The President’s Speech

Live blog tonight. comment away.

Taegan Goddard has a partial transcript.

Notice the red, white and blue — Biden in blue, Pelosi in red, Obama in blue suit and red tie. Planned?

Well, you can sure tell where the Democrats are sitting in the audience.

“No one should be treated that way in the United States of America.” Amen.


1. No change for people who have insurance now. Repeat.
2. Insurance cannot be denied for preexisting condition.
3. Insurance companies cannot drop or reduce coverage people are paying for.
4. No annual or lifetime caps.
5. Limit on patients’ out of pocket expenses.
6. Checkups and preventive care will be covered.

Quality, affordable choice:

1. Insurance exchange. I’m not excited about the exchange. Tell me about the public option. Repubs are applauding the exchange.

2. Tax credits for low income insurance purchasers.

3. OK, I’m lost with the McCain thing. I’ll have to check that.

Oh, those risk-taking young folks who don’t buy insurance. Mandatory health insurance. I think that’s the only way any of this can work.

Key controversies. Death panels. Lie, plain and simple. Republicans not applauding. Look at those meatheads.

Who is yelling about the illegal immigrants?

Paying for abortion — under the bus. Sad.

PUBLIC OPTION. He finally mentions it.

Stress competition. Good point.

Not for profit public option. Must have. Less than 5 percent of Americans would sign up? Hmmm. Taxpayers not subsidizing. Option self-sufficient? Compare to public and private colleges. Good comparison.

Yeah, we’re open to other ideas, but the public option is a minimum.

“If Americans can’t find affordable coverage, we will provide you with a choice.”

“No government bureaucrat or insurance company bureaucrat will get between you and the coverage you need.”

Not one dime to deficit. OK.

Waste, fraud, abuse. Talk to seniors. Demagoguery and distortion. History of Medicare.

“Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.” I’m skeptical, but maybe it’s possible

“I don’t believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.” It isn’t, but even doctors believe it is. He’s throwing a bone to the Right.

Add it all up, and the plan I’m proposing will cost around $900 billion over ten years – less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration.

Let’s put that on a T-shirt.

Most of these costs will be paid for with money already being spent – but spent badly – in the existing health care system.


But know this: I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it.

The NY Times has the full transcript. Ted Kennedy comin’ up.

Obama is pulling the guilt strings. All you Republicans knew Ted Kennedy. Heh.

And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter – that at that point we don’t merely lose our capacity to solve big challenges. We lose something essential about ourselves.

He’s getting emotional.

What was true then remains true today. I understand how difficult this health care debate has been. I know that many in this country are deeply skeptical that government is looking out for them. I understand that the politically safe move would be to kick the can further down the road – to defer reform one more year, or one more election, or one more term.

But that’s not what the moment calls for. That’s not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when it’s hard.

Standing applause.

OK, that was the speech. I still don’t know what the yelling was about with the immigrants.

Rachel Maddow thinks we liberals will be happy with the latter part of the speech.

Republican Response:

First impression: Charles Boustany is less of a dork than Bobby Jindal.

Summary: Lies, lies, lies, lies, lies.

No insurance across state lines. It’s a scam.

Olbermann: Dr. Boustany has been sued for malpractice three times.

The yeller was Congressman Joe Wilson of South Carolina, who yelled “You lie!” when the President said there would be no coverage for illegal aliens.

The GOP Is Going to Get Somebody Killed

Just fistfights, so far.

Police broke up a raucous crowd outside a Tampa, Fla., town hall meeting on healthcare Thursday, and a fistfight broke out inside the meeting, witnesses said.

Hundreds of people turned out for the meeting at the Children’s Board of Hillsborough County, and people on opposing sides yelled and chanted outside, WTSP-TV, Tampa Bay, reported.

From what I can make out from news stories, people who showed up to stop the meeting were outraged that there were people there who actually supported health care reform and who got seats in the hall.

Congratulations, wingnuts. You’ve turned into the new DFHs.


Paul Krugman: “Art Laffer (why is he, of all people, on my TV?) asks what it will be like when the government runs Medicare and Medicaid.”

Really, he said that. Here’s the video.

And the dippy CNN moderator let it slide. Another genius.

In WaPo, John Bolton published a op ed titled “Clinton’s Unwise Trip to North Korea.”

