Clinton Shows Desperation With Dishonest Attacks Against Sanders On Health Care & Guns

Clinton Attacks Sanders

A common characteristic of a Hillary Clinton campaign is to distort the views of her opponent and lie about the facts as opposed to engaging in an honest exchange of ideas. We saw this when she ran against Barack Obama eight years ago, and have repeatedly seen this in the past several months. She appears to have stepped up her smear campaign now that she is losing her lead in the polls.

Democracy For America has also issued a response to what they refer to as Clinton’s “bald-faced lies” on Sanders’s gun record and “right-wing attacks” on healthcare. Their response can be found here.

The Clinton campaign has been attacking Sanders with distortions of his views on health care and gun control this week, having Chelsea deliver some of the attacks on health care:

“Sen. Sanders wants to dismantle Obamacare, dismantle the CHIP program, dismantle Medicare, and dismantle private insurance,” she said during a campaign stop in New Hampshire. “I worry if we give Republicans Democratic permission to do that, we’ll go back to an era – before we had the Affordable Care Act – that would strip millions and millions and millions of people off their health insurance.”

This attack, similar to the attacks from Hillary Clinton during the last Democratic Debate, greatly distorts Sanders’ proposal for Medicare For All. Rather than dismantle Medicare, Sanders proposes providing Medicare for everyone as it provides better coverage at a lower cost than any other system we currently have. It would further expand the number of people covered, and not take away health coverage from millions.

The Week also responded to what they call Hillary Clinton’s dirty attack on Bernie Sanders:

Hillary Clinton took aim at Bernie Sanders’ single-payer health care plan on Monday, characterizing it as “turning over your and my health insurance to governors,” specifically naming Republican Terry Branstad. It’s a pretty clear reference to the many conservative states that have refused ObamaCare’s Medicaid expansion — implying that Sanders would allow conservative states to opt out of his plan, and hence partially destroy all federal health insurance programs.

This is absolutely false.

After showing how Clinton is lying about Sanders’ plan, the article concluded with what is obviously happening: “In any case, it’s obvious what’s happening here. Clinton has been flagging in the polls of late, and as usual she’s turned to fighting dirty.”

Clinton’s use of such dirty attacks on Sanders’ support for a true universal health care plan is quite a flip-flop considering that in 2008, while also launching dishonest attacks on Obama’s health care plan, Clinton equated any disagreement with her plan with the tactics of Karl Rove. The Sanders campaign issued this response (with the video above):

Hillary Clinton once said it “undermined core Democratic values” and gives “aid and comfort” to the special interests and “their allies in the Republican Party” for Democrats to attack each other’s health care plans. Today, in another flip-flop, she’s doing exactly what she once decried.

In the wake of new polls showing that Sen. Bernie Sanders’ campaign is gaining ground or leading in the Iowa caucuses, Clinton’s campaign has stepped up attacks on Sanders and his health care proposal. The most recent volley is an attack on Sanders’ plan to create a Medicare-for-all health care system for all Americans.

Clinton’s attacks on a Democratic Party rival over universal health care marks a very public flip flop by her and her campaign. She is now using the same Karl Rove tactics she once decried in this video.

Clinton is also repeating her dishonest attacks on Bernie Sander’s record on guns. She is basing this on votes from several years ago, ignoring the fact that bills have a lot of components and Sanders’ votes based upon some aspects of a bill does not indicate an opposition to gun control.

In reality, Sanders has received a lifetime grade of D- from the NRA (along with at least one F) due to gun control measures which he has supported, including bans on assault weapons, restrictions on concealed weapons, ending the “gun-show loophole,” and expanded background checks, plus opposing shortening waiting periods. Democracy for America has dismissed Clinton’s attacks on Sanders’ gun record by saying “talk like that is so absurdly false it’s almost funny.”

Clinton has also been far to the right of her current position on gun control in the past, such as when she debated Barack Obama in 2008. Clinton has taken multiple positions on gun control over the years, campaigning even further to the right at times in 2008 when she described herself as a “pro-gun churchgoer.” Despite her major flip-flops on guns, Clinton also sent out a dishonest flier attacking Obama on guns, just one way she is repeating the same dishonest tactics employed in her unsuccessful 2008 campaign.

Clinton’s dishonest attacks on Sanders so far appear to be backfiring, as donations to Sanders have increased in response to these attacks, which is not the first time Sanders has raised money off dishonest attacks from the Clinton campaign. Plus opposition to the nomination of Hillary Clinton appears to be getting stronger among liberals. Charles Chamberlain, the Executive Director of Democracy for America, concluded his response to Clinton’s lies on Sanders record with this:

“…regardless of who wins our nomination, the goal of Democrats holding on to the White House in 2016 is being made more difficult every second the Clinton campaign continues to distort the facts on Bernie Sanders’s strong record against gun violence and attack a core progressive idea like universal healthcare.

“Bernie Sanders and any Democrat can beat right-wing attacks when they’re leveled by Republicans, but Democrats taking those same swings only hurts our ability to unite the Democratic coalition we need to win in November.

Update: Clinton’s lead down to two points in Des Moines Register poll (withing margin of error).

Outrageous Statements From Donald Trump Distract From Serious Flaws In Other Conservative Candidates (Including Clinton)

Trumps and Clintons

One of the many problems with Donald Trump’s outrageous statements (undoubtedly made more to attract attention and support from a certain segment of the Republican Party than out of conviction) is that it might be making people fail to realize that many other candidates running also have positions which in a normal year might disqualify them from serious consideration. This is most clearly true within the Republican Party, but Hillary Clinton also benefits from the non-stop vulgar and sexist attacks on her from Trump. Donald Trump’s views make the flaws in the other candidates look far less significant in comparison, but there remains reasons why other candidates would be unacceptable as president.

