Pictured: a typical Mexican, as imagined by Lou Dobbs

“When this president and open-borders, illegal-alien-amnesty advocates say, ‘You can’t deport them,’ my answer is, ‘You wanna bet?’ Because this is the United States.”

Lou Dobbs on 60 Minutes, 2007

The only chance Lou had in politics was to keep blaming those sneaky Mexicans for everything from terrorism to leprosy, in order to cobble together enough Minuteman/nativist asshole votes in some lily white part of the country.

Now, that’s officially over.

Mr. Dobbs told Spanish-language network Telemundo he now supports a plan to legalize millions of undocumented workers, a stance he long lambasted as an unfair “amnesty.” [...] Mr. Dobbs twice mentioned a possible legalization plan for the estimated 12 million illegal immigrants in the U.S., saying at one point that “we need the ability to legalize illegal immigrants under certain conditions.”

Legalize illegals?! SHAMNESTY!!!1!1

This really sucks. I was looking forward to Dobbs and Tancredo competing for the “who hates brown people more” prize in the 2012 GOP primary.

A lot of people are asking why HCAN is spending money praising Blanche Lincoln this morning:

Health Care for America Now has launched new television ads praising the two Democratic senators from Arkansas and giving quiet support to Ben Nelson, the centrist Democrat from Nebraska.

HCAN, as the coalition is known, includes liberal groups such as Campaign for America’s Future and MoveOn.org and labor unions such as the AFL-CIO.

[]

Airing on broadcast and cable in Little Rock, Jonesboro, and Ft. Smith, that ad praises Lincoln and Pryor for standing up to health insurance companies.

Hmm….”standing up to health insurance companies.” Well, that is a bit of a stretch. Goldman-Sachs expects health insurance stocks to rise by 59% with no public option, but drop 36% if there is one to challenge their monopolies and help keep costs down. Blanche has taken over half a million dollars from insurance companies in campaign donations. She went on to the floor of the Senate and guaranteed them no public option by offering up a “ransom note” on the health care bill with her pledge to join a Republican filibuster. How that qualifies as “standing up” to them is anyone’s guess.

But they’re spending $175,000 in Arkansas. That will pretty much wallpaper the state with accolades for Lincoln for “standing up” to health insurance companies, when actually she pledged to filibuster the public option on Saturday.

People gave $10, $15, $20 from their social security and fixed income checks to help FDL Action PAC put up an ad in Arkansas in September telling Blanche Lincoln to “act like a Democrat, or we’ll find someone who will.” It wasn’t one of those cheap, shitty cable buys that raises a bunch of money and then spends only a small fraction of it on ads nobody ever sees. We raised $80,000 and spent more than that ($85,000, I believe) wallpapering the state with 1,000 points of prime time network buys for two weeks. The average person in Arkansas saw the ad 10 times. Our goal was to draw out primary challengers.

It was the talk of the state, it freaked Lincoln out, and PhRMA jumped in with an ad buy in her defense (which they put out through Americans for Stable Quality Care) the next week.

But if anyone is surprised that HCAN jumped in to undo all of that, they shouldn’t be. . . .  Blanche Lincoln is an incumbent. HCAN is an extension of the incumbency protection racket. They get their money because the Democratic Party and the White House direct donors to them for the purpose of using health care reform for political advantage. PhRMA has paid for their ad buys. Their job is to see that $80 million in health care reform money makes its way into the pockets of loyal Democratic operatives and makes it easier for Democrats to get reelected.

If left to their own devices, I think the people at HCAN would do the right thing. I don’t even think Richard Kirsch is venal, he’s just unbelievably stupid.

August 13:

“We are absolutely surprised at the way that the right focused so much on this as soon as August began,” said Richard Kirsch, campaign manager for HCAN.

November 18:

The push to provide late air cover comes after a bruising at the hands of the U.S. Chamber of Commerce, which has dumped a multimillion-dollar sum into ads, and the 60-Plus Association, a conservative seniors’ group.

“We were surprised by the scale,” said Richard Kirsch, national campaign manager for Health Care for America Now.

Really? The Chamber dropped $100 million on lobbying alone last year, and somebody is surprised they’re spending like drunken sailors against health care reform?

