PERRspectives tag:www.perrspectives.com,2009-01-17:/blog//2 2009-11-08T00:30:25Z Movable Type Pro 4.23-en This is an XML content feed. It is intended to be viewed in a newsreader or syndicated to another site. Gingrich and Perry Tout Texas Health Care Mess tag:www.perrspectives.com,2009:/blog//2.1661 2009-11-06T22:19:12Z 2009-11-08T00:30:25Z Everything, they say, is bigger in the Texas. So it is with the failure of the health care system. Leading the nation with a jaw-dropping 25% of its residents uninsured, Texas ranked 46th in the Commonwealth Fund's 2009 scorecard of... Jon Perr http://www.perrspectives.com/ Everything, they say, is bigger in the Texas. So it is with the failure of the health care system. Leading the nation with a jaw-dropping 25% of its residents uninsured, Texas ranked 46th in the Commonwealth Fund's 2009 scorecard of state health care performance. All of which makes today's op-ed by Newt Gingrich and Governor Rick Perry touting the mess in Texas all the more puzzling.

Just two days after the CBO dismissed a House Republican plan that would barely dent the rolls of the uninsured, Perry and Gingrich blasted Democratic health care reform in a Washington Post screed titled, "Let States Lead the Way." Besides dredging up Newt's worn out 1990's vintage talking points on unfunded mandates, the duo insist it is the Lone Star State which should be at the front of that vanguard:

Texas, for example, has adopted approaches to controlling health-care costs while improving choice, advancing quality of care and expanding coverage. Consider the successful 2003 tort reform. Fewer frivolous lawsuits have attracted record numbers of doctors to the state as medical malpractice insurance premiums dropped by half. Christus Health, a large Catholic nonprofit system with a significant presence in Texas, spent about $100 million on liability defense payments in 2003. Last year, Christus spent $2.3 million on such payments. Much of that savings has gone into expanding health-care services in low-income neighborhoods.

As the Post's Erza Klein asks, "how's that working out?"

The answer, of course, is quite poorly. While from 2007 to 2009 Texas nudged its way from a horrific 48th to a merely miserable 46th in the Commonwealth Fund rankings, the health care system there remains an ongoing calamity for its residents. Among the poster children for the failure of red state health care, Perry's state brought up the rear across the five indicators measured. When it comes to health care access and equity, Texas is dead last.

While it is predictable that Republicans Gingrich and Perry cite Texas' draconian tort reform law as an example for the nation, the data is far from clear as to its benefits in actually reducing malpractice premiums, lowering costs and attracting physicians to the underserved state.

As I previously noted in "Republican Malpractice Myths," it comes as no surprise that a cavalcade of GOP leaders, including Perry, Sarah Palin, John Cornyn and John Kyl cited the same study showing malpractice awards caps enacted in 2003 in Texas fueled an increase in the number of physicians in the Lone Star State:

According to the Pacific Research Institute, medical licenses in Texas have increased 18 percent in the last four years, with 7,000 new doctors moving to the state.

The actual impact of the Texas law, however, remains in dispute. The state's rising population, its 48th place ranking in physicians per capita, its staggering percentage of uninsured, its lack of an income tax and the 147% jump in malpractice premiums in 2003 alone make gauging the unique contribution of malpractice caps difficult to assess. Regardless, health care costs in Texas have continued their upward spiral.

What seems beyond dispute is that other similar malpractice cap states like Mississippi have not seen an influx of new doctors. The Jackson Free Press took exception to Governor Haley Barbour's claim that tort reform meant that physicians "have quit leaving the state and limiting their practices to avoid lawsuit abuse":

But non-partisan facts show that doctors were never really leaving the state in the first place. A 2003 Government Accountability Office report, "Medical Malpractice: Implications of Rising Premiums on Access to Health Care," took a hard look at five medical "crisis" states--Mississippi, Nevada, Pennsylvania, West Virginia and Florida--and dismissed reports of doctor emigration from states.

Information compiled by the American Medical Association--which supports tort reform and President Obama's vision of health reform--shows that the number of physicians in Mississippi rose steadily in years leading up to tort-reform legislation in 2004, and even slowed its increase following 2004.

From 2004 to 2005, the state actually recorded no increase over the 5,872 doctors counted in 2004, and added only 18 new physicians in 2006. The year 2007 reflected an increase of 71 physicians--still less than the 145-increase between 2000 and 2001 and the 99-doctor increase between 1998 and 1999. Even the time between 2002 and 2003--arguably the years of the worst tort abuse, according to tort-reform proponents--experienced a growth in the state doctor population of 140.

Ironically, to the degree that Texas and other red state bastions of medical misery have made minor improvements in recent years, the credit in large part goes to the federal government and the expansion by Democrats of initiatives like the State Children's Health Insurance Program (SCHIP). As the Commonwealth Fund concluded its 2009 study:

The 2009 State Scorecard paints a picture of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs. On a positive note, there were gains in children's coverage as a result of national reforms, and improvement in some measures of hospital and nursing home care following federal efforts to publicly report quality data.

In a final irony, as Klein suggests, there is a Republican Governor with whom Gingrich could have partnered to make the case for the states as the laboratories of health care reform: Mitt Romney. Thanks to its own insurance mandate passed during Mitt's tenure, the percentage of uninsured in 6th ranked Massachusetts has dropped to 3%. But as Klein muses:

Romney, however, disowned his bill after he realized the Republican base didn't like health-care reform.

Regardless, when it comes to a model for reforming the U.S. health care system, don't mess with Texas.

]]> http://www.perrspectives.com/blog/archives/001661.htm Pat Boone and the Right-Wing War on the AARP tag:www.perrspectives.com,2009:/blog//2.1660 2009-11-05T19:06:33Z 2009-11-05T19:22:51Z Back in 2003, Republican leaders praised the AARP for its support of President Bush's unfunded and deeply flawed Medicare prescription benefit. But now that the 40 million member organization has endorsed the House Democrats' health care reform bill, the GOP... Jon Perr http://www.perrspectives.com/

Back in 2003, Republican leaders praised the AARP for its support of President Bush's unfunded and deeply flawed Medicare prescription benefit. But now that the 40 million member organization has endorsed the House Democrats' health care reform bill, the GOP is declaring war on its one-time ally. Helping lead the attack is an array of industry-funded front groups and their reactionary has-been spokesmen like Pat Boone.

Last week, Republican Congressmen Dave Reichert (R-WA) and Mike Pence (R-IN) implied the nation's leading organization for seniors was in for the ACORN treatment from the GOP and its media allies. Despite the thorough debunking of right-wing claims that Democratic health care reform proposals would slash Medicare benefits for46 million American elderly:

Pence and Reichert suggested that support was the result of corruption inside the AARP and not based on the interests of its membership.

"What you've got here is a backroom deal," Pence said of reform measures expected to be introduced by Senate Majority Leader Harry Reid this afternoon. "Democrats are protecting the salaries of the heads of groups like AARP while cutting Medicare"...

The GOP is using more than just rhetoric to go after the group. Rep. Dave Reichert (R-WA) claims to have launched an investigation into AARP in his home state. Reichert says his "ongoing" investigation focuses on whether AARP should be classified as an insurance company because of its revenue from royalties the group gets from licensing its brand for insurance products.

Sounding the clarion call for conservatives is aging singer turned World Net Daily regular Pat Boone. Boone, who in recent months branded Barack Obama a "president without a country" who is "waterboarding America" over "socialistic health care and a host of other ultraliberal causes," is also the celebrity mouthpiece for the 60 Plus Association.