Politico looked at The Wild Ideas You Missed While Donald Trump Was Talking, finding that many people are not noticing extreme views from other Republican candidates when Trump gets most of the attention:

The good news for Republicans, arguably, is that their rhetoric has been so consistently over-the-top that it has started to sound routine; academics call this “shifting the Overton window,” the range of what’s considered politically acceptable. I’ve watched all the debates as well as the undercards live, but when I reviewed the transcripts, I was amazed how many radical statements had slipped under my radar. Ted Cruz called for putting the United States back on the gold standard. Marco Rubio accused President Barack Obama of destroying the U.S. military. Huckabee said Bernie Madoff’s rip-offs weren’t as bad as what the government has done to people on Social Security and Medicare. Lindsey Graham said his administration would monitor all “Islamic websites,” not just jihadist ones. I had even forgotten Trump’s claim that vaccines caused autism in a 2-year-old girl he knew.

Vaccines do not cause autism. Goldbuggery is crackpot economics. The U.S. military is still by far the strongest in the world. And what the government has done to people on Social Security and Medicare is give them pensions and health care. But none of those statements drew any pushback from the other Republican candidates, or, for that matter, the media moderators. Neither did Ben Carson’s assertion that if the United States had set a goal of oil independence within a decade, moderate Arab states would have “turned over Osama bin Laden and anybody else you wanted on a silver platter within two weeks,” which is wackadoodle on multiple levels.

On the other hand, the Republican debates do present an extremely distorted view of Obama’s record, with nobody present to present the facts:

These are presumably winning messages in a Republican primary. It’s not clear whether they would be in a general election. The reality of the Obama era, for all its warts, is that unemployment has dropped to 5 percent, the deficit has shrunk by two thirds, illegal immigration has plateaued, far fewer U.S. soldiers are dying abroad and Americans are more likely to be killed by lightning than by terrorists at home. The question is whether the run-for-your-lives talking points will crash into statistical reality, or whether they will gradually help create a new political reality.

The Republicans do deserve some credit for being willing to display their views in public. The article does chastise the Democrats here in concluding that the Republicans are “acting like a confident party—perhaps an overconfident party—while the Democrats are acting like they’ve lost their feck.”

In reality, it is the Clinton campaign (which only wanted four debates) and the DNC, which expanded the number to six but hid most of them on nights when few would be watching, which are acting cowardly. Both Sanders and O’Malley have been pushing for more debates. I also think that Clinton has benefited from the exaggerated coverage paid to Trump. If not for his unexpected success in the Republican race, the big story of the year might be Sanders’ challenge to Clinton. After all, Sanders does beat Trump in head to head contests–and often by a larger margin than Clinton does.

Clinton benefits in other ways from Trump being in the race. The large number of lies from Trump dominated the year-end report from Factcheck.org. This led to a fairly long list of lies from Clinton being less obvious, posted further down in the story after Trump’s lies.

The concentration by the media on outrageous comments from Trump distracts from talk about the unethical conduct from Clinton, as well has the poor judgment she has shown throughout her career. Most importantly, it distracts from a more thorough look at Clinton’s views, including her neoconservative views on foreign policy, her conservative views on social/cultural issues, and her turn to the right on economic issues and health care. It also might be kept in mind that, with all his unacceptable statements and views, Donald Trump did oppose the Iraq war which Clinton pushed so hard for, and which turned out to be a disaster.

Ben Carson Doesn’t Know Any More About Health Care Policy Than He Knows About The Constitution Or Foreign Policy

Ben Carson Health Plan

You might know Ben Carson as the ignorant theocratic who does not understand the Constitution of the United States or understand separation of church and state. Or you might know him as the Republican who had been challenging Donald Trump for leadership in the GOP race until it became apparent that he didn’t know a thing about foreign policy. Today we were introduced to a new Ben Carson–a doctor who doesn’t have any idea how to formulate a health care plan.

Carson tried to distract from his ignorance about other matters by introducing his health care plan (copy here). There are far more pictures than detailed policy in the pdf. There is a lot of talk about hating Obamacare and of providing a market solution–two lines which Republicans love but which don’t hold up too well if you think about them. The whole reason for Obamacare was that the market was not able to handle providing health care coverage. We wound up with perverse profit motives which led insurance companies to try to profit by denying care and eliminating coverage from those who were sicker.

Carson’s plan relies on “health empowerment accounts,” which are essentially another name for health savings accounts–which people can already purchase with high deductible plans under Obamacare (which is exactly what I have done). Except if you get rid of Obamacare, you also get rid of the preventative care covered without out of pocket expenses, the subsidies to help people afford it, coverage for young adults on their parents’ plans, and the guarantee that nobody can be denied coverage.

The biggest folly in Carson’s plan is to gradually increase the eligibility age for Medicare from 65 to 70. We should be doing the reverse–gradually lowering the eligibility age. (Or better yet, go with Bernie Sanders’ plan and offer Medicare for All right now). Our traditional private health care insurance has generally worked for the young (unless they got really sick and became as expensive to care for as the elderly). The problem has been with covering people as they get into their 40’s and 50’s and start developing more medical problems which private insurance companies would rather not deal with.

Medicare handles the chronically ill much better. Originally this problem might have been dealt with under the Affordable Care Act with either a public option modeled on Medicare or a buy in for Medicare. For the benefit of those who have forgotten the details surrounding the fight to enact the Affordable Care Act, the two most conservative Senators voting with the Democrats, Joe Lieberman and Ben Nelson, would only vote for Obamacare if these ideas were dropped, and there were no votes to spare with the Republicans one hundred percent united in voting against it.