Because the unions are on the board and there was division in those ranks over how health care reform was going to go down, there were few opportunities to “do the right thing,” and when that happened, HCAN took them for optical reasons if nothing else. But their list of “accomplishments,” next to their stated goals, are pathetic.

Everyone bought into the “coalition” concept because that was where the money was going to flow, and they figured, well, better us than somebody else. But they did so at the price of their own personal credibility, and they’ll always have to wear that. Their concern for “health care reform” lasted only as long as there wasn’t money involved, and when millions of dollars entered the picture, most of their energies were spent trying to appear to be doing something they weren’t.

Remember Richard Kirsch’s “Guns of August?” How does protecting Blanche Lincoln from a primary challenge and insulating her from responsibility for shilling for insurance companies fit into that?

The whole “coalition” model is busted, at least as a vehicle for reform. As a way for Democratic operatives to get rich, it’s quite good. Same thing happened with AAEI and immigration. Tens of millions of dollars in foundation money from Atlantic Philanthropies, Robert Wood Johnson and Soros that was earmarked for non-partisan health care reform got shoveled out the door for attack ads against Republicans.

If HCAN’s ads on behalf of Lincoln were a surprise to anyone, they shouldn’t have been. They will continue to operate as part of the Democratic party infrastructure, try to kill primary challengers and move to protect their “own.” And that means Blanche Lincoln. If health care reform happens in the meantime, well, what a happy coincidence.

(photo via Billionaires for Wealthcare)

Scarecrow explains the importance of the public option for the financial future of this Nation here. He points out that employer-based insurance is shrinking, and we need a transition to some other system. The public option is just such a transition. Scarecrow points to this report from the Economic Policy Institute, based on Census Bureau data up to 2008, which tells us that the number of people covered by employer-sponsored insurance dropped from 64.2% in 2000 to 59.5% in 2008.

The facts support this survey. Three of the five largest health care companies have seen enormous drops in their employer based coverage in the last year:

Cigna: 800 thousand
Wellpoint: 1.5 million
UnitedHealth: 1.71 million

The insurers blame the drops on unemployment, and they expect that trend to continue.

Decreased membership is not a financial problem for the insurance companies, which are raising prices faster than the drops in enrollment. Cigna reported earnings of $1.19 per share in the third quarter compared with $.62 for the same period last year. This is much higher than expected.

UNH reports revenues of $.89 per share, also much higher than the expected. Revenues for the insurance subs were only down 3.4%, less than the drop in enrollment, so policy rates increased substantially.

Humana reported $1.77, in line with expectations. That includes unrealized investment losses of $69mn. About 30% of its health insurance is Medicare and other senior markets, making it different from the other companies. It just shows the value of depending on government subsidies through Medicare Advantage.

Aetna (AET) reported $.75 in earnings, substantially higher than expected. Its enrollment was up 7.7% over 3Q 2008, but down over 2Q 2009, and AET expects the downward trend to continue. Revenues were up 14.4%, almost double the increase in enrollment. I reported on Wellpoint earlier.

Employers will pass some or all of the rising costs on to their employees. As the number of people covered by employer insurance drops, prices will rise. Administrative costs are significantly higher for individuals than for employer based insurance. A study by the Congressional Research Service says that administrative expenses for large groups, over 1,000, are in the range of 5 -11% of claims, and in small groups, the range is 33-37% of claims. The range is at least that high for individual policies. As people shift from employer based insurance to individual policies, prices will rise dramatically, based strictly on increased administrative costs.

Administrative expenses in the public option are expected to be in the range of Medicare administrative costs, which Ezra Klein estimates at 5-6% of claims. This figure is higher than the usual figure of 2% because it includes outsourcing of certain costs. Lower administrative costs are an enormous improvement. It may be that access to the public exchange will result in somewhat lower administrative costs, even without a public option. But it is perfectly clear that the public option is the one thing that will make a real difference.

Phillip Carter

Phillip Carter helped found Iraq and Afghanistan Veterans of America after a tour of duty advising the Iraqi police in Baqubah. He wrote amicus briefs in two Supreme Court cases, FAIR v. Rumsfeld and Hamdan v. Rumsfeld, where the Court reined in the Bush Administration’s executive over-reach, and became a leading critic of their methods in the war on terror. When he was hired by the Defense Department in April to coordinate detainee policy and help with the closure of the Guantanamo Bay prison camp, civil liberties groups considered that the Obama Administration was moving in the right direction.

