributed to Obama’s victory over Hillary Clinton when Clinton was seen as the candidate of the Democratic establishment. This was seen as a symbolic passing of the torch from his brother to Obama. Now it is up to Obama to make the affordable health care which Kennedy had fought for available to all Americans.

Posted in Breaking News, Democrats, Health Care. Tags: , , , . 12 Comments »

The Best Health Care In The World?

August 26, 2009 — Ron Chusid

Conservatives often oppose health care reform by claiming that the United States has the best health care in the world and that changing the system would reduce the quality. This argument has two major problems. First of all, if anything provisions being advocated would improve upon and not reduce the quality of care here. More importantly, the entire premise is wrong. The United States ranks first only if you start reading at the bottom up by many measures.

While the United States does provide excellent care for those with good coverage (such as those in the government financed Medicare program), overall the US does not rank very well due to lack of access to adequate care for tens of millions of people. The Robert Wood Johnson Foundation has posted a study of how the United States compares to other countries. From their introduction:

An analysis from the Urban Institute looks at the evidence on how quality of care in the United States compares to that in other countries and provides implications for health reform. Authors Elizabeth Docteur and Robert Berenson find that international studies of health care quality do not in and of themselves provide a definitive answer to this question.

What they do show is that the evidence for American superiority in quality of care (or lack thereof) is a mixed bag, with the nation doing relatively well in some areas—such as cancer care—and less well in others—such as mortality from treatable and preventable conditions.

And while evidence base is incomplete and suffers from other limitations, it does not provide support for the oft-repeated claim that the “U.S. health care is the best in the world.” In fact, there is no hard evidence that identifies particular areas in which U.S. health care quality is truly exceptional.

Addressing the American public’s widespread concern about the potential negative impact of health reform on the quality of care they currently receive, the authors conclude that reform should in fact be seen as an opportunity to systematically improve quality of care, rather than a threat to the existing system. It provides an opportunity to build on strengths and correct weaknesses in U.S. health care, working towards aims for improvement that the care provided is safe, effective, patient centered, timely, efficient and equitable.

Many rankings of health care systems place the United States even below several third world countries but such rankings can be misleading. Many factors impact mortality rates beyond the quality of the health care system. Because of these problems, researchers at the London School of Hygiene and Tropical Medicine looked more specifically at preventable deaths in nineteen industrialized countries. The United States came in last at number nineteen. France, which commonly heads rankings of health care, came in first.

If the United States matched the quality of the top three countries, there would be 101,000 less deaths per year. It is hard to argue that we shouldn’t change our health care system based upon such numbers.

Posted in Health Care. Tags: , , , . 8 Comments »
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