Carson’s idea to increase the eligibility age of Medicare to 70 is awful, although that might not be the worst part of the plan. Carson also wants to replace the government Medicare plan with private insurance companies. Everyone would get a fixed contribution from the government towards purchasing a plan. Presumably if the fixed contribution is not enough to purchase an adequate plan they would be on their own (with their health empowerment plan, if there is enough there), but to conservatives that’s freedom. Medicare patient’s already have the option of a private plan instead of the government plan. We have found that it costs fourteen percent more to care for patients under the private plans than under the government plans–so much for greater efficiency in the private sector.

Brain surgery, along with rocket science, was once considered among the most difficult of intellectual pursuits. Now that America has become familiar with neurosurgeon Ben Carson, we will have to reconsider that idea.

Politico Looks At The Different Types Of Dishonesty From Clinton, Trump, & Carson

Pinoccio

Many politicians find ways to benefit from lying, and it might not be coincidental that the three front runners from the two major parties are candidates who have spread a lot of misinformation this year. Politico has looked at the lies from Hillary Clinton, Donald Trump, and Ben Carson, finding differences in the types of lies they tell:

Not all lies are created equal. When Hillary Clinton lies, she generally does so with legalistic care. You get the sense that she knows what the exact truth is. But you also get the sense that she knows she’ll suffer if she provides the whole truth, so she shades the facts with interpretations and embellishments that flatter or favor her. She presents an incomplete timeline for her email account. She claims that her email practices were “permitted.” She overstates her cases and fibs with the numbers. Clinton has been doing it so long and so well that by 1996, New York Times columnist William Safire had already diagnosed her as a “congenital liar.”

Trump’s and Carson’s lies, on the other hand, come from the land of bullshit, that wonderful place where loose facts and wishful thinking mate to produce a quotable soundbite. They’re not trying to deceive you in a Clintonian fashion. They’re indifferent to the truth, content to say the first things that pop into their brains. You can see this strategy at work in Trump’s story about the American Muslims celebrating the fall of the twin towers, or his bogus assertion that the federal government is steering refugees to states that have Republican governors, or his claim that “61 percent of our bridges are in trouble.” He’s just winging it. If something gets broken in the telling of one of his stories, he doesn’t think it’s his fault.

Ben Carson brings the quality of moonshine to his lies. Whenever he goes on, he voices the sort of stuff you hear mumbled from the sozzled end of a dive bar. Take, for example, his claim that Mahmoud Abbas, Ali Khamenei and Vladimir Putin were classmates at Patrice Lumumba University in Moscow, or his idea that “a lot of people who go into prison straight” come out gay. Carson is much better at spotting other candidate’s lies than he is his own. Originally, he backed Trump’s claim about celebrating American Muslims. Yesterday, he said that the film he saw was shot in the Middle East, not New Jersey.

This summary only touches the surface of the many lies told by all three of these candidates.  Ben Carson has been exposed for other lies about his biography. I recently noted some of the questionable claims made by Donald Trump as to what he observed on 9/11. While it doesn’t mean she lies any more that her Republican opponents, I have pointed out far more lies by Hillary Clinton in this election cycle alone due to concentrating coverage on the Democratic race.

I recently noted how Clinton has been accused of lying about Edward Snowden in the second Democratic debate, although this might have been a mistake based upon her conservative mind set as opposed to an intentional lie. Her false claims about Sanders’ support for Medicare for All was more likely an outright lie considering how she has flip-flopped on single payer health plans. She was also exposed by the fact checkers for dishonesty during the first debate. Clinton has similarly been dishonest in her other smears against Sanders, reminiscent of the campaign she ran against Barack Obama eight years ago, during which many think she crossed the line, even considering our usual standards for a political campaign.

Politico also looked at why these candidates get away with such frequent lying:

We generally dislike liars, so why do we tolerate well-documented political lies? For one thing, findings by the fact-checkers aren’t evenly distributed within the culture. Nobody but political fanatics pay much mind to them. To injure a politician, documentation of his lie must puddle out to television and the Web, where the sizable audiences reside. But even then, the politician has the advantage. He can level a countercharge, saying that he’s telling the truth and the press—the scheming, oily, wicked, privacy-invading press—has it in for him and is doing all the lying.

As trust in the press (and other institutions) has fallen in recent decades, the counterattack gambit has worked for many politicians. This has been Trump’s path. He complicates the fact-checkers’ job by lying with effortlessness and rapidity, making it become difficult to keep up with his bullplucky. After getting caught in a lie, Trump tends to retweet or repeat it, writes Tufts University’s Daniel W. Drezner today. Next, he bullies the media for reporting on his statement. (Today, for example, Trump demanded an apology from the Post for pinning Pinocchios to his 9/11 tale.) If Trump ever deigns to backtrack on a brazen lie, it’s to claim that he’s been misinterpreted.

I think another factor is also important–partisanship. Many people will defend members of their party, while criticizing members of the opposing party of dishonesty. We have seen comparable acceptance of dishonesty among Republicans  for years, including the manner in which many still believe George Bush was telling the truth, and even that there was WMD in Iraq long after the government admitted this was not true. Many Republicans will repeat the lies spread by scientists on the payroll of the petroleum industry to promote their agenda on climate change, even after  it has been revealed that Exxon’s own scientists knew the truth about global warming forty years ago.

Of course such hypocrisy can be seen in both parties, as many Democrats are willing to ignore Hillary’s Clinton’s long career which has been characterized by dishonesty, corruption, and undermining liberal principles whenever it was politically expedient. Some simply ignore the facts, while other see it as a good thing that someone on their side is matching the Republicans in their tactics. Partisan Democrats who back Clinton certainly cannot claim any moral superiority to Republican voters–which is one reason that so many independents who consider her to be dishonest  are expressing a lack of interest in voting Democratic–possibly paving the way for dishonest Republican politicians such as Trump or Carson to get  elected in 2016. Bernie Sanders’ campaign against Hillary Clinton is differentiating those Democrats who support principles as opposed to those practice blind partisanship.