He abruptly resigned late last week:

A key official in the Obama administration’s effort to remake detention policy and close the military prison at Guantanamo Bay has resigned.

Phillip Carter, who was appointed deputy assistant secretary of defense for detainee policy in April, said in a brief telephone interview that he was leaving for “personal and family reasons” and not because of any policy differences with the administration. He tendered his resignation Friday, Pentagon officials said.

Carter, a lawyer and Iraq war veteran, was responsible for coordinating global policy on detainees.

“Family reasons” is a common excuse, and we’ll never know the real reasons for the resignation.

But this comes on the heels of the ouster of Gregory Craig as White House counsel, who was involved in the same area of policy, around Guantanamo and detainees. And his resignation has since led to informed speculation about the Administration’s troublesome record on civil liberties. Time Magazine’s long report about Craig’s tenure is a must-read to understand the dynamic. . . :

Interviews with two dozen current and former officials show that Obama’s public decision to reverse himself and fight the release of the [torture] photographs signaled a behind-the-scenes turning point in his young presidency. Beginning in the first two weeks of May, Obama took harder lines on government secrecy, on the fate of prisoners at Guantánamo Bay and on the prosecution of terrorists worldwide. The President was moving away from some promises he had made during the campaign and toward more moderate positions, some favored by George W. Bush. At the same time, he quietly shifted responsibility for the legal framework for counterterrorism from Craig to political advisers overseen by Emanuel, who was more inclined to strike a balance between left and right.

The unseen struggle took place in the spring, but the results are emerging now. On Nov. 13, Attorney General Eric Holder unveiled plans to try Guantánamo Bay detainees in federal courts, as preferred by liberals, but he also announced he would try other suspected terrorists using extrajudicial proceedings out of Bush’s playbook. The Administration is preparing to unveil its blueprint for closing the prison, but Obama will do so using some of the same Bush-era legal tools he once deplored.

Outside of the connection between “moderate positions” and George Bush, this is insightful, as is the whole article. And if it’s correct, a shift away from the rhetoric on which Obama ran in the campaign, and toward the actions of his predecessor, would surely have weighed on someone who ran Veterans for Obama and was a chief critic of Bush’s detainee policies. Someone like Phillip Carter.

If that’s the case, then I don’t think we’ve heard the last of him…

Health care non-expert Ron Brownstein of The Atlantic

Rahm Emanuel is making practically every staffer in the White House read Ronald Brownstein’s completely uninformed article about the great “free market economagic” cost saving solutions in the Senate bill. This explains a lot about why the current health care reform proposals are so bad. This is probably the single worst piece of news I have heard during the entire health care debate. If someone as powerful as Rahm thinks there is any value in Brownstein’s writing, reform is in very bad shape.

The problem is Brownstein just doesn’t understand health care systems. Take for example this jewel:

And, with only a few exceptions, that’s just about all the systemic reforms analysts from the center to the left have identified as the most promising strategies for changing the economic incentives in the medical system. (The public competitor to private insurance companies championed by the Left would affect who writes the checks in the medical system, but not what the checks are written to pay for.) Most of the other big ideas for controlling costs (such as medical malpractice reform) tend to draw support primarily among Republicans.

This one paragraph should show you how completely Brownstein lacks even the most basic knowledge about health care reform. The CBO concluded the Republicans’ “big idea” for controlling cost, extreme medical malpractice reform, would save/generate $54 billion for the Federal government. (I would challenge Brownstein to name another single Republican idea that would actually reduce cost, because they did not include any in their alternative bill two weeks ago, and I have heard of no others from them.) Let’s compare this to the public option.

According to the CMS, the strong public option (which paid Medicare rates plus 5%) promoted by House progressives would have costs 18% below that of private health insurance companies. The CBO concluded it would have saved $110 billion. This public option design was still considered weak by reform activists. Mandating that Medicare providers take part in the public option would have saved another $91 billion. If the public option could pay Medicare rates instead of Medicare rates plus 5%, that would have saved roughly another $50 billion. These savings are with the public option only being available to the small number of people on the new exchange.