Shortly after, we learned that Big Bill obtained the release of the two American journalists held by North Korea.

What’s Not to Like?

Matt Yglesias quotes a commenter at Marginal Revolution.

At birth, someone living in the Netherlands can expect to live 2.35 years longer than someone born in the US, but at age 65, the difference is reversed, and someone living in the US can expect to live 0.4 years longer than someone living in the Netherlands. This difference can be explained by assuming that semi-socialized health care is better for young and worse for old people, or, at least as likely, different policies are not the main cause of the difference.

Sources: CDC national vital statistics 2004, and RIVM 2007 levensverwachting, (in Dutch).

Matt jumps in and points out what was invisible to the commenter — after 65, Americans get health care through Medicare.

Americans over the age of 65 participate in a Canadian-style national health insurance scheme known as Medicare. The data, if we want to take it seriously, indicates that the Dutch system is better than private sector medicine but worse than Medicare and tends to support a “Medicare for all” approach.

In a recent post I cited an article in Roll Call that said states whose citizens have the least access to health care also have the highest Medicare costs, per person. The authors speculate that the bump in Medicare costs reflects lifetimes of health care neglect.

Put another way, if you want Medicare costs to go down, give people better health care in the first 65 years of their lives.

Regarding Medicare costs, Paul Krugman wrote recently,

Here’s the raw fact, from the National Health Expenditure data: since 1970 Medicare costs per beneficiary have risen at an annual rate of 8.8% — but insurance premiums have risen at an annual rate of 9.9%. The rise in Medicare costs is just part of the overall rise in health care spending. And in fact Medicare spending has lagged private spending: if insurance premiums had risen “only” as much as Medicare spending, they’d be 1/3 lower than they are.

How do these numbers not show us that Americans are getting substandard medical care? But as Jonathan Alter says, our current system is great! What’s not to like? (Read Alter before commenting.)

Astroturf Mobs Disrupting Town Hall Meetings

Visit for Breaking News, World News, and News about the Economy

Here’s the memo that Wolffe and Axelrod discuss in the video. It was leaked by a volunteer for FreedomWorks. Essentially, it’s a plan for manipulating stupid, fearful people to create the appearance of a huge, grassroots opposition to health care reform.

I had read news stories about mobs disrupting the town hall meetings of U.S. representatives, mostly Democrats. But this bit from Countdown last night was the first I’d heard that people were being bused around to disrupt the meetings. I’m not seeing much more about that this morning.

I surfed around this morning, and in a few news stories I found mention of a group called Americans for Prosperity doing at least some of this mob organizing. According to SourceWatch, AFP is an astroturf 501(c) organization established in 2003 and originally affiliated with Citizens for a Sound Economy. Citizens for a Sound Economy is a “think tank” established by the Koch Family Foundations, a major player in the right-wing think tank biz. Koch throws money at most of the big-name think tanks, including the Heritage Foundation, Cato, and the Manhattan Institute.

Citizens for a Sound Economy? According to People for the American Way,

FreedomWorks was formed with the 2004 merger of Citizens for a Sound Economy, headed by former House Majority Leader Dick Armey, and Empower America, co-founded by supply-side pioneer Jack Kemp, to push for lower taxes— especially on investment and inheritance— smaller safety-net programs, and fewer regulations on business and industry.

Essentially, in 2004 Citizens for a Sound Economy split into two groups, FreedomWorks and Americans for Prosperity, and the FreedomWorks part merged with Empower America.

SourceWatch says that FreedomWorks has been accused of being a “mouthpiece for hire,” taking on any cause it is paid to take on.

The smaller spinoff, AFP, does not disclose the identity of corporate donors (wanna bet there’s insurance company money involved?), but SourceWatch says AFP has received substantive grants from the Lynde and Harry Bradley Foundation and the Claude R. Lambe Charitable Foundation.

Last year AFP sponsored a hot air balloon cross-country tour with the slogan, “Global Warming Alarmism: Lost Jobs, Higher Taxes, Less Freedom.” Before that, they campaigned to oppose smoke-free workplace bans and cigarette excise tax increases (during which time it was learned AFP was getting money from big tobacco companies). Now it’s organizing protests of Democratic representatives to oppose health care reform and also “cap and trade” energy reform. As part of this, it has begun a “patient’s first” bus tour.