Nation’s Largest Organization of Nurses Joins Liberal Writers In Protesting Hillary Clinton’s Attacks On Bernie Sanders

National Nurses Union Medicare For All

Hillary Clinton’s sharp move towards the right has many liberals questioning how much further right she will move in the general election, and if elected president. Her recent attacks on Bernie Sanders for his advocacy of a single payer health plan, which as I have noted she once supported, has resulted in considerable criticism from the left and a major nurses organization.

Jonathan Cohn, Senior National Correspondent at The Huffington Post asked, Why is she talking like a Republican? He also pointed out, “This is why Hillary Clinton makes so many progressives queasy.” Jim Newell at Slate wrote, Hillary Is Already Triangulating Against Liberals: Her new attack on Bernie Sanders’ single-payer health care plan shows her indifference to progressive voters. He pointed out that “she is a Clinton, and this is what they do.”

National Nurses United, which previously endorsed Bernie Sanders for president, has issued a press release to respond to Clinton’s attacks on Sanders over his support for a single payer plan:

National Nurses United, the largest U.S. organization of nurses, condemned the Hillary Clinton campaign today for its attack on Sen. Bernie Sanders’ proposal for healthcare for all, including its slanted use of data on the economics of Medicare for all.

“Any politician that refuses to finance guaranteed health care has abandoned my patients, and I will never abandon my patients. That’s why we support improved Medicare for all, and that’s why I support Bernie Sanders,” said NNU Co-President Jean Ross, RN.

“While the Affordable Care Act corrected some of the worst injustices in our insurance, profit-based healthcare system, the work of healthcare reform is far from done,” said Ross. “Today, 33 million Americans remain uninsured. Tens of millions more remain underinsured, facing bankruptcy due to unpayable medical bills or the choice of getting the care they need or paying for food or housing for their families.”

“The only fix for our broken system once and for all is the prescription Bernie Sanders has so eloquently presented – joining the rest of the world by expanding and updating Medicare to cover everyone,” Ross said.

NNU also criticized Clinton for citing a rightwing report first published in the Wall Street Journal on the inflated cost of $15 trillion to implement a Medicare for all system. The Journal report claimed as its source research by University of Massachusetts Amherst economics professor Gerald Friedman.

But Friedman himself has criticized the Journal report, noting in a Huffington Post column that the “economic benefits from Senator Sanders’ proposal would create dynamic gains by freeing American businesses to compete without the burden of an inefficient and wasteful health insurance system.”

Those include a “productivity boost coming from a more efficient health care system and a healthier population, [that] would raise economic output and provide billions of dollars in additional tax revenues to offset some of the additional federal spending,” said Friedman.

Friedman estimates nearly $10 trillion in savings while still reducing national health care spending by over $5 trillion. “With these net savings, the additional $14.7 trillion in federal spending brings savings to the private sector (and state and local governments) of over $19.7 trillion,” Friedman wrote.

Clinton is “ignoring the enormous savings that would come by assuring people could get proper care where and when they need it,” Ross added.

For example, a report out just last week noted $6.4 billion in lost wages and productivity in low income communities through premature deaths due to colon cancer, according to researchers at the Centers for Disease Control and Prevention.

“Dismissing the yearning of millions of Americans for a more humane healthcare system not based on ability to pay, and relying on a disputed data is disgraceful,” said Ross. “It’s a reminder again why nurses across the U.S. have been rallying and campaigning for a candidate who will never stop fighting for guaranteed healthcare for all.”

I further discussed Clinton’s fallacious attacks on Sanders here.

By attacking Sanders from the right on health care and economic policy, along with reminding the left how hawkish she is in her recent speech at the Council on Foreign Relations, Clinton risks seeing progressive voters refuse to vote for her.

Conor Lynch at Salon warns that Hillary Clinton is playing a dangerous game: How her anti-Bernie talking points could cost her — and America — big time. He began, “Hillary Clinton is starting to remind progressives why the name Clinton brings up such a mixed bag of emotions, and why it’s so hard to believe Clinton’s pivot to the left this campaign season.”He concluded:

But Clinton is making it harder for progressives to support her. With a history of hawkish foreign policy and Wall Street backing, she truly is the lesser to two evils. (A neoliberal is better than a fascist, after all [referring to Donald Trump]) But many on the left tend to vote with their conscience, and going after single-payer healthcare and hurling dishonest attacks on Sanders will only alienate progressives further.

Her problem is also not likely to be limited to progressive voters. When Clinton campaigns as a Republican-lite, many potential Democratic voters are not going to see very much reason to turn out to vote, risking the same fate for Democrats as they suffered in 2014.

Clinton Attacks Sanders On Progressive Agenda Including Single Payer Health Care

BernieSanders-Healthcare2

Hillary Clinton distorted the meaning of single payer health plans in the second Democratic debate and is continuing to attack Sanders’ progressive agenda on the campaign trail. Politico reports, “Three days after the fairly cordial second Democratic debate, Clinton’s campaign is mounting an attack against Sen. Bernie Sanders for proposals to raise taxes on the middle class that were part of the national single-payer health care bills he introduced in Congress.”

As Jonathan Cohn, Senior National Correspondent at The Huffington Post asks, Why is she talking like a Republican? He also points out, “This is why Hillary Clinton makes so many progressives queasy.”