Allowing every company to buy into this super-robust public option would give them a choice that would be roughly 20% cheaper than their current insurance plan. If even some of those savings were passed on to employees in the form of higher salaries, that would translate into hundreds of billions in increased tax revenue. This one progressive idea, which could save about $250-800 billion, is bad mouthed by Brownstein, yet he claims the Republicans continuous screaming about tort reform, which would save only $54 billion, is one of the “big ideas” for controlling costs.

The Senate bill would make some cost saving baby steps away from fee-for-service medicine, but this is not the real way to get serious about cost control. This is just “reform” to make believers in “free market economagic” happy. If Brownstein really wants to know why the rest of the industrialized world spends about half of what we do on health care (on a per capita basis), I have a nine step solution:

Step 1: Call the German Ministry of Health.
Step 2: Ask why they spend so much less on health care.
Step 3: Call the French Ministry of Health.
Step 4: Ask why they spend so much less on health care.
Step 5: Call the Japanese Ministry of Health.
Step 6: Ask why they spend so much less on health care.
Step 7: Call the Belgian Ministry of Health.
Step 8: Ask why they spend so much less on health care.
Step 9: Repeat Steps 1 thru 8 with as many countries as needed. 

What these countries all have in common is a single reimbursement rate negotiator. It is either a government agency or regulated cabal of all insurance providers that set most reimbursement rates. That is why they pay so much less for everything. They pay 30%-500% less for doctor visits, hospital stays, drugs, lab tests, procedures, etc. Our insane system of hundreds of insurers secretly negotiating reimbursement rates individually with thousands of providers and manufactures is a recipe for administrative waste, inefficiency, higher prices, and more expensive care.

The number one reason we pay so much more for health care has nothing to do with overusing care because of a fee-for-service system. It is just that the “fee” we pay for those services is so dramatically higher than any other nation’s.

It is not just what the public option’s “checks are written to pay for.” The hope was the public option could negotiate better rates, and therefore write smaller checks. It could create system-wide change if other insurers followed suit.

This line from Brownstein is just comically wrong:

And, with only a few exceptions, that’s just about all the systemic reforms analysts from the center to the left have identified as the most promising strategies for changing the economic incentives in the medical system.

Take, for example, the sweetheart PhRMA deal preventing almost any savings from the drug industry. We spend about $200 billion a year on prescription drugs in this country. We spend roughly 20% more per capita on drugs than the second highest country, France, and roughly twice as much as most european countries. If we implemented progressive solutions like drug reimportation and allowing Medicare to directly negotiate for drug prices, that would save at least a hundred billion bucks. If we allowed the government to negotiate drug prices for everyone in the country, like most countries do, we should at least be able to get our per capita spending on drugs to a level similar to Canada. That would be roughly half a trillion dollars in savings on drugs over only the next 10 years.

There is a wealth of progressive cost control solutions that were not even considered in Congress. All told, they would have saved our country trillions over the next decade. On the other hand the Senate bill makes only tiny steps to slightly reduce over-utilization. Brownstein does the nation a disservice by publishing this article while completely ignoring the real cost issue. Rahm Emanuel commits a near-criminal act by making people at the highest levels of our government read this article as if it had any value. No wonder the health care reform plans have been so bad so far. With the reform effort led by fools who don’t even understand the nature of the problem, it is no wonder existing proposals contain almost no real solutions.

Remember all that “sexist!” outrage about the Palin Newsweek cover? Doesn’t apply here.

Of course I’m aware that neither radio host is suggesting that Landrieu actually traded sex for $300 million. I get that it’s a metaphor. But its a misogynist one that never gets applied to male senators. It works by making her political capacity a function of her gender, and then marginalizing that gender by reducing her legitimate actions to a mutually exploitative sexual transaction. That’s not something men in politics get accused of when they bargain on behalf of their underprivileged constituents.

IOKIYAR.

A group of conservative Republican leaders is proposing a solution to the internecine warfare over what the party should stand for: a 10-point checklist gauging proper adherence to core principles like opposing government financing for abortion and, more generally, President Obama’s “socialist agenda.”

Oh, they’re makin’ a list
won’t edit it twice,
gonna find out
who’s crazy and white
Righty Clause is comin’
to town…

Ah yes, the ultimate litmus test. How quaint. Presciently, Pudentilla at Skippy summed the list up best:

definitions
an american conservative is someone who believes that

a) the vatican ought to decide our domestic policy;
b) israel ought to decide our foreign policy;
c) communist china ought to decide our economic policy; and
d) osama bin ladin ought to decide who gets tried in our courts.