One suspects AFP is an astroturf-organization-for-hire. Special interest groups and corporations can pay them to organize protests against whatever reform they are trying to stop. Interestingly, there may be a connection between AFP and the infamous Mike Castle-birther lunatics episode, according to Think Progress. In that case, it seems the mob was supposed to protest Rep. Castle’s vote in favor of “cap and trade,” and it went off script.

Apparently the meetings are getting frightening. The Associated Press reports that after a recent meeting Rep. Tim Bishop, D-N.Y., needed a police escort to get to his car. If this continues, sooner or later somebody is going to be hurt. I say in the interest of public safety, town hall meetings could be held on the Web.

Update: See also —

FreedomWorks Orchestrates ‘Grassroots’ Movements To Serve Dick Armey’s Corporate Clients

More details on the “bus the mob” effort from Think Progress.

Katrina in Slow Motion

Steven Pearlstein, business columnist for the New York Times Washington Post, writes,

Among the range of options for health-care reform, there’s one that is sure to raise your taxes, increase your out-of-pocket medical expenses, swell the federal deficit, leave more Americans without insurance and guarantee that wages will remain stagnant.

That’s the option of doing nothing, letting things continue to drift as they have for the past two decades as we continue to search in vain for the perfect plan that would let everyone have everything they want and preserve everything they already have while getting someone else to pay for it.

So the next time you hear someone throwing a hissy fit because health reform might raise taxes on some people, or steer people into managed care, or require small businesses to contribute $2 a day for each employee’s coverage, just remember to ask yourself: And that’s compared with what?

I’ve seen projected costs for the status quo that are much higher than the projected costs of what the Right derides as “Obamacare,” yet somehow the people one sees on cable news are not worked up into a lather about the status quo costs. Just the costs of reform.

Meanwhile, one in six adult Americans have no health insurance. That doesn’t tell us how many millions more have insurance policies that will fail them if they get sick. I read about the Blue Dogs in Congress and Democratic obstructionists like Max Baucus, dithering around and picking the President’s plan to death because they are afraid of political fallout, and I want to break heads.

It’s like New Orleans after Katrina, when people were waiting on roofs to be rescued and the Bush Administration was preoccupied with how the hurricane might be used for political advantage. The lives of millions of Americans are forfeit to the whims of the insurance industry, and Baucus worries about “bipartisanship.” There are parents who daily watch their children struggle with health impairment without proper treatment, and the Blue Dogs dither. People are stuck in dead-end jobs and even marriages because they’re afraid of losing health benefits. And the Republicans scream that a national health care plan would deprive people of “liberty.”

It’s Katrina in slow motion, and we’re all New Orleans.

Bobby Jindal, Insurance Industry Shill

Since Bobby Jindal has about as much hope of being POTUS as I have of being Pope, I hope the insurance industry gave him a good tip for the pack of lies Jindal published in the Wall Street Journal today. He writes,

The left in Washington has concluded that honesty will not yield its desired policy result. So it resorts to a fundamentally dishonest approach to reform. I say this because the marketing of the Democrats’ plans as presented in the House of Representatives and endorsed heartily by President Obama rests on three falsehoods.

However, what Jindal doesn’t tell you is that he gets his “facts” about the Democrats’ plans from UnitedHealthcare, a health insurance company. Yep, the Lewin Group, which Jindal cites as the “study” claiming the public option will drive private insurance out of business, is a subsidiary of UnitedHealthcare, a fact Jindal does not disclose. The study was commissioned by the Heritage Foundation.

Jindal is especially pathetic, considering that the Lewin Group was outed by McClatchy as an insurance company front a couple of days ago.

Congressman Pete Stark of California fired back (page very slow to load):

“The Lewin Group is paid to produce estimates favorable to each client’s position. As a wholly owned subsidiary of UnitedHealthcare, the country’s largest private insurance company, the Lewin Group’s so-called ‘analysis’ is suspect. The Heritage Foundation got the study they paid for, but it is pure fiction.

“The Congressional Budget Office found that H.R. 3200 increases employer-sponsored insurance and less than 10 million people would choose the public health insurance option by 2019.”

Here’s a point-by-point comparison of the Lewin Group claims versus the CBO estimates.