Sanders’ campaign responded:

“On Medicare for all, the middle class would be far better off because it would save taxpayers money,” Sanders spokesman Michael Briggs said in response to Clinton’s latest line of attack. “More people would get better care at less cost. Didn’t she used to be for that? We wouldn’t throw money away on costly premiums for profit-making private insurance companies. Pharmaceutical companies would no longer be able to rip off Americans with the most expensive prescription drugs in the world. Didn’t she used to be for that?”

“Secretary Clinton has singled out Senator Gillibrand and praised her [family leave] legislation which, it turns out, Secretary Clinton now refuses to support because of the way it’s paid for,” Briggs added, noting it requires a small tax hike on the middle class. “No wonder people have their doubts about her.”

His campaign web site has further information:

What’s the Truth About the Clinton Campaign False Attacks?

The truth is that a single-payer plan will save American families money and provide universal health care.

Under the legislation offered by Sen. Sanders in 2013, families with taxable income under $250,000 a year (individuals under $200,000) would pay a tax of 2.2 percent of taxable income.

That means a family with a taxable income of $100,000 a year would pay $2,200 a year – but would be relieved of paying any private health insurance premiums and any copayments or deductibles.

A family making $50,000 would pay $1,100 a year.

The page also notes that, “The Clinton campaign received more contributions from the pharmaceutical industry than any other – Republican or Democrat – through the first six months of the campaign.”

Clinton’s attack sounds like a  repetition of attacks on Sanders in The Wall Street Journal in September. Physicians For A National Health Program responded:

In a front-page Wall Street Journal article a few days ago, the projection was made that a single-payer national health insurance program (NHI), as part of the presidential campaign of Senator Bernie Sanders (I-VT), would cost $15 trillion over ten years. Accurate though that figure is, this under-researched article conveys disingenuous misinformation to a broad readership that might be inclined to dismiss such a program as too expensive to even consider.

This article is irresponsible in what it doesn’t say— what the savings would be of reining in our current wasteful, overly bureaucratic profit-driven medical industrial complex, and the benefits that NHI would bring to our entire population compared to what we have now or have ever had.

Thanks to a landmark study in 2013 by Gerald Friedman, Professor and Chairman of the Department of Economics at the University of Massachusetts, we have a solid financial analysis of the costs and benefits of a single-payer national health plan. With NHI, $592 billion would be saved annually by cutting the administrative waste of some 1,300 private health insurers ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion). These savings would be enough to cover all of the 44 million uninsured (at the time of his study) and upgrade benefits for all other Americans, even including dental and long-term care. A single-payer public financing system would be established, similar to traditional (not privatized) Medicare, coupled with a private delivery system. Instead of having to pay the increasing costs of private health insurance, so often with unaffordable deductibles and other cost-sharing, patients would present their NHI cards at the point of service without cost-sharing or other out-of-pocket costs. Care would be based on medical need, not ability to pay…

There is far more on this in the full post. Common Dreams adds:

Sanders’ embrace of a single-payer system—also widely backed by the American public—earned him the endorsement of the National Nurses United (NNU), the nation’s largest organization of nurses. NNU Executive Director RoseAnn DeMoro said in August that his ” issues align with nurses from top to bottom,” including his “insist[ance] that healthcare for everyone is a right not a privilege.”

Clinton Flip Flop

There is added irony in that this is yet another flip-flop from Hillary Clinton. She has flip-flopped on some selective economic issues to try to attract progressive support, and she has flip-flopped on gun control.  As I recently posted, some of her statements on gun legislation were  like the views from Sanders which she attacks. At other times she has taken a more conservative viewpoint.  As Martin O’Malley pointed out during the second debate, she has held at least three views, portraying herself  “as Annie Oakley and saying we don’t need those regulations.” Clinton has also supported a single payer plan in the past. This is from Clinton in 1994, both supporting single payer and showing no objection to a general tax to fund it (emphasis mine):

..I believe, and I may be to totally off base on this, but I believe that by the year 2000 we will have a single payer system. I don’t think it’s — I don’t even think it’s a close call politically.

I think the momentum for a single payer system will sweep the country. And regardless of the referendum outcome in California, it will be such a huge popular issue in the sense of populist issue that even if it’s not successful the first time, it will eventually be. So for those who think that building on the existing public-private system with an employer mandate is radical, I think they are extremely short-sighted, but that is their choice.

There are many ways to compromise health care reform, and I don’t think that the President could have been clearer in every public statement he has made that he has one bottom line. It is universal coverage by a date certain. And he has basically told the Congress, you know, you’ve got different ways of getting there. Come to us, and let’s look at it. There are only three ways to get to universal coverage. You know, a lot of people stand up and applaud universal coverage, and they sit down, and you say, “Well, how are you going to get there?”, and they don’t want to confront that there are only three ways.

You either have a general tax — the single payer approach that replaces existing private investment — or you have an employer mandate, or you have an individual mandate. And there isn’t any other way to get to universal coverage. The market cannot deliver universal coverage in the foreseeable future, and any compromise that people try to suggest that would permit the market  to have a few years to try to deliver universal coverage without a mandate that would take effect to actually finish the job will guarantee a single payer heath care system.

Or maybe we are just dealing with ignorance of the topic as opposed to flip-flopping.  Physicians For A National Health Program pointed out her confusion on Medicare for All as a model for single payer plans displayed in an interview in The New York Times in 2008:

Q: Last question. You talked earlier in the interview about how your plan maintains the private insurance system. But in October, at the forum of the Kaiser Family Foundation, you were asked whether your plan to make government insurance, a Medicare-type plan, available to all was a backdoor route to a single payer system, and you said, “What are we afraid of? Let’s see where the competition leads us.” So is it okay with you if the market ultimately dictates that the U.S. system sort of morphs into a single-payer system? And if so, doesn’t that arm the Republicans with exactly what you were talking about, this claim that it’s socialized medicine?