The Blues Brothers Band –  Rubber Biscuit live on New Years Eve, 1978, at Winterland in San Francisco, CA.  TBBB were featured along with The New Riders of The Purple Sage and The Grateful Dead at this show, the final Winterland concert.

What’s on your mind?

Let’s talk turkey (Limbaugh) and dinner (tonight’s State Dinner at the White House), which pretty much will be over by the time we’re chatting away.

Conservative blowhard Rush “Limburger Windbag”Limbaugh claims Obama is hijacking Thanksgiving,

a uniquely American holiday

by holding the grand event, his first State Dinner–gasp–two days before the cranberry sauce gets served and Uncle Frank shreds the turkey with grand ceremony. And even more appalling, implies Rush, it’s for India! And then he goes on to gargle that the only reason it’s not being held

on Wednesday or even Thursday is the Indian Prime Minister must have to get back home to deal with the nukes in Pakistan

Gosh Rush, you should know that India is the world’s largest democracy, and is critical in stabilizing Afghanistan, where we’ve announced we’re sending 35,000 troops to

finish the job

. That make it’s a better choice than oh, say France, who Rush hates. Or just about any other country. Because no matter who was the guest, Rush would bitch like a mother-in-law over lumpy gravy because the host is Obama.

Indian Prime Minister Manmohan Singh will be joined by a large yet select group of politicians including Claire McCaskil, Jim McDermott, and John Kerry; Hollywood luminaries Steven Spielberg, David Geffen and Jeffrey Katzenberg, along with Gayle King (what, no Oprah!? That’s right, NO Oprah!), Alfre Woodard, Katie Couric, Brian Williams and Robin Robert.

Also on the list noted guests with ties to India like Obama’s original choice for the post of U.S. surgeon general/CNN Medical Correspondent Sanjay Gupta, Deepak Chopra, director M. Night Shyamalan and Kalpen Modi, Associate Director, Office of Public Engagement, aka the actor Kal Penn, aka Kumar of Harold and Kumar fame. Oh and really cool–Jennifer Hudosn will be singing!

The dinner takes place in a huge tent on the South Lawn, and guest will dine on Indian influenced dishes with choices for vegetarians and vegans. The menu includes a salad of arugula grown in the White House garden, potato and eggplant salad, red lentil soup with fresh cheese, and potato dumplings with tomato chutney. Entrees are a choice of chick peas and okra or green curry prawns, served with caramelized salsify, smoke collard greens and coconut aged basmati.

For dessert? Pumpkin pie and pear tartin, followed by coffee with petit fours, cashew brittle, pecan pralines, passion fruit and vanilla gelees, and chocolate dipped fruit. Each course is paired an American white wine.

So what’s on your menu? And really, what leftover recipes do you have in mind?

The president, I think, is going to have to tell the left wing of his party and the balking liberal Senators that it is crazy to pull down the entirety of health care over this one issue which the president has already said is not the be all end all of health reform.

…And in print:

[M]y concern about letting the public option jeopardize health reform is precisely because I think that expanding access to health care is such a moral imperative.

The problem is that Marcus and all the other public-option-doesn’t-matter wankers are conflating “health care” with “health insurance.”  Sure, if we have mandates without a public option, lots of people will have insurance, but it’ll be overpriced crap with steep deductibles and lousy coverage.  Forcing people to buy shitty insurance they can’t afford doesn’t sound like much of a moral imperative to me, but then I’m not Ruth Marcus.  Or an insurance company.

Everyone agrees that not enough people have insurance, but it’s the details where the devil is.  To rip off recycle quote a post I wrote back at my place a few months ago:

Progressives: There are 45 million people in this country without health insurance!  This is an outrage!

Insurance Industry: There are 45 million people in this country without health insurance!  This is an outrage!

Everyone agrees that there are too many uninsured, but where progressives see pain and death and need, insurance companies and their allies see untapped bank accounts and retirement funds.  Progressives want to help the uninsured, insurance companies want to milk them.  And the Ruth Marcuses of the world can’t tell the difference.