When Pat Boone isn't proposing the metaphorical gassing of "all manner of parasites, vermin, roaches, rats, worms and termites" of President Obama and his team in the White House, he's leading the charge for the self-proclaimed right-wing alternative to the AARP:

The 60 Plus Association is a non-partisan seniors advocacy group with a free enterprise, less government, less taxes approach to seniors issues. 60 Plus has set ending the federal estate tax and saving Social Security for the young as its top priorities. 60 Plus is often viewed as the conservative alternative to the American Association of Retired Persons (AARP).

Of course, the 60 Plus Association is non-partisan in much the same way that bricks float. As SourceWatch, Rachel Maddow and FireDogLake all documented, "60 Plus has been a front group for the pharmaceutical industry since its inception." As Greg Sargent detailed, Boone's group, led by president and long-time Bush supporter Jim Martin, in 2005 backed Social Security privatization. Now, the 60 Plus Association with $2 million in funding from Big Pharma is producing ads and distributing direct mail with fabricated health care reform horror stories designed to scare the bejesus out of America's seniors.

As Maddow and FDL related, 60 Plus is tightly integrated into the usual suspects of right-wing astro-turfing, including FreedomWorks, the Tea Party movement, Bonner & Associates and even Jack Abramoff. And virtually all of its political skullduggery is funded by its friends in pharmaceutical lobby:

In 2002, 60 Plus received 91% of its total revenue - $11 million dollars - from one undisclosed donor, which the Washington Post reported lined up perfectly with "an unrestricted educational grant" to 60 Plus from PhRMa, the drugmaker lobby group. Jim Martin, the 60 Plus President, has acknowledged in interviews that it received money from pharmaceuticals, saying "I wish it was more."

As it turns out, Pat Boone and the 60 Plus Association aren't the only ones doing the Republican Party's dirty work in trying to kill health care reform. The American Seniors Association (ASA) and former Hollywood Squares host Peter Marshall, another group with another D-List celebrity front man, is trying to do the same thing.

The ASA garnered the spotlight in August when CBS News highlighted the organization in a fawning segment titled, "Thousands Quit AARP over Health Care Reform." But while noting ASA's aspiration to be the "conservative alternative" to the AARP, CBS' Sharyl Attkisson did nothing to research either the group's background or its claims.

While parroting the ASA's claim that the Obama plan "calls for $313 billion dollars in Medicare cuts over ten years," CBS provided neither context nor fact-checking. As Politifact examined in detail, President Obama is proposing $177 billion in savings from the private Medicare Advantage program, which "costs taxpayers on average of 14 percent more than the traditional Medicare plan." As Marc Steinberg of Families USA noted, "The core benefits of Medicare won't change." Just as important, Obama has pledged to reduce the notorious - and financially devastating - "donut hole" in the Bush Medicare drug plan.

Which is why the AARP is not falling for the Republicans' scare tactics. The organization's vice president for social impact noted, "AARP has not endorsed any plan at this point." As CBS reported:

Yet the AARP's Cheryl Matheis couldn't find anything to quibble with, including the Medicare cuts which she says will not affect benefits.

Of course, the CBS story wasn't really about health care. Instead, it was about the reactionary free-market conservative agenda and Republican scorched earth opposition to Barack Obama at all costs.

A little digging into Stuart Barton's 60,000 member American Seniors Association would have made that clear. Founded in 2005 by Barton's father Jerry as the National Association for Senior Concerns (NASCON), the group targeted the "radical agenda" of the AARP. Topping its program is Social Security privatization, hard-line opposition to immigration reform, and an overhaul of Medicare, which Barton deemed "the most abused and wasteful of all federal programs that could be bankrupt even before Social Security." As its press page shows, the ASA is a right-wing talking point regurgitation machine:

"On page 425 of the bill, a person must go to counseling every five years to basically learn how to die," Barton says. "As I read this and hear about no preventative care, it dawned on me that Obama's plan is to let all these baby boomers die quicker so we don't have to care for them in old age."

The ASA's "Four Pillars," also extolled by former Hollywood Squares game show host and honorary chairman Peter Marshall, are a hardliner's dream and a senior citizen's nightmare:

  1. Medicare Reform: This most abused and wasteful of all federal programs could be bankrupt before the Social Security System runs dry!

  2. Social Security Reform: Voluntary personal accounts safe from government meddling must be approved providing senior citizens options and keeping the system solvent.

  3. Illegal Aliens: Lawbreakers do not deserve Social Security payments intended for you and your family who are citizens.

  4. Tax Reform: An easily understood and simplified tax code in the form of the Fair Tax.

As that laundry list makes clear, the American Seniors Association like the 60 Plus Association cares less about the needs of America's elderly and more about the agenda of the right-wing of the Republican Party.

Meanwhile to President Obama's obvious delight in Washington, AARP CEO A. Barry Rand announced his group's backing of Democratic health care reform:

"AARP is proud to endorse the Affordable Health Care for America Act. We urge members of the House to pass this critical bill this year so our healthcare system can work for all of us."

No doubt, Pat Boone and his reactionary backers won't be happy. It's only a question of time before he calls for the "tenting" of the AARP.

]]> http://www.perrspectives.com/blog/archives/001660.htm Cheney Turns to Sgt. Schultz Defense in Plame Case tag:www.perrspectives.com,2009:/blog//2.1659 2009-11-03T19:18:24Z 2009-11-03T19:28:35Z During the controversy over the Bush administration's prosecutor purge in 2007, former Attorney General Alberto Gonzales raised selective amnesia to an art form. In one single day of Congressional testimony, Gonzales uttered some variant of "I don't recall" 64 times,... Jon Perr http://www.perrspectives.com/

During the controversy over the Bush administration's prosecutor purge in 2007, former Attorney General Alberto Gonzales raised selective amnesia to an art form. In one single day of Congressional testimony, Gonzales uttered some variant of "I don't recall" 64 times, including the comical, "Senator, that I don't recall remembering." Now with the release of the notes from his 2004 interview with the FBI in the Scooter Libby case, it turns out Dick Cheney's memory is even worse.

Like Gonzales, Vice President Cheney turned to the "Sgt. Schultz Defense." Like the hapless Hogan's Heroes prison guard who routinely protested, "I know nothing - nothing!" Cheney on 72 different occasions in the 28 page FBI summary claimed he could not recall virtually anything about the retaliation against Ambassador Joe Wilson that led to the outing of covert CIA operative wife, Valerie Plame.

As Citizens for Ethics and Responsibility in Washington (CREW) put it, the group whose lawsuit triggered the release of the FBI interview notes, "Cheney 'cannot recall' almost anything about Plame outing." Nick Baumann, writing in Mother Jones, documented "22 Things Dick Cheney Can't Recall About the Plame Case."

Among the instances of Cheney's feigned ignorance large and small is a temporary bout of just-time Alzheimer's when it came to his own notes in response to Wilson's infamous July 6, 2003 about supposed yellow cake in Niger. He had no memory of the questions he scrawled on a copy of Wilson's piece, including the question, "did his wife send him on a junket?"

When asked about Wilson's New York Times editorial of July 6, 2003, Cheney stated that he was "relatively certain he spoke to someone about the article, but he cannot recall exactly who it was." Even when shown a copy of the editorial with notes in his own handwriting in the margin, he indicated "he has no specific recollection of when he wrote the notes" and that "he cannot recall if he discussed the underlined portions of the editorial with any one."