MRS. CLINTON: No, because I think what we would be offering would be a Medicare-like system, which is something people are familiar with, and you know whether we would call it Medicare 2.0 or whatever we would call it. And we’d see whether people want that or not. And where it morphs to, I think this whole system will morph. I mean, look at where Medicare started and where it is today. In large measure, some of the problems we have are because of the way it evolved. But I think from my perspective, having this Medicare-like alternative really does answer the desires of people. And there’s a significant minority who want quote a single-payer system. It at least gives them the feeling it’s not for profit, they’re not paying somebody a billion dollars for raising their premiums 200 percent and all the rest of the problems that we face with the for-profit system. You get the costs of overhead and administration down as much as possible. I believe in choice. Let Americans choose and what better way to determine that than letting the market have some competition and you know see where it does lead to.

Q: And if the choice is a single-payer system, that’s fine by you?

MRS. CLINTON: You know, I think that would be highly unlikely. I think that, you know, there’s too many bells and whistles that Americans want that would not be available in kind of a bare-bones Medicare-like system but I think it’s important to have that competition.

Comment:

By Don McCanne, MD

Competition between a bare-bones Medicare-like plan versus private bells-and-whistles insurance? What kind of framing is that!?

In her proposal, is she really advocating for a public Medicare-like option that provides only bare-bones coverage? That’s certainly not the model that single payer advocates propose.

Is she suggesting that the private insurance industry will be able to provide us with an insurance product that includes all of the bells and whistles at a premium that is affordable? If such a plan were to be offered it would have a very small market limited to only the wealthiest of us. Insurers typically shun small markets.

On this issue, at least, it looks like Clinton has been moving to the right over the years.

I could understand a politician not pursuing a single payer plan because of the political obstacles in getting it passed. It is a totally different thing when Hillary Clinton repeats right wing talking points to attack Sanders for desiring a single payer plan, especially when she once had a far more liberal view on the subject.

Update: Nation’s Largest Organization of Nurses Joins Liberal Writers In Protesting Hillary Clinton’s Attacks On Bernie Sanders

Bernie Sanders Fights Back Against Conservative Attacks From Wall Street Journal & Clinton Camp

Sanders Responds WSJ

I imagine it is a good thing that both conservatives and the Clinton campaign now see Bernie Sanders as a threat, with both attacking him from the right.

The Wall Street Journal ran a scare story earlier this week entitled, Price Tag of Bernie Sanders’s Proposals: $18 Trillion:

He proposes $1 trillion to repair roads, bridges and airports. His college-affordability program would cost $750 billion over a decade. Smaller programs would provide youth jobs and prevent cuts to private pension plans. He would raise an additional $1.2 trillion in Social Security taxes in order to increase benefits and pay those already promised for 50 years. That would bolster the program but fall short of the 75 years of solvency that is typically what policy makers aim to achieve.

Mr. Sanders says he also would propose an expansion of federal support for child care and preschool, though he hasn’t said how much those programs would cost, and they aren’t included in this total.

His most expensive proposal, by far, is his plan to extend Medicare, the federal health program for seniors, to all Americans.

Sanders has responded, pointing out how a single payer plan would be more cost effective:

“That is not the reality. We will be responding to The Wall Street Journal on that,” Sanders told MSNBC’s Andrea Mitchell of the overall estimate.

“I think most of the expense that they put in there, the expenditures have to do with the single-payer healthcare system,” he continued. “They significantly exaggerated the cost of that, and they forgot to tell the American people in that article that that means eliminating the costs that you incur with private health insurance.”

Paul Waldman has also defended Sanders in a post entitled, No, Bernie Sanders is not going to bankrupt America to the tune of $18 trillion:

…while Sanders does want to spend significant amounts of money, almost all of it is on things we’re already paying for; he just wants to change how we pay for them. In some ways it’s by spreading out a cost currently borne by a limited number of people to all taxpayers. His plan for free public college would do this: right now, it’s paid for by students and their families, while under Sanders’ plan we’d all pay for it in the same way we all pay for parks or the military or food safety.

But the bulk of what Sanders wants to do is in the first category: to have us pay through taxes for things we’re already paying for in other ways. Depending on your perspective on government, you may think that’s a bad idea. But we shouldn’t treat his proposals as though they’re going to cost us $18 trillion on top of what we’re already paying.

He next discussed single payer systems, leading to this key point:

There’s something else to keep in mind: every single-payer system in the world, and there are many of them of varying flavors, is cheaper than the American health care system. Every single one. So whatever you might say about Sanders’ advocacy for a single-payer system, you can’t say it represents some kind of profligate, free-spending idea that would cost us all terrible amounts of money.

He next discussed spending on infrastructure, and then how much less we would have to spend under Republican tax plans which primarily provide tax cuts to the wealthy:

The conservatives who are acting appalled at the number the Journal came up with are also the same people who never seem to care what a tax cut costs, because they think cutting taxes is a moral and practical good, in the same way that liberals think providing people with health coverage is a moral and practical good. For instance, Jeb Bush recently proposed a tax cut plan whose 10-year cost could be as high as $3.4 trillion. That’s a lot of money that the government wouldn’t be able to spend on the things it’s doing right now, although the campaign argues that we’d get much of that money back in increased revenues because of the spectacular growth the tax cuts would create. If you remember the claims that George W. Bush’s tax cuts would create stunning growth and prosperity for all, you might be just a bit skeptical of the Jeb campaign’s similar assertions. But in any case, we can’t evaluate the value of Jeb’s plan just by saying that $3.4 trillion is a big number. If you knew that the average family in the middle of the income distribution would get less than $1,000 from Jeb’s plan, while the average family in the top one percent would get a tax cut of over $80,000, then you’d have a better sense of whether it’s a good or bad idea.

