American Osteopathic Association Endorses Health Care Reform Legislation

The AOA has joined the AMA in endorsing the health care reform legislation along with making recommendations for changes. The recommendations include eliminating the flawed physician payment formula and significantly modifying or abolishing the Independent Payment Advisory Board.

Following is the text of the item in today’s AOA Daily Report which includes their letter to President Obama, Speaker Pelosi, and Majority Leader Reid:

The full AOA Board of Trustees convened today to finalize the AOA’s official position on health system reform legislation as Congress nears a final vote after a year-long debate.  The Board examined how the bill aligns with AOA policies established by the AOA House of Delegates over the last 30 years and developed a letter to President Obama, Speaker of the House Nancy Pelosi, and Senate Majority Leader Harry Reid delineating our unanimous support of advancing the legislative process as well as our strong recommendations on how to ensure access to care, promote primary care, provide for fair physician payment, and reduce overall health care costs, especially by enacting federal PLI reform.  Read a copy of the letter here.

Earlier I posted a copy of a statement faxed and emailed to physicians in support of the legislation by the American Medical Association along with links to letters sent by the AMA with their suggestions for improvements in the legislation.

AMA Supports Passage Of Health Care Reform With Recommendations For Improvements

The American Medical Association which previously endorsed passage of the House and Senate health care reform bills has sent out a fax to physicians supporting passage of the revised bill to be voted upon this Sunday. The fax states that “We worked hard and made significant progress toward resolving” problems with the original Senate bill. They also state there are issues “that cannot be addressed through the current reconciliation process and will need to be address by Congress and the administration.”

The AMA calls for changes including repealing the Medicare sustainable growth rate formula, making changes in the Independent Payment Advisory Board, the cost-quality value index, rules for data release, and enactment of effective medical liability reforms.

While they consider this bill “an imperfect product” and see problems in the bill which I agree with, the  AMA concludes that this bill “does, in fact, improve the ability of patients and their physicians to achieve better health outcomes.”

Update: The American Medical Association has also released a press release supporting the bill and a letter to Nancy Pelosi outlining their view. A more detailed explanation of these points was included in this  letter to Harry Reid and Nancy Pelosi in January.

Update 2: The fax has also been sent by email making it easier to post on line. The text is under the fold.

Update 3: The American Osteopathic Association supports health care reform legislation.


Conservative News Network Hires Yet Another Conservative

While CNN began with a reputation for being a liberal network, it has increasingly become the Conservative News Network since being sold by Ted Turner. While certainly not as far right as Fox, and preserving some degree of journalistic integrity, CNN has hired far more Republicans than others in the past several years. There is yet another addition–Erick Erickson of Red State.

Steve Benen finds this pick to be far worse than all the other conservatives which CNN has hired in recent years:

This is easily the worst decision CNN has ever made. That the network probably reviewed Erickson’s work before hiring him, and offered him a job anyway, suggests CNN’s professional standards for what constitutes “an important voice” have all but disappeared.

The point here isn’t that it’s disappointing to see CNN hire yet another conservative voice, adding to its already-large stable of conservative voices. To be sure, it’s frustrating, but it’s nothing new.

The problem here is with Erickson himself.

For example, it wasn’t long ago when Erickson explained his belief on why the left has a stronger online presence than the right. He attributed it to an asymmetry in free time, since conservatives “have families because we don’t abort our kids, and we have jobs because we believe in capitalism.”

This is the same Erickson who recently called retiring Supreme Court Justice David Souter a “goat f–king child molester,” referred to two sitting U.S. senators as “healthcare suicide bombers,” praised protesters for “tell[ing] Nancy Pelosi and the Congress to send Obama to a death panel” (he later backpedaled on that one), and described President Obama’s Nobel Prize as “an affirmative action quota.”

And perhaps my personal favorite was the time, just last year, when Erickson was angry about new environmental regulations relating to dishwasher detergent. He told his readers, “At what point do the people tell the politicians to go to hell? At what point do they get off the couch, march down to their state legislator’s house, pull him outside, and beat him to a bloody pulp for being an idiot?”

There was a point when major professional outlets would look at a voice like this as an “extremist,” to be shut out of the mainstream of America’s civil discourse. CNN, however, considers this record of radical rhetoric, and concludes it should pay him to offer on-air political commentary.