The rest of Jindal’s carnival pitch is the usual right-wing blah blah blah — giving the poor “help in buying private coverage through a refundable tax credit,” for example. His solution for motivating insurance companies to provide more coverage for people with pre-existing conditions is “Reinsurance, high-risk pools, and other mechanisms can reduce the dangers of adverse risk selection and the incentive to avoid covering the sick.” Segregating people into high-risk pools is going to help them get affordable insurance, how?

Basically, Jindal’s op ed is all word salad; lots of the right buzzwords, but nothing that you could string together to make a coherent policy.

Update: see “Health Insurance Industry Spins Data in Fight Against Public Plan.”

Insurance Insurance

I have discovered a proposal for “fixing” health care on the Cato Institute website that is an absolute hoot.

The plan (see PDF) is to eliminate employee health benefit insurance and all government health care support, and throw everyone into the private insurance market. Insurance companies would be allowed to risk-rate premiums, so that as people got older and/or sicker their premiums would go up.

However, Cato says, this doesn’t have to be a problem. The solution is … wait for it … insurance insurance. They call it “health status insurance,” but essentially it’s insurance insurance. It’s a separate policy you take that will insure you against catastrophic increases in your health insurance.

I’m not kidding. That’s the brilliant plan.

Of course, the insurance insurance would only be reasonably priced if young and healthy people are willing to pay for it along with their regular health insurance premiums. And Cato is against any kind of mandates. But young people are certain to be willing to pay for two separate insurance policies to pay for health care, even if the second one isn’t something they think they will need for years. Wouldn’t they?

You can’t make this stuff up.

All Liberals Are the Same

Peter Singer is an Australian philosopher with a lot of provocative ideas. I don’t always agree with his ideas, although I don’t always disagree, either. He’s the sort of fellow who generates a perspective that’s interesting to think about, but I think sometimes he likes to say outrageous things just to stir the pot. He is alleged to have postulated that maybe it’s OK to euthanize handicapped infants, for example. I don’t know if that’s exactly what he said, and at the moment I’m not interested enough to check it out. However, one may be grateful he’s an academic and not actually in charge of anything.

Anyway, Singer wrote an op ed for the New York Times titled “Why We Must Ration Health Care.” The op ed is a philosophical exercise, not a policy proposal — Singer’s no economist or policy wonk — and he’s basically saying, here’s another way to think about this. His essential point is that people ought to own up to the reality that health care is a commodity with limits and is rationed. He makes the observation that U.S. health care is rationed now, by ability to pay.

Dr. Art Kellermann, associate dean for public policy at Emory School of Medicine in Atlanta, recently wrote of a woman who came into his emergency room in critical condition because a blood vessel had burst in her brain. She was uninsured and had chosen to buy food for her children instead of spending money on her blood-pressure medicine. In the emergency room, she received excellent high-tech medical care, but by the time she got there, it was too late to save her. …

…When the media feature someone like Bruce Hardy or Jack Rosser, we readily relate to individuals who are harmed by a government agency’s decision to limit the cost of health care. But we tend not to hear about — and thus don’t identify with — the particular individuals who die in emergency rooms because they have no health insurance.

This is an excellent observation. I have quibbles about some of Singer’s reasoning, and how he presents his ideas, but still, it’s thought-provoking. However, my first reaction to his headline was “Why Pete Singer Should Shut Up,” because I knew this would enflame the passions of the Right and throw them into a cage-rattling, feces-throwing fit. We don’t need any more of that now. And sure enough, a number of rightie bloggers are having hysterical fits about the headline, although so far none I have seen seem to have actually read Singer’s op ed.

For example, A.J. Strata writes, “Americans Have Succeeded Without Rationing Health Care.” Singer gave one example after another of the way Americans do ration health care, and in fact, ration it even more than the awful European countries with “government run” health care.

Far more Americans reported forgoing health care because of cost. More than half (54 percent) reported not filling a prescription, not visiting a doctor when sick or not getting recommended care. In comparison, in the United Kingdom the figure was 13 percent, and in the Netherlands, only 7 percent.

I take it A.J. didn’t get that far into the article, as he makes no attempt to address Singer’s point.

My favorite example of teh stupid, however, is American Power, which turned Singer’s headline into “Obama Will Ration Health Care,” because, you know, all liberals think alike. So whatever some Australian philosopher says must be what Barack Obama intends to do. Brilliant.