Even more important, as FireDogLake documented in detail, Cheney played dumb about his role in the selective declassification of the 2002 National Intelligence Estimate (NIE) on Iraq. Libby and his administration allies had used the NIE piecemeal to counter Wilson's charges in the press, but as Mother Jones pointed, Cheney claimed to the FBI not to remember:

  • Having a conversation with Libby during which Libby said he wanted to share the judgments of the National Intelligence Estimate with Judith Miller.

  • Whether Libby told him that certain material in the NIE had to be declassified before it could be shared.

Sadly for Vice President Cheney, we know this happened, because Scooter Libby himself said so during his prosecution by Patrick Fitzgerald. As Murray Waas wrote in the National Journal on April 14, 2006 in a piece titled "Cheney Authorized Leak Of CIA Report, Libby Says":

Vice President Dick Cheney directed his then-chief of staff, I. Lewis "Scooter" Libby, on July 12, 2003 to leak to the media portions of a then-highly classified CIA report that Cheney hoped would undermine the credibility of former Ambassador Joseph C. Wilson, a critic of the Bush administration's Iraq policy, according to Libby's grand jury testimony in the CIA leak case and sources who have read the classified report.

As the National Journal's Waas reported two months later on July 3, 2006, it was President Bush himself who confirmed to Fitzgerald that he asked Cheney to lead the counterattack on the Wilsons:

President Bush told the special prosecutor in the CIA leak case that he directed Vice President Dick Cheney to personally lead an effort to counter allegations made by former Ambassador Joseph C. Wilson IV that his administration had misrepresented intelligence information to make the case to go to war with Iraq, according to people familiar with the president's interview.

Bush also told federal prosecutors during his June 24, 2004, interview in the Oval Office that he had directed Cheney, as part of that broader effort, to disclose highly classified intelligence information that would not only defend his administration but also discredit Wilson, the sources said.

But Bush told investigators that he was unaware that Cheney had directed I. Lewis "Scooter" Libby, the vice president's chief of staff, to covertly leak the classified information to the media instead of releasing it to the public after undergoing the formal governmental declassification processes.

Cheney's total no-recall goes on and on. While Cheney at worst may have lied to federal investigators, at best he left his former chief-of-staff twisting in the wind. As the Washington Post noted:

In many cases, Cheney appeared to leave his chief of staff exposed on damaging admissions that Libby and others had made in the grand jury. Though his memory was hazy on many other things, he said he was certain he had heard no report of Libby's conversations about Plame with Rove, White House spokesman Ari Fleischer or Undersecretary of State Marc Grossman.

Guilt, both his own and that he felt over Libby's subsequent conviction, may be behind his lobbying for Libby's pardon that continued through the final hours of the Bush presidency. Regardless, to ensure the "cloud over the vice president" doesn't dissipate, Dick Cheney will continue to insist he knows nothing.

Just like Sgt. Schultz.

]]> http://www.perrspectives.com/blog/archives/001659.htm The Hatch Truth: GOP Blocking Health Care to Prevent Permanent Democratic Majority tag:www.perrspectives.com,2009:/blog//2.1658 2009-11-03T01:41:53Z 2009-11-03T02:06:44Z A gaffe, Michael Kinsley famously mused, is what results when a politician inadvertently tells the truth. And so it was Monday when Utah Republican Senator Orrin Hatch came clean about his party's scorched-earth opposition to health care reform being championed... Jon Perr http://www.perrspectives.com/

A gaffe, Michael Kinsley famously mused, is what results when a politician inadvertently tells the truth. And so it was Monday when Utah Republican Senator Orrin Hatch came clean about his party's scorched-earth opposition to health care reform being championed by President Obama and Congressional Democrats. Hatch acknowledged, as I've long argued, that the GOP is worried not that Obama's health care initiatives might fail, but that they might succeed.

As he did in his pivotal effort to block Bill Clinton's health care efforts starting in 1993, conservative strategist Bill Kristol warned his Republican allies then as now that that a victory for President Obama would earn his party the thanks of a grateful public and guarantee Democratic majorities for the foreseeable future. In an interview with CNS Monday, Senator Hatch revealed that was his darkest fear as well:

HATCH: That's their goal. Move people into government that way. Do it in increments. They've actually said it. They've said it out loud.

Q: This is a step-by-step approach --

HATCH: A step-by-step approach to socialized medicine. And if they get there, of course, you're going to have a very rough time having a two-party system in this country, because almost everybody's going to say, "All we ever were, all we ever are, all we ever hope to be depends on the Democratic Party."

Q: They'll have reduced the American people to dependency on the federal government.

HATCH: Yeah, you got that right. That's their goal. That's what keeps Democrats in power.

Of course, President Obama and the Democratic Party have no interest in fostering dependency among Americans, but instead seek to remedy the crippling health care crisis which threatens their financial security and the nation's future. As with their staunch opposition to Social Security and Medicare, programs which dramatically reduced poverty among the elderly, Republicans now want to stop at all costs the third pillar of the Democratic social contract.

For that, grateful American voters would doubtless reward Democrats at the polls. On that point, Orrin Hatch is absolutely right. And, for once, telling the truth.

]]> http://www.perrspectives.com/blog/archives/001658.htm Bush's Iron Law of Bin Laden Still Holds tag:www.perrspectives.com,2009:/blog//2.1657 2009-11-02T18:22:19Z 2009-11-02T18:43:30Z Like a broken clock, even George W. Bush can be right twice a day. And so it was with his pronouncement on the fate of Obama Bin Laden before a weekend conference of business leaders in New Delhi, "I guess... Jon Perr http://www.perrspectives.com/ Like a broken clock, even George W. Bush can be right twice a day. And so it was with his pronouncement on the fate of Obama Bin Laden before a weekend conference of business leaders in New Delhi, "I guess he is not dead." But the 43rd president wasn't merely stating the obvious regarding the Al Qaeda chieftain who escaped his under-resourced effort in Afghanistan. As it turns out, Dubya even out of office is following the same playbook he used in it: the threat posed by Bin Laden is directly proportional to the threat to President Bush's political standing. Call it Bush's "Iron Law of Bin Laden."

Bush's nonchalance this weekend reflects the simple fact that the danger posed by the 9/11 mastermind can no longer help - or hurt - him politically:

Asked whether al-Qaida chief Osama bin Laden could be alive, Bush said "I guess he is not dead."

He, however, noted that Laden is hiding and "not leading victory parades" or "espousing his cause" on TV.

He expressed confidence that Laden will be brought to justice which "he deserves to be" and it was a matter of time.

But it was a different picture indeed in the wake of revelations that President Bush had authorized illicit surveillance of Americans by the NSA. Trying to fight back the growing public outcry over his illegal domestic wiretapping program, President Bush used the Bin Laden bogeyman once again during his remarks in January 2006 at the National Security Agency. Bush lashed out at his critics:

"All I would ask them to do is listen to the words of Osama bin Laden and take him seriously. When he says he's going to hurt the American people again, or try to, he means it. I take it seriously, and the people of NSA take it seriously."

Bush, of course, did not take Bin Laden seriously in four years previously. Questioned about his silence regarding Bin Laden in the months following the American failure to capture the Al Qaeda chieftain in Tora Bora, Afghanistan, a nonchalant Bush on March 13, 2002 downplayed his significance:

"So I don't know where he is. You know, I just don't spend that much time on him, Kelly, to be honest with you...I'll repeat what I said. I truly am not that concerned about him."

Bush may have been embarrassed by his failure to capture Bin Laden in 2002, but by the fall of 2004, he faced the prospect of American voters who seemed to recall the murder of 3,000 of their countrymen. In the third presidential debate with John Kerry, a childlike Bush on October 13, 2004 tried for a "do over" of his statement two and a half years earlier:

"Gosh, I just don't think I ever said I'm not worried about Osama bin Laden. It's kind of one of those exaggerations. Of course we're worried about Osama bin Laden."