Sanders not only defended himself against this attack from the right on economics. He has also defended himself against attacks from a Clinton Super PAC in a recent fund raising email.

Attacks from the right from the Clinton camp might become increasingly common. Many liberals have been certain that Clinton’s move to the left was insincere, and that she would move to the right for the general election and if elected. We never guessed she would move towards the right so soon. As I noted last week, Clinton’s support has been falling among liberals, with Clinton now returning to calling herself a centrist to contrast herself with Sanders. Jonathan Allen picked up on this shift more recently writing, While everyone else was talking about her authenticity, Hillary Clinton changed her position.

The revelation that Hillary Clinton is planning to be more spontaneous and authentic brought a booming collective laugh from Republicans, some Democrats, and opinion writers last week. The group guffaw drowned out a related shift in her positioning that is far more important: Now she wants to be known as a moderate.

“You know, I get accused of being kind of moderate and center,” Clinton said in Ohio September 10, according to CNN. “I plead guilty.”

That’s a tire-squealing turn from the first five months of her campaign, when Clinton emphasized her progressive credentials. She built a policy platform significantly to the left of where many Democrats expected her to stand — in favor of new regulations of the financial services industry, “ending the era of mass incarceration,” and reforming campaign finance laws, to name a few items on her agenda. The focus on populism was described as a newfound affinity for the left, a return to liberal roots, an effort to crowd out the competition, a general election strategy based on energizing Democrats, or some combination thereof. The truth is that Clinton’s record is pretty liberal, except when it comes to national defense and trade.

Now she’s pivoting back toward the centrist label that defined her husband’s campaigns and presidency. The obvious reason for Clinton to switch tacks now is that her initial strategy didn’t work: On the strength of backing from liberals, Vermont Sen. Bernie Sanders has surged to leads in New Hampshire and Iowa. That’s a good reason for her to shake things up a bit, but it’s only part of a story that is more about drawing a contrast with Sanders, sending a signal to her supporters that she’s ready to really fight for the nomination, and making sure that she’s comfortable in the political skin she’s wearing for the rest of the campaign.

Allen caught the general direction of the shift, but missed how conservative her record actually is. Beyond national defense and trade which he mentioned, she has also been rather conservative on civil liberties, the environment, and social/cultural issues. While her views on economics might technically be labeled as liberal, she is far to the right of where Democrats influenced by the views of people such as Elizabeth Warren are now at.

After looking at more wonkish policy matters, Allen hit the key matter with the subtitle: The shift is partly about portraying Sanders as too extreme

By portraying herself as a moderate, Clinton is subtly saying that Sanders is too extreme — that he’s one of the people standing on the sidelines shouting rather than trying to “get something done.” The inference voters are supposed to draw is that would make it harder for Sanders to win the presidency and even harder for him to govern.

Running as a moderate (or to be honest, a conservative) might be more “authentic” for Clinton, but in joining the right wing in calling Sanders too extreme, Clinton is missing the direction much of the country is moving in. As I have pointed out many times before, Bernie Sanders Is The Future Of The Democratic Party. As I’ve also pointed out previously, Sanders’ Views Are Becoming More Mainstream Than Clinton’s Conservative Views.

CMS Agrees To Demands From Physicians & Congress To Modify Rules For Electronic Medical Records

I recently discussed the problems with the government regulations for conversion to electronic medical records. The majority of doctors have been unable to comply with the regulations which were scheduled to begin this January (already postponed from last October) for reasons beyond our control. A bill with bipartisan sponsors was introduced in Congress to postpone the current requirements further until October, 2015. While this would be helpful, further changes are also needed in the requirements.

CMS has responded to the complaints, sending out an email to physicians today stating that the rules will be reevaluated this spring. This includes considering changing the requirement from a 365 day reporting period for 2015 to a 90 day reporting period, which would essentially postpone the requirements until October. The email also stated they would be “Modifying other aspects of the programs to match long-term goals, reduce complexity, and lessen providers’ reporting burden.” Modifications have already been made in the past to the regulations to reduce their complexity, but further modifications remain necessary.

While no official changes were announced at this time, it seems inconceivable that they will not go long with recommendations to postpone when the changes are due until October now that they have announced plans to consider this. It will also be necessary to make other revisions to the rules, which also now is under consideration. Complicating matters further, in addition to these requirements for electronic medical records, conversion to ICD-10 diagnoses codes (which has also been postponed several times) is also now scheduled to occur in October.

CMS has also announced plans to reconsider the regulations on their blog.

A Bigger Computer Fiasco For The Obama Administration Than Healthcare.gov

The fiasco with the initial opening of the exchanges at healthcare.gov has become a well-known IT glitch from the Obama administration, but that might not turn out to be their biggest mistake regarding computers and health care. As it primarily involves physicians and hospitals, as opposed to the general public, far fewer people are aware with the ongoing problems regarding implementation of Meaningful Use Stage 2 requirements for electronic medical records.

The original stimulus package after Barack Obama took office included a program to provide funds to medical practices to be used for conversion to electronic medical records. In order to qualify for the incentive payments, physicians and hospitals have to follow a set of Meaningful Use requirements which have increased requirements for each stage. Initially there would be incentive payments (which turned out to be far less than the costs of conversion to electronic medical records), and subsequently there are penalties for failing to comply. The first stage was successful in terms of getting large numbers of doctors to adopt electronic medical records, but it is more questionable as to whether this is really resulting in the desired cost savings.

Stage 2 was initially required by October 2014. This would have greatly increased the use of electronic medical records, possibly resulting in more medical cost savings, but the requirements were unrealistic. The law originally required that physicians comply with the requirements of Stage 2 for a 90 day period in 2014, which essentially meant that we could wait until October 1 to implement them. When it was apparent that most physicians could not comply with this, the government postponed this until January 2015.