CNN will no doubt hear about blog posts like this one, and assume that liberals are angry because the network hired a right-wing blogger. But that’s not it — there are thoughtful, intelligent conservative bloggers in the country, who occasionally have insightful things to say. The problem here is that Erick Erickson isn’t one of them.

GOP Fundraising Documents Cost Them A Donor

The recent accidental release of a presentation for donors prepared by the Republican National Committee continues to create embarrassment. The presentation shows how the GOP, lacking any real policies, tries to fool donors with appeals based upon fear. Ben Smith reports on one former donor who has decided not to contribute to the party:

A prominent Evangelical figure and Republican donor says he will end his contributions to the organized Republican Party in reaction to the leaked fundraising presentation that advised using “fear” to solicit contributions and displayed an image of President Obama as the Joker from Batman.

Mark DeMoss, who heads a major Christian public relations firm in Atlanta and served as a liaison to the Evangelical community for Mitt Romney in 2008, wrote Chairman Michael Steele yesterday that he was “ashamed” of the presentation, calling depictions of Obama, Speaker Nancy Pelosi, and Majority Leader Harry Reid “shameful, immature and uncivil, at best.”

“I’m afraid the presentation is representative of a culture and mindset within the Republican National Committee,” DeMoss, a past member of the RNC’s “Eagle” program for top donors who gave the party $15,000 in 2008, wrote in the letter to Steele, which he shared with POLITICO. “Consequently, I will no longer contribute to any fundraising entity of our Party—but will contribute only to individual candidates I choose to support.”

Personally I think people should have become wise to the minset of the Republican National Committee when they sent out fund raising letters in 2004 trying to scare people by saying John Kerry would take away their bibles. Better late than never. The full text of the letter is under the fold:


Republican Documents Show Plan For Fund Raising Based Upon Appealing To Fear

The Republican Party is doing better at present than most would have expected last year but they still have the same fundamental problem: they are wrong on all the issues. Their arguments continue to be based by making multiple claims which are counter to fact. That’s the hand they have, and they are going all out with it.

Politico has obtained a copy of a presentation from the Republican National Committee outlining their strategy of conning donors they denigrate into contributing money by raising false fears about Obama and socialism:

In neat PowerPoint pages, it lifts the curtain on the often-cynical terms of political marketing, displaying an air of disdain for the party’s donors that is usually confined to the barroom conversations of political operatives.

The presentation explains the Republican fundraising in simple terms.

“What can you sell when you do not have the White House, the House, or the Senate…?” it asks.

The answer: “Save the country from trending toward Socialism!”

Manipulating donors with crude caricatures and playing on their fears is hardly unique to Republicans or to the RNC – Democrats raised millions off George W. Bush in similar terms – but rarely is it practiced in such cartoonish terms.

One page, headed “The Evil Empire,” pictures Obama as the Joker from Batman, while House Speaker Nancy Pelosi and Senate Majority Leaders Harry Reid are depicted as Cruella DeVille and Scooby Doo, respectively.

The documents also discusses how to approach different groups of donors:

The most unusual section of the presentation is a set of six slides headed “RNC Marketing 101.” The presentation divides fundraising into two traditional categories, direct marketing and major donors, and lays out the details of how to approach each group.

The small donors who are the targets of direct marketing are described under the heading “Visceral Giving.” Their motivations are listed as “fear;” “Extreme negative feelings toward existing Administration;” and “Reactionary.”

Major donors, by contrast, are treated in a column headed “Calculated Giving.”

Their motivations include: “Peer to Peer Pressure”; “access”; and “Ego-Driven.”

The slide also allows that donors may have more honorable motives, including “Patriotic Duty.”

A major Republican donor described the state of the RNC’s relationship with major donors as “disastrous,” with veteran givers beginning to abandon the committee, which is becoming increasingly reliant on small donors.

Breaking News: John McCain Was on Meet the Press

John McCain was on Meet the Press again today. When did they pass the Constitutional amendment saying that the person with the most electoral votes becomes president, and the person who comes in second becomes a regular guest on Meet the Press? Is he being prepared to become the next host of the show?

On This Week Nancy Pelosi sounded confident of obtaining enough votes in the House to pass health care reform in the House. The House has already passed one health care reform bill but now must pass one to match the one passed in the Senate.

Mixed Signals on Health Care Reform

Going into President Obama’s first State of the Union Address we continue to get mixed signals as to plans to proceed with health care reform. White House communications director Dan Pfeiffer did say that Obama will reiterate his commitment to health care reform.

Members of the House are saying that they are willing to consider passing the Senate bill along with passing a second bill with fixes which will be passed as part of budget reconciliation where only a simple majority is needed for passage. However House Speaker Nancy Pelosi is also talking about a two track effort to pass simpler matters first and more comprehensive reform at a later date. Considering the degree of opposition to the bill nationally, as well as opposition to passing the Senate bill in the House, this might be the most realistic path.

Passing a more scaled-back plan with promises of more comprehensive reforms in the future might not be accepted by the left but Bennie Sanders, one of the most liberal member of the Senate, has signaled his willingness to support a scaled-back effort.

It might not even be necessary to scale back a new bill very much. Polls show that half the country want to start over, but that those who say this do not know what is actually in the bill. Theoretically Congress could pass a new bill which is virtually the same as the old bill, name it New Health Care Reform, and most voters would not know the difference. What would matter is explaining the individual components as polling has been clear that while Americans might say they oppose Obama-care in general they also support all the key aspects when asked specific questions.

Andrew Sullivan Argues That We Still Can

Andrew Sullivan responded to a letter from a reader who feels the frustration many of us feel regarding how a small number of Senators can block reform. The reader argues that Obama cannot change the system and he says he is done. Sullivan  begs him not to give up:

We supported Obama precisely because he was trying to combat this system, to attempt governance that was not hostage to news-cycle Rovian politics. And this he has tried to do, operating within a system that is the one we have, in a climate that the last four decades has created. He has achieved, despite the carping on the left and rage on the right, many good things. Health insurance reform is one of the toughest. And the more I have studied this subject, the more sensible the Senate bill actually appears – given the exigencies of the system and the economic distress of the moment.

I don’t think ramming the Senate bill through the House and trying to get through reconciliation will work. I do think Obama has a golden opportunity at his SOTU to do what he did last September, and patiently explain why some reform is necessary, that he is open to constructive criticism, but that he was elected to get difficult things done. What he needs to do politically is expose the vacuity of the opposition, by hanging back a little and letting their politics of no and never sink in. If he can credibly explain how he will bring the budget back to balance, and how healthcare reform is actually partly a means to do this, he can regain the initiative.

This is the GOP’s high water-mark. They have abdicated any responsibility to tackle the problems we all acknowledge, while indulging in extremist rhetoric. They live for the spin and the rage. So this is the moment they have been waiting for. Most Americans don’t think this way. They are legitimately worried that health reform is too costly right now. They’re wrong if we find the will in the coming years to ensure that the Medicare cuts are real and the cost controls are followed up. And we need to do our part in persuading them.

This is not over. In some ways, it is only just beginning.

Which is why Obama needs us breathing down his neck, and galvanizing support for necessary reform – now, more than in the campaign. If we give up, we will be copying the hysteria and nihilism of the right. Do not give up. Focus. Argue. Mobilize.

Yes. We. Can.

Sullivan is right that Obama must sell the country on any plan before it is passed. Obama might not be able to succeed but this is what he needs to try to do. We cannot expect any good results if we try to ram through a bill which is both flawed and unpopular as many liberals are demanding. This no longer even appears to be an option with Nancy Pelosi stating she does not have the votes to pass the Senate plan.

Obama should have stuck to his initial instincts from the start and stayed away from any plan with mandates. There are plenty of other ways around the free rider problem. If we are to get past the right wing noise machine which blocks legislation by distorting it, health reform needs to be sold in smaller bits and pieces which people can understand. It is okay if we do not get everything at once if we are making progress, but a mandate makes partial reform which forces everyone to purchase private insurance with no guarantee of affordability unpalatable to far too many voters.

Democrats Should Not Tolerate Restrictions on Basic Liberties As in Stupak Amendment

Nancy Pelosi clearly knows far more than I do about getting bills passed. It is certainly possible that she knows what she is doing in attaching the Stupak Amendment to health care reform. Maybe this was necessary for initial passage in the House and maybe she has reason to be certain that a final bill will be passed without such restrictions on abortion rights. We won’t know until we see how this all plays out but I consider to fear she made a huge mistake.

Talking Points Memo summarizes a study which shows why I doubt that Democrats should have voted for any bill containing  the Stupak Amendment as it risks making it impossible for all women to purchase insurance which includes coverage of abortion:

A new study by the George Washington University School of Public Health and Health Services adds some expert imprimatur to what many progressives have been saying all along: The Stupak amendment to the House health care bill–which will prevent millions of women from buying health insurance policies that cover abortion–is likely to have consequences that reach far beyond its supposedly intended scope.

The report concludes that “the treatment exclusions required under the Stupak/Pitts Amendment will have an industry-wide effect, eliminating coverage of medically indicated abortions over time for all women, not only those whose coverage is derived through a health insurance exchange.”

In other words, though the immediate impact of the Stupak amendment will be limited to the millions of women initially insured through a new insurance exchange, over time, as the exchanges grow, the insurance industry will scale down their abortion coverage options until they offer none at all.

“As a result, Stupak/Pitts can be expected to move the industry away from current norms of coverage for medically indicated abortions. In combination with the Hyde Amendment, Stupak/Pitts will impose a coverage exclusion for medically indicated abortions on such a widespread basis that the health benefit services industry can be expected to recalibrate product design downward across the board in order to accommodate the exclusion in selected markets.”

It is disappointing that the Democrats have so far voted for a bill which contains such an amendment. This is about the fundamental right of a woman to control her own body. Democrats should not be willing to compromise over such fundamentsl rights. Rather than compromising, they should have spoken out against this attempt by Republicans to control health care and interfear in the decisions made between a patient and her doctor.

The Republican Party in recent years has become the organ of an authoritarian movement. The Democrats need to present a clear alternative to their views, not compromise over basic rights. Offering a clear voice in support of individual liberty, on abortion rights as well as other issues where the Republicans desire increased government intervention in the lives of individuals (despite their hypocritical adoption of the language of liberty), might also give independents a reason to stick with the Democrats.  If the Democrats fail to offer a clear contrast between themselves and the Republicans we are likely to continue to see stories about the loss of independent support.

Another Poll This Week Shows Republican Support At New Low

Many Republican sites are showing an overly-optimistic and selective reading of recent polls. There certainly are potential dangers for Obama and the Democrats after months of the right hitting them with false claims about policies such as health care reform. That does not mean that there is any support for the Republicans to return to power. First Read provides this reality check from the latest NBC News/Wall Street Journal poll:

Put simply, the GOP’s brand is still a mess. According to the poll, just 25% have a positive opinion of the party (compared with 42% for the Dem Party), which ties the GOP’s low-water mark in the survey and which is a worse score than it ever had during the Bush presidency. (Honest question: Can the party still blame Bush for their problems if their numbers have gotten lower since he left the scene?) In addition, only 23% approve of the way in which congressional Republicans have handled health care (compared with 43% for Obama). And looking ahead to the 2010 midterms, 46% prefer a Democratic-controlled Congress, versus 38% who want a GOP-controlled Congress. Last month, Dems held a 43%-40% advantage. Also, don’t miss this: Despite being out of office and (relatively) out of the news, Sarah Palin’s fav/unfav in our poll has dropped from 32%-43% in July to 27%-46% now. In fact, her numbers now are nearly identical to Nancy Pelosi’s (26%-42%). By the way, both Palin and Pelosi are more popular than the Republican Party.

While any dissastisfaction with Obama does not provide helpful news for the Republicans, it is notable that, “nearly half of respondents (46%) support building an independent political party to compete with the Democrats and Republicans.”

As I discussed earlier in the week, in noting that Public Policy Polling also shows the Republicans at new lows, if post historical trends continue the Republicans should pick up some seats in the off year elections next year. The Republicans are showing greater intensity,  even if their numbers are lower, and are likely to turn out in greater numbers, especially with Obama not on the ballot. Many Democrats are also faced with defending districts which historically have been in Republican hands. Between this and an overall anti-incumbent sentiment, I would expect some to be unable to hold on to newly won Democratic seats.