Which brings us full circle. In the aftermath of 9/11, President Bush used the specter of Osama Bin Laden to rally what had been a faltering presidency. In a show of frontier bravado, Bush talked tough about Bin Laden just days after the 9/11 attacks:

"There's an old poster out west, as I recall, that said, 'Wanted: Dead or Alive.'"

Ultimately, Bush later insisted, he came to regret "using bad language" like "dead or alive" or "bring 'em on." (That begrudging concession followed his stunning April 2004 declaration that " I'm sure something will pop into my head here...maybe I'm not as quick on my feet as I should be in coming up with one" when asked to name his biggest mistake as president.) But President Bush seems blissfully unconcerned about his failure to capture or kill Osama Bin Laden, as his latest pooh-poohing shows. After all, George W. Bush doesn't need him anymore.

UPDATE: For older readers, Bush's recent announcement may sound like Chevy Chase's 1970's routine on Saturday Night Live, "Generalissimo Francisco Franco is still dead."

]]> http://www.perrspectives.com/blog/archives/001657.htm Jeb Bush's Brother and the GOP Attack on U.S. Capitalism tag:www.perrspectives.com,2009:/blog//2.1656 2009-11-02T02:24:21Z 2009-11-02T02:56:19Z On Wednesday, former Florida Governor Jeb Bush doubtless pleased his audience at the U.S Chamber of Commerce when he declared, "I think President Obama has used the bully pulpit as a way to attack capitalism." But in his knee-jerk assault... Jon Perr http://www.perrspectives.com/ On Wednesday, former Florida Governor Jeb Bush doubtless pleased his audience at the U.S Chamber of Commerce when he declared, "I think President Obama has used the bully pulpit as a way to attack capitalism." But in his knee-jerk assault on his brother's successor, Governor Bush conveniently omitted that George W. Bush compiled the worst economic record of any president since Herbert Hoover. Of course, when it comes to GDP, employment, the stock market or just about any other measure of the health of American capitalism, the historical record is clear: the economy almost always does better under Democrats.

The verdict on President Bush's reign of ruin was pronounced even before Barack Obama took the oath of office. Just days after the Washington Post documented that George W. Bush presided over the worst eight-year economic performance in the modern American presidency, the New York Times on January 24 featured an analysis ("Economic Setbacks That Define the Bush Years") comparing presidential performance going back to Eisenhower. As the Times showed, George W. Bush, the first MBA president, was a historic failure when it came to expanding GDP, producing jobs and fueling stock market growth.

But it was the release of a Census Bureau report in September ("Income, Poverty, and Health Insurance Coverage in the United States: 2008") which in 67 pages laid bare the economic devastation and human toll during the Bush presidency. As The Atlantic ("Closing The Book On The Bush Legacy") rightly noted, "It's not a record many Republicans are likely to point to with pride":

On every major measurement, the Census Bureau report shows that the country lost ground during Bush's two terms. While Bush was in office, the median household income declined, poverty increased, childhood poverty increased even more, and the number of Americans without health insurance spiked. By contrast, the country's condition improved on each of those measures during Bill Clinton's two terms, often substantially.

This table (via The Reaction) provides a horrifying snapshot of the scope of the national calamity under George W. Bush:

The extent of the failure by Jeb's brother was particularly glaring when it came to employment and job creation. The dismal 3 million jobs created under President Bush didn't merely pale in comparison to the 23 million produced during Bill Clinton's tenure. As the reliably Republican Wall Street Journal summed up its interactive table on the subject, "Bush on Jobs: The Worst Track Record on Record." In September 2009, the Congressional Joint Economic Committee charted Bush's job creation disaster, the worst since Hoover:

Sadly for Jeb Bush and his Republican allies, the GOP's pitiful record on the economy isn't limited to his brother. History shows that from GDP growth and job creation to managing the national debt and producing gains for investors, it is the Democratic Party which is the friend of Wall Street and Main Street alike.

As the New York Times detailed in January, across almost every indicator (article here, charts here), Democrats outperformed their Republican counterparts:

For the investor class so fond of perpetuating the myth of Republicans' superior economic stewardship, the collapse of the stock marketing during the Bush recession must be particularly galling. The Standard & Poor's 500 spiraled down at annual rate of 5.6% during Bush's time in the Oval Office, a disaster even worse than Richard Nixon's abysmal 4.0% yearly decline. (Only Herbert Hoover's cataclysmic 31% plunge makes Bush look good in comparison.)

As it turns out, as the New York Times also showed in October 2008, the Democratic Party "has been better for American pocketbooks and capitalism as a whole." To make its case, the New York Times asked readers to imagine having put their money where its mouth is. Contrary to Republican mythology, Americans fare better - much, much better - under Democratic administrations:

As of Friday, a $10,000 investment in the S.& P. stock market index would have grown to $11,733 if invested under Republican presidents only, although that would be $51,211 if we exclude Herbert Hoover's presidency during the Great Depression. Invested under Democratic presidents only, $10,000 would have grown to $300,671 at a compound rate of 8.9 percent over nearly 40 years.

(For the eye-popping chart of the S&P's performance under each of the presidents from Hoover through Bush 43, visit here.)

As the broader record shows, the best path to prosperity is to elect Democratic presidents.

The superior performance of Democratic presidents covers virtually the entire spectrum of economic indicators. As Elliott Parker of the University of Nevada, Reno detailed in a 2006 paper, since 1949 Democratic administrations have done better than Republican ones when it comes to unemployment (5.2% to 6.0%), job creation (-.0.4% decrease in unemployment, compared to 0.3% increase), GDP growth rate (4.2% to 2.9%), and even corporate profits as a share of GDP. And to be sure, he found the Dow benefits from Democrats in the White House.

There's no shortage of studies to show that stock market returns are higher under Democratic leadership. (As it turns out, Wall Street's performance is also better when Democrats control Congress.) In 2000, Pedro Santa-Clara and Rossen Valkanov of UCLA's Anderson School of Business concluded that "that the average excess return in the stock market is higher under Democratic than Republican presidents - a difference of 9 percent per year for the value-weighted portfolio and 16 percent for the equal-weighted portfolio." As the New York Times noted of UCLA study in 2003:

"It's not even close. The stock market does far better under Democrats...

...Professors Santa-Clara and Valkanov look at the excess market return - the difference between a broad index of stock prices (basically the Standard & Poor's 500-stock index) and the three-month Treasury bill rate - between 1927 and 1998. The excess return measures how attractive stock investments are compared with completely safe investments like short-term T-bills.

Using this measure, they find that during those 72 years the stock market returned about 11 percent more a year under Democratic presidents and 2 percent more under Republicans - a striking difference."

In 2002, Slate similarly concluded that "Democrats, it turns out, are much better for the stock market than Republicans":

Slate ran the numbers and found that since 1900, Democratic presidents have produced a 12.3 percent annual total return on the S&P 500, but Republicans only an 8 percent return. In 2000, the Stock Trader's Almanac, which slices and dices Wall Street performance figures like baseball stats, came up with nearly the same numbers (13.4 percent versus 8.1 percent) by measuring Dow price appreciation. (Most of the 20th century's bear markets, incidentally, have been Republican bear markets: the Crash of '29, the early '70s oil shock, the '87 correction, and the current stall occurred under GOP presidents.)

According to almanac editor Jeffrey Hirsch, the presidential party figures are among the most significant he's found. If the stock market were random, we'd expect such a result only one-quarter of the time. "I don't know why people are convinced Republicans are good for the stock market," Hirsch says.

Why? Because the Bushes and their Republican water carriers continue - with great success - to perpetuate the myth that the regulation-free policies of the GOP that so benefit them personally somehow help the American people overall.

Meanwhile, Jeb Bush is just the latest conservative to accuse Barack Obama of being a "socialist", a "communist" or worse. Unfortunately for Jeb and his fellow Republican propagandists, the words of Harry Truman are as true today as when he uttered them generations ago:

"If you want to live like a Republican, vote Democratic."
]]> http://www.perrspectives.com/blog/archives/001656.htm "Emergency Room" McConnell Claims Public Option May Kill You tag:www.perrspectives.com,2009:/blog//2.1655 2009-10-30T18:36:28Z 2009-10-31T01:56:20Z Back in September, a study by Harvard Medical School found that over 44,000 Americans die each year due to lack of health insurance. Now, in a complete reversal of both logic and the truth, Senate Minority Leader Mitch McConnell (R-KY)... Jon Perr http://www.perrspectives.com/

Back in September, a study by Harvard Medical School found that over 44,000 Americans die each year due to lack of health insurance. Now, in a complete reversal of both logic and the truth, Senate Minority Leader Mitch McConnell (R-KY) announced that it is the availability of a public insurance option which could prove fatal. Of course, McConnell's announcement that the public option "may cost you your life" should come as no surprise. After all, in July he echoed George W. Bush and Tom Delay in declaring that thanks to the emergency room, Americans "don't go without health care."

Mitch McConnell's latest fear-mongering came during an appearance on Dennis Miller's radio show. Blasting the "opt-out" version of the public option in the Senate bill, the Senator from the state ranked 45th in health care performance insisted access to coverage could be deadly:

MCCONNELL: Well, it doesn't make any difference frankly whether you opt-in or you opt-out, it's still a government plan. You know, Medicaid, the program for the poor now, states can opt-out of that, but none of them have. I think if you have any kind of government insurance program, you're going to be stuck with it and it will lead us in the direction of the European style, you know, sort of British-style, single payer, government run system. And those systems are known for delays, denial of care and, you know, if your particular malady doesn't fit the government regulation, you don't get the medication.
MILLER: Right.
MCCONNELL: And it may cost you your life. I mean, we don't want to go down that path.

While he has generally left the myth-making about "death panels" and "pulling the plug on grandma" to Sarah Palin, Chuck Grassley and other tall tale tellers in the GOP, Senator McConnell has otherwise been fabricator-in-chief when it comes to Republican talking points on health care.

For months, McConnell has been peddling health care horror stories from Canada and the UK, parading supposed victims of those "socialist" systems. As it turned out, when not deceiving the American people outright about his poster children, McConnell was certain to withhold inconvenient truths which undermined his stereotypes.

Throughout June, the Kentuckian faithfully parroted Republican spinmeister Frank Luntz' prepackaged sound bite that reform "could lead to the government rationing care, making people stand in line and denying treatment like they do in other countries with national healthcare." For example:

"Americans don't want their health care denied or delayed. But once government health care is the only option, bureaucratic hassles, endless hours stuck on hold waiting for a government service rep, restrictions on care, and rationing are sure to follow." (June 3, 2009)
"All of us want reform, but not reform that denies, delays, or rations health care." (June 10, 2009)
"Americans want to see changes in the health care system. But they don't want changes that deny, delay, or ration care." (June 11, 2009)

Appearing on Meet the Press in July, Senator McConnell joined a long list of Republican leaders including President Bush, indicted former House Minority Leader Tom Delay and Rep. Paul Broun (R-GA) pointing to America's emergency rooms as one solution to the crisis of the U.S. health care system:

GREGORY: Do you think it's a moral issue that 47 million Americans go without health insurance?
McCONNELL: Well, they don't go without health care. It's not the most efficient way to provide it. As we know, the doctors in the hospitals are sworn to provide health care. We all agree it is not the most efficient way to provide health care to find somebody only in the emergency room and then pass those costs on to those who are paying for insurance. So it is important, I think, to reduce the number of uninsured. The question is, what is the best way to do that?

Then, of course, there's McConnell's central role in Republican efforts to scare the bejesus out of America's seniors over mythical Medicare benefits cuts. As it turns out, the GOP didn't merely oppose Medicare its inception; McConnell was a key player in the Republican effort to gut the program by 15% in the 1990's. Again, McConnell repeatedly turned to rapid-fire lies beginning in July about Obama's Medicare funding plans to machine gun health care reform:

"Some in Congress seem to be in such a rush to pass just any reform, rather than the right reform, that they're looking everywhere for the money to pay for it -- even if it means sticking it to seniors with cuts to Medicare."

That salvo came just two weeks after McConnell promised to defeat health care reform in the Senate, warning America's highest turnout voting block:

"They are going to pay for this plan by cutting Medicare, that is cutting seniors."

And so it goes. The reform bills now being considered in the House would ultimately provide health insurance coverage to 35 million more Americans. It should go without saying that far from "costing you your life," the public option some people will select would save theirs. Of course, for Mitch McConnell, that welcome future will come only over his dead body.

]]> http://www.perrspectives.com/blog/archives/001655.htm Media Lament Recession's Impact on the Tragically Rich tag:www.perrspectives.com,2009:/blog//2.1654 2009-10-29T23:40:40Z 2009-10-30T02:28:23Z One week after its devastating documentary ("The Warning") on federal regulator Brooksley Born's unheeded warning in the 1990's about the potential disaster in the offing for the U.S. financial system, on Tuesday the PBS program Frontline aired an episode which... Jon Perr http://www.perrspectives.com/

One week after its devastating documentary ("The Warning") on federal regulator Brooksley Born's unheeded warning in the 1990's about the potential disaster in the offing for the U.S. financial system, on Tuesday the PBS program Frontline aired an episode which portrayed the subsequent recession's harsh impact on the residents of an Upper East Side New York neighborhood. But in focusing on the nouveau pain of the upper-middle class and above, "Close to Home" was hardly breaking new ground. For months, in their coverage of the recession supposed liberal media bastions CBS News and New York Times have been lamenting the suffering of the tragically rich.

As PBS producer Ofra Bikel described her objective:

I decided not to do a program about the down-and-outs. So much of it was done on television: sad, heartbreaking stories of plants -- even whole towns -- closing down, people left with no jobs, no savings, no homes and no future.

I felt that I wanted to do something about the middle class or even the upper middle class -- the very people who usually outlive the economic storms and who do not talk very much about their finances, their losses and their problems, especially to strangers. How are they doing now?

In Bikel's defense, the hair salon owner and the customers she profiled in her own toney Manhattan neighborhood were not the Wall Street investment bankers and traders who helped bring the American economy to its knees. And to be sure, many of their stories of lost jobs, declining savings and diminished prospects resonated with viewers.

But at the end of the day, many of those in what Bikel deemed "one of the most affluent and powerful neighborhoods in America" are hardly proxies for the nation's broad middle class. They are about as representative, it turns out, as the readers of The New York Times' regular feature, "Wealth Matters."

In his columns examining the "strategies that the wealthy use to manage not only their money but their overall well-being," the Times Paul Sullivan has also catalogued the supposedly outsized impact of the recession on the newly not-quite-as-rich. For example, in an October 2 piece titled "Too Rich to Worry? Not in This Downturn," Sullivan warned:

It turns out the other half -- or at least the tiny slice who live at the top of the wealth pyramid -- are not sleeping any better than the rest of America.

At a closed-door meeting of advisers to family offices -- which serve families who typically are worth more than $500 million -- I learned that the super-rich are just as concerned about the future as everyone else.

Even though the stock market has rebounded from its March 9 low, the family office advisers said many of their wealthiest clients were bracing for more bad news and wondering how it would affect their family unity.

"They are now looking at financial planning and things middle-class families live by," Kathryn McCarthy, a leading adviser to wealthy families, including the Rockefellers, said at the gathering this week convened by Bessemer Trust.

Before you start laughing up your sleeve, be advised that this is not a good thing. When the super-rich get cold feet, the rest of America gets swine flu.

Two weeks later ("All This Anger Against the Rich May Be Unhealthy"), Sullivan seemed stunned that he had "touched a particularly raw nerve" among readers who blasted his previous column as "so stupid that you ought to be slapped for it." Without noting record levels of income inequality not seen since the 1920's, the massive windfall for the wealthy from the Bush tax cuts or the absence of data to conclusively show that reduced deductions hurts charitable giving, Sullivan warned:

A big concern among the wealthy right now, their advisers say, is not populist anger but how it might translate into tax-the-rich legislation on the federal and state levels. Their concern is twofold.

The first is that any tax increase has a direct impact on the income they withdraw from their portfolios. More money going to the government means less to live on...

The second concern may be disheartening for those who are angry at the rich but like the museum exhibition or scholarship they pay for: increased taxes could cut into donations. While there is not a direct correlation between tax deductibility and personal donations, there is a correlation between increased taxes in a continued weak economy and charitable giving.

But the New York Times penchant to ask "brother, can you spare a million?" is not limited to Paul Sullivan's fawning over the rich and famous. In an August 20, 2009 feature, David Leonhardt and Geraldine Fabrikant concluded, "After a 30-year run, [the] rise of the super-rich hits a sobering wall." As it turns out, the halcyon days of record-setting inequality are so 2007:

They began to pull away from everyone else in the 1970s. By 2006, income was more concentrated at the top than it had been since the late 1920s. The recent news about resurgent Wall Street pay has seemed to suggest that not even the Great Recession could reverse the rise in income inequality.

But economists say -- and data is beginning to show -- that a significant change may in fact be under way. The rich, as a group, are no longer getting richer. Over the last two years, they have become poorer. And many may not return to their old levels of wealth and income anytime soon.

To illustrate the down-on-their-luck wealthy, the Times turned to software entrepreneur John McAfee as a case study of the perils of the life of excess:

In 2007, Mr. McAfee sold a 10,000-square-foot home in Colorado with a view of Pike's Peak. He had spent $25 million to buy the property and build the house. He received $5.7 million for it. When Lehman collapsed last fall, its bonds became virtually worthless. Mr. McAfee's stock investments cost him millions more.

One day, he realized, as he said, "Whoa, my cash is gone."

His remaining net worth of about $4 million makes him vastly wealthier than most Americans, of course. But he has nonetheless found himself needing cash and desperately trying to reduce his monthly expenses.

But for advocacy of trickle-down economics so naked it would make Ronald Reagan blush, you need to turn on CBS News with Katie Couric.

Invariably, the CBS Evening News series "The Financial Family Tree" shows the ripple effect from the wealthiest Americans on down the economic food chain. From the struggling recreational boat manufacturer and salesman in Florida and restaurateurs in Massachusetts ("Recession Reaches Nantucket Island") to the vineyards of Northern California and a baking company in the Cayman Islands ("Sagging Sales, Even in a Beach Paradise"), most of the stories start with the diminished consumption of the better-off.

For example, declining sales of U.S. wine led to layoffs at Fetzer Vineyards. For one of its former executives who lost his six-figure salary, that had dire implications for the horses he and his wife have been raising for years on their "wine country spread:"

Putting on the brakes includes dropping plans to enter horse shows that can cost $2,000.

"She is material to go on to the nationals," Banach said patting a horse."But we won't be going."

Mercifully, as CBS reported Sunday, the recession has an upside for the well-to-do, who can find bargains on their designer clothes at booming high-end thrift stores:

At Manhattan's Memorial Sloane Kettering Thrift Ship in New York City, which caters to a well-heeled clientele. They've got thousand-dollar Chanel suits on sale, so business is brisk...

One thrift shopper told CBS News she doesn't miss retail shopping.

"I bought a David Meister dress here that was from this year and it was $398 online and I got it for $8 and I wore it to a wedding on Sunday," she said.

In June, CBS announced that "in recession, swapping is the new shopping" in Miami Beach:

It's Thursday evening and a posh Miami Beach home has been turned into a bargain basement - where swapping is the new shopping.

Fifteen shopaholics clean out their closets, and trade gently-worn Gucci for someone else's Chanel.

"Yeah, not taking out your wallet is fun and getting something new is fun," said Trudy Corey, one of the Miami Beach "shoppers."

Apparently, it's cheaper than ever to dress for success when you're "going Galt."

Of course, none of the above is meant to diminish the losses, hardship and suffering of Americans of every region, line of work and income strata as a result of the Bush recession. But it's hard to expect much sympathy for the well-heeled when lower and middle-class people are getting kicked in the teeth. In any event, as the not-so-subtle coverage by the New York Times, CBS and even PBS suggests, the class war in America is over or, perhaps, is only being waged by one side.

UPDATE: As the AP reported in April, one of group of people is doing better than ever serving the tragically rich during the recession: their therapists.

]]> http://www.perrspectives.com/blog/archives/001654.htm Strong GDP Growth Doesn't Calm Stimulus Fight tag:www.perrspectives.com,2009:/blog//2.1653 2009-10-29T17:31:23Z 2009-10-29T17:49:42Z On Thursday, the Commerce Department announced that the U.S. economy expanded at a surprisingly strong 3.5% rate. But despite Q3 GDP growth which exceeded consensus estimates, the outsized impact of one-time programs including the Cash for Clunkers incentives and the... Jon Perr http://www.perrspectives.com/

On Thursday, the Commerce Department announced that the U.S. economy expanded at a surprisingly strong 3.5% rate. But despite Q3 GDP growth which exceeded consensus estimates, the outsized impact of one-time programs including the Cash for Clunkers incentives and the tax credit for first-time home buyers suggests the pace of economic expansion will slow in succeeding quarters. And with unemployment likely to top 10%, the heated politics of the recovery and the Obama stimulus which helped fuel it will only get more contentious still.

Christina Romer, Obama's chief of the Council of Economic Advisors, announced the first GDP gains since the Bush recession that began in December 2007 turned into a downward spiral in the summer of 2008:

"After four consecutive quarters of decline, positive GDP growth is an encouraging sign that the U.S. economy is moving in the right direction."

The dramatic turnaround in the economy, which plummeted by 5.4% in the fourth quarter of last year and a ataggering 6.4% in Q1, can largely be attributed to the impact of the $787 billion American Recovery and Reinvestment Act (ARRA) and emergency steps taken to save the financial system. As the New York Times noted:

Much of the growth can be attributed to the billions in federal aid devoted to economic renewal, including policies that encouraged consumer spending on cars and housing...

The cash-for-clunkers program helped boost consumer spending on durable goods, which grew by an annual rate of 22.3 percent in the third quarter compared to a decline of 5.6 percent in the previous quarter. Similarly, economists say the $8,000 federal tax credit for first-time homebuyers helped revive spending on housing, which increased 23.4 percent in the third quarter, in contrast to a decrease of 23.3 percent in the second quarter.

Today's good news follows the unexpectedly strong turnaround in Q2, when the small 0.7% decline in GDP showed the hemorrhaging had been cauterized. For the three month period which ended in June, the Economic Policy Institute announced the Obama stimulus measures overall added "up to 3 full percentage points of annualized growth in the quarter." For its part, the Wall Street Journal in September agreed with that assessment:

Many forecasters say stimulus spending is adding two to three percentage points to economic growth in the second and third quarters, when measured at an annual rate. The impact in the second quarter, calculated by analyzing how the extra funds flowing into the economy boost consumption, investment and spending, helped slow the rate of decline and will lay the groundwork for positive growth in the third quarter -- something that seemed almost implausible just a few months ago. Some economists say the 1% contraction in the second quarter would have been far worse, possibly as much as 3.2%, if not for the stimulus.

For the third quarter, economists at Goldman Sachs & Co. predict the U.S. economy will grow by 3.3%. "Without that extra stimulus, we would be somewhere around zero," said Jan Hatzius, chief U.S. economist for Goldman.

But going forward, the picture in economists' crystal balls looks murky, to say the least. The Cash for Clunkers program has come and gone, and the housing credit is set to expire on November 30. (The latter may yet be extended.) As the AP reported:

A top concern is whether the recovery can continue after government supports are gone.

Many economists predict economic activity won't grow as much in the months ahead as the bracing impact of Obama's $787 billion package of increased government spending and tax cuts fades.

The National Association for Business Economics thinks growth will slow to a 2.4 percent pace in the current October-December quarter. It expects a 2.5 percent growth rate in the first three months of next year, although other economists believe the pace will be closer to 1 percent.

Romer, in remarks last week said the government's stimulus spending already had its biggest impact and probably won't contribute to significant growth next year.

Despite growing exports, a 1.1% jump in business spending on equipment and inventories at "rock-bottom" levels, prospects for job growth remain sluggish. Today's 9.8% unemployment rate may reach 10.5% before hiring improves next year. It's with good reason Romer acknowledged, "we still have a long road to travel until the economy is fully recovered," adding, "The turnaround in crucial labor market indicators, such as employment and the unemployment rate, typically occurs after the turnaround in GDP."

All of which makes the Friday's White House report on American jobs saved or created by the stimulus such a political lightning rod. In early September, the Obama administration estimated that 1 million jobs could be credited to the ARRA. And a preliminary, partial investigation of by USA Today released yesterday supported that claim:

States have reported using stimulus money to create or save more than 388,000 jobs so far this year, buttressing the Obama administration's claim that the $787 billion plan has had a significant impact on the economy.

That total, based on a USA TODAY review of reports from 33 states and Puerto Rico, includes teachers, construction workers, and others whose jobs were funded by stimulus money awarded to states. The administration plans Friday to release reports from all 50 states, providing the broadest accounting yet of the stimulus plan's impact.

But certain to inflame Republicans clamoring that the stimulus had "failed" is an AP article this morning which claimed, "An early progress report on President Barack Obama's economic recovery plan overstates by thousands the number of jobs created or saved through the stimulus program." While acknowledging the errors in some of the individual job estimates, the Obama White House pushed back:

"This story draws misleading conclusions from a handful of examples," Ed DeSeve, an Obama adviser helping to oversee the stimulus program, said.

"Tomorrow, more than 100,000 recipient reports will be posted on Recovery.gov," DeSeve said. "Unlike the small number of reports reviewed by AP, these reports have been reviewed for weeks, errors have been spotted and corrected, and additional layers of review by state and local governments have further improved the data quality."

Regardless, Thursday's GDP numbers reflect a dramatic improvement for an American economy which teetered on the brink of a second Great Depression earlier this year. But with the highly anticipated White House jobs report due Friday, some like Paul Krugman will argue the Obama stimulus package was too small, while Republicans will doubtless claim it never should have been passed.

]]> http://www.perrspectives.com/blog/archives/001653.htm Limbaugh Calls Obama a "Man-Child." Again. tag:www.perrspectives.com,2009:/blog//2.1652 2009-10-28T18:54:00Z 2009-10-28T20:58:23Z Rush Limbaugh is like a faulty septic tank, always overflowing and spewing s**t everywhere. In addition to his frequent racist diatribes, Limbaugh's effluence routinely contains such on-air vulgarisms as "grab the ankles" and "bend over." Now, the right-wing radio host... Jon Perr http://www.perrspectives.com/

Rush Limbaugh is like a faulty septic tank, always overflowing and spewing s**t everywhere. In addition to his frequent racist diatribes, Limbaugh's effluence routinely contains such on-air vulgarisms as "grab the ankles" and "bend over." Now, the right-wing radio host has branded President Obama a "man-child." And as it turns out, it's not the first time.

Blasting the President on everything from the supposed "war" on Fox News and health care reform to the U.S. Chamber of Commerce and Afghanistan policy, Limbaugh announced:

"People are finally standing up to this little boy, this little man-child president whose primary job, if you will, in life has been leisure. This guy is practiced at leisure than more anything else."

Of course, the "man-child" slur is hardly a recent addition to the Limbaugh repertoire. Back on November 6, 2008, he joined a long list of Republican politicians and conservative pundits comically blaming Obama's election for the Wall Street meltdown:

"The Obama recession is in full swing, ladies and gentlemen. Stocks are dying, which is a precursor of things to come. This is an Obama recession. Might turn into a depression. He hasn't done anything yet but his ideas are killing the economy. His ideas are killing Wall Street...

...The market's down today because of the jobless numbers. That's how the Drive-Bys see it. Uhhhhh, we have the largest market plunge after an election in history. Thank you, man-child Barack Obama."

Needless to say, as the stock market rebounded, Limbaugh and his allies predictably remained silent.

In any event, in his never-ending effort the diminish the Democratic President, Rush Limbaugh will doubtless soon come up with far worse than "man-child" to disparage Barack Obama. As the saying goes, same s**t, different day.

UPDATE: As Media Matters now documents, Rush Limbaugh has used the "man-child" and none-too-thinly veiled racial slur "boy" to brand Barack Obama on multiple other occasions.

]]> http://www.perrspectives.com/blog/archives/001652.htm Broun Joins Palin in Backing GOP Plan to Privatize Medicare tag:www.perrspectives.com,2009:/blog//2.1651 2009-10-27T17:04:28Z 2009-10-27T17:10:57Z Among the more comic story lines of the Republican war on health care reform has been the Party's side-splitting defense of Medicare. After all, the GOP not only tried to block the program in the 1960's, but tried again to... Jon Perr http://www.perrspectives.com/ Among the more comic story lines of the Republican war on health care reform has been the Party's side-splitting defense of Medicare. After all, the GOP not only tried to block the program in the 1960's, but tried again to gut it thirty years later. But after Senate Minority Leader Mitch McConnell warned Democrats were intent on "sticking it to seniors with cuts to Medicare" and RNC chief Michael Steele called for "no cuts to Medicare to pay for another program," the GOP has predictably returned to form. As it turns out, Georgia Rep. Paul Broun is just the latest Republican to join Sarah Palin in seeking to privatize Medicare out of existence.

While a recent survey revealed that 59% of conservatives and 62% of McCain voters believe that Medicare is not a government program, the Republican leadership remains intent on making it so. As ThinkProgress reported Monday, Broun has proposed legislation that would roll back the Medicare system and replace it with a system of vouchers that seniors could use to purchase private insurance:

U.S. Rep. Paul Broun introduced his own health care reform bill last week that would, among other things, privatize the Medicare insurance program for seniors.

Broun's bill would replace government benefits with vouchers that could be spent on private insurance or put in tax-free medical savings accounts.

As it turns out, Broun's warning shot is just the latest salvo this year in the perpetual Republican war on the program that provides health insurance for 46 million Americans. As Steve Benen of the Washington Monthly noted:

In April, 137 Republicans voted in support of a GOP alternative budget. It didn't generate a lot of attention, but the plan, drafted by the House Budget Committee's Rep. Paul Ryan (R-Wis.) called for "replacing the traditional Medicare program with subsidies to help retirees enroll in private health care plans."

The AP noted at the time that Republican leaders were "clearly nervous that votes in favor of the GOP alternative have exposed their members to political danger."

(In July, New York Democrat Anthony Weiner called their bluff, introducing an amendment that would eliminate "government-run Medicare." No Republicans voted for it.)

Perhaps the highest profile Republican leading the charge to privatize Medicare is former Alaska Governor Sarah Palin. After her earlier fear-mongering over mythical "death panels," in September Palin went rogue on the op-ed page of the Wall Street Journal, regurgitating the right-wing call for vouchers:

Instead of poll-driven "solutions," let's talk about real health-care reform: market-oriented, patient-centered, and result-driven. As the Cato Institute's Michael Cannon and others have argued, such policies include giving all individuals the same tax benefits received by those who get coverage through their employers; providing Medicare recipients with vouchers that allow them to purchase their own coverage; reforming tort laws to potentially save billions each year in wasteful spending; and changing costly state regulations to allow people to buy insurance across state lines. Rather than another top-down government plan, let's give Americans control over their own health care.

Of course, Paul Broun is hardly the ideal pitch man for the GOP's Medicare privatization push, having previously argued both that Barack Obama is "showing me signs of being Marxist" and "that's exactly what Hitler did in Nazi Germany and it's exactly what the Soviet Union did." But Broun is well within the mainstream of Republican thought not only when it comes to Medicare, but to the GOP's solution for the American health care crisis overall: the emergency room. Like George W. Bush, Tom Delay and Mitch McConnell before him, Broun helpfully explained:

"People who have depression, who have chronic diseases in this country...can always get care in this country by going to the emergency room."
]]> http://www.perrspectives.com/blog/archives/001651.htm Study Claims U.S. Health Care System Wastes $700 Billion Annually tag:www.perrspectives.com,2009:/blog//2.1650 2009-10-27T07:46:25Z 2009-10-27T16:03:28Z In the wake of its shocking assessment that employer-provided health insurance now covers only 54.6% of the American people, Thomson Reuters released a disturbing assessment of wasteful spending in the U.S. health care system Echoing the estimates of Obama OMB... Jon Perr http://www.perrspectives.com/ In the wake of its shocking assessment that employer-provided health insurance now covers only 54.6% of the American people, Thomson Reuters released a disturbing assessment of wasteful spending in the U.S. health care system Echoing the estimates of Obama OMB chief Peter Orszag and others, the analysis concluded that the United States wastes up to $700 billion a year - a third of the nation's total $2 trillion health care spending.

As Robert Kelley, vice president of healthcare analytics at Thomson Reuters and author of the white paper, put it:

"The bad news is that an estimated $700 billion is wasted annually. That's one-third of the nation's healthcare bill. The good news is that by attacking waste, healthcare costs can be reduced without adversely affecting the quality of care or access to care. That's the point of this report - to identify areas in the healthcare system that can generate game-changing savings."

Those game-changing savings, TR found, could be found across a broad range of health care spending. Between $600 billion and $850 billion, it estimated, is wasted on:

  • Unnecessary Care (40% of healthcare waste): Unwarranted treatment, such as the over-use of antibiotics and the use of diagnostic lab tests to protect against malpractice exposure, accounts for $250 billion to $325 billion in annual healthcare spending.

  • Fraud (19% of healthcare waste): Healthcare fraud costs $125 billion to $175 billion each year, manifesting itself in everything from fraudulent Medicare claims to kickbacks for referrals for unnecessary services.

  • Administrative Inefficiency (17% of healthcare waste): The large volume of redundant paperwork in the U.S healthcare system accounts for $100 billion to $150 billion in spending annually.

  • Healthcare Provider Errors (12% of healthcare waste): Medical mistakes account for $75 billion to $100 billion in unnecessary spending each year.

  • Preventable Conditions (6% of healthcare waste): Approximately $25 billion to $50 billion is spent annually on hospitalizations to address conditions such as uncontrolled diabetes, which are much less costly to treat when individuals receive timely access to outpatient care.

  • Lack of Care Coordination (6% of healthcare waste): Inefficient communication between providers, including lack of access to medical records when specialists intervene, leads to duplication of tests and inappropriate treatments that cost $25 billion to $50 billion annually.

But in its catalog of health care spending horrors, however, Thomson Reuters may have understated potential savings in one area while overstating them in another.

When it comes to "preventable conditions," over time the United States may be able to realize far greater cost savings than the $25 to $50 billion TR estimated. For example, other studies have gauged the impact of the American obesity epidemic alone at $147 billion a year. (The cost of treating the diabetes with which it is often related run as high as $190 billion a year.) An August 2009 study by PriceWaterhouseCoopers claimed that risky behavior such as smoking, obesity and alcohol abuse combined produced a $493 billion annual price tag for the United States. For its part, Thomson Reuters in its report acknowledged the unmeasured impact of individual behaviors:

It is also important to note that, although not included in our estimate of a total range, the waste associated with treating a level of disease prevalence that could be significantly reduced through modified individual behavior, is significant. Although the responsibility for pursuing a healthier lifestyle is ultimately a personal one, the healthcare system has an opportunity to encourage better individual choices.

But in pegging the waste due to "unwarranted use" of health care services as high as $325 billion per year, Thomson Reuters may have overshot the target by a large margin.

Key to its analysis (contained in the full report available separately from Thomson Reuters) is an inflated assessment of the "defensive medicine" practiced by hospitals and physicians due to fears of malpractice litigation. As the New York Times' David Leonhardt detailed, Harvard economist Amitabh Chandra put the tab at $60 billion annually (3% of total spending) for the extra procedures, tests, doctor referrals and hospitals visits physicians order just to protect them from potential future lawsuits. And earlier this month, the Congressional Budget Office calculated that an onerous package of tort limitations would yield annual savings of $11 billion.

Sadly, Thomson Reuters like Sarah Palin and the National Review referred to the same 1996 study by Daniel Kessler and Mark McClellan to produce a whopping $200 billion price tag for defensive medicine. Looking only at Medicare heart patients in hospital settings, the paper concluded that "malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications." Extrapolated to the entire $2 trillion U.S. health sector, the hypothetical savings from that magical 9% would catapult to $200 billion a year.

For the mouthpieces of the right (and even some, like Bill Bradley, on the left), that figure became the gospel truth. For her part, Sarah Palin lifted the fuzzy math directly from Dr. Stuart Weinstein, with the American Academy of Orthopedic Surgeons:

"If the Kessler and McClellan estimates were applied to total U.S. healthcare spending in 2005, the defensive medicine costs would total between $100 billion and $178 billion per year. Add to this the cost of defending malpractice cases, paying compensation, and covering additional administrative costs (a total of $29.4 billion)."

But as FactCheck.org, Media Matters and a host of others documented, both the GAO and the CBO itself long ago rejected that very extrapolation. The Congressional Budget Office previously found "no evidence that restrictions on tort liability reduce medical spending" and concluded:

"In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency."

(That earlier assessment was updated in the recent CBO scoring for Utah