It was quickly apparent that this was no solution, partially as the new requirements required a full twelve months of compliance with the Stage 2 rules. By requiring compliance by this January, this only gave an additional three months. The same problems which prevented compliance with the rules by October 2014 are still present this January.

The biggest obstacle is that the rules require communication between systems which do not exist in the present software. Before making such requirements, the government should have set up a secure system for communication between computer systems rather than hoping that each individual vendor would offer a solution. Another problem is that the requirements include factors which are outside of a medical office’s control. For example, a medical office could set up a patient portal as required in order for patients to assess medical information. However, there are requirements not only to establish this, but for five percent of patients to utilize it. Many physicians, such as those with primarily elderly patients are especially concerned that not enough will even be interested in using such computerized tools. Fortunately this requirement was at least reduced from ten percent in the original regulations to five percent.

Compliance with the rules is further complicated by it being all or nothing. A medical office might follow 90 percent of the rules but will get zero incentive money and pay the full penalties for non-compliance. There are some exclusions and some flexibility in some areas, but this still creates far too great a burden on physician practices.

When the government first changed the rules last fall delaying the requirements for Stage 2 until January, some members of Congress did realize that this was not long enough to have any impact. There was a bipartisan bill introduced to reduce the requirements for a 90 day period in 2015, essentially giving physicians until October instead of January. This was not introduced until shortly before Congress went on recess prior to the election, and died before the end of the last session. Earlier this month Renee Ellmers (R-N.C.) and Ron Kind (D- Wis.) introduced The Flexibility in Health IT Reporting (Flex-IT) Act of 2015 to restore the 90 day requirement. The bill also has the support of organizations including the American Academy of Family Physicians, American Hospital Association, American Medical Association, College of Healthcare Information Management Executives and Medical Group Management Association.

Even this only postpones the problem and we don’t know if the technology will be any better this fall than it is now. A recent survey of physicians found that 55 percent do not plan to attest to Stage 2, despite the financial penalties.

This failure in the implementation of computerized medical records could be a far worse fiasco than the initial roll out of the exchanges under the Affordable Care Act. The manner in which the Obama administration quickly fixed that problem turned out to be a tremendous success, and this problem is also fixable. A real fix will take more than just postponing requirements.

The government must rethink the logic behind the requirements. Most industries have computerized on their own without being forced to by the government. Some government assistance in conversion to electronic medical records would be helpful, such as establishing standards for communication between systems. Physicians must also be given flexibility to determine for ourselves which aspects of computerization are really of value for caring for our patients and which are not, rather than being forced to follow a long set of rules and only receive credit for 100 percent compliance, or being dependent on factors beyond our control.

PolitiFact Lie of The Year: Exaggerations about Ebola

Conservatives used Ebola as one means of spreading fear, helping them in the 2014 midterm elections. PoltiFact has now made exaggerations about Ebola their 2014 Lie of the Year. This includes both conservative hysteria which greatly exaggerated the threat faced in a developed nation such as the United States and many of the right wing conspiracy theories. I have already discussed many of these false claims, often in the context of debunking right wing attempts to restrict civil liberties while ignoring the science. From PoltiFact:

Thomas Eric Duncan left Monrovia, Liberia, on Sept. 19, for Dallas. Eleven days later, doctors diagnosed Duncan with Ebola.

Eight days after that, he was dead.

Duncan’s case is just one of two Ebola-related fatalities in the United States, and since Duncan traveled to Dallas, more Americans — at least nine, and likely many more — have died from the flu.

Yet fear of the disease stretched to every corner of America this fall, stoked by exaggerated claims from politicians and pundits. They said Ebola was easy to catch, that illegal immigrants may be carrying the virus across the southern border, that it was all part of a government or corporate conspiracy.

The claims — all wrong — distorted the debate about a serious public health issue. Together, they earn our Lie of the Year for 2014…

Fox News analyst George Will claimed Ebola could be spread into the general population through a sneeze or a cough, saying the conventional wisdom that Ebola spreads only through direct contact with bodily fluids was wrong.

“The problem is the original assumption, said with great certitude if not certainty, was that you need to have direct contact, meaning with bodily fluids from someone, because it’s not airborne,” Will said. “There are doctors who are saying that in a sneeze or some cough, some of the airborne particles can be infectious.” False.

U.S. Sen. Rand Paul, R-Ky., described Ebola as “incredibly contagious,” “very transmissible” and “easy to catch.” Mostly False.

Internet conspirators claimed President Obama intended to detain people who had signs of illness. Pants on Fire. Bloggers also said the outbreak was started in a bioweapons lab funded by George Soros and Bill Gates. Pants on Fire.

A Georgia congressman claimed there were reports of people carrying diseases including Ebola across the southern border. Pants on Fire. Sen. John McCain, R-Ariz., said Americans were told the country would be Ebola-free. False.

When combined, the claims edged the nation toward panic. Governors fought Washington over the federal response. The Centers for Disease Control and Prevention stumbled to explain details about transmission of the virus and its own prevention measures. American universities turned away people from Africa, whether they were near the outbreak or not.

The post went on to discuss the actual medical facts.

Not surprisingly the misinformation came from many of the usual subjects such as Fox and Republicans such as John McCain and Rand Paul. Their conspiracies theories also involved the usual subjects of right wing attacks like Barack Obama and George Soros.

At least one good thing did come about from the Ebola hysteria. Republicans, with the help of the NRA, had blocked the appointment of Vivek Murthy for Surgeon General for months. The Ebola outbreak placed increased attention on this vacancy and he was finally confirmed by the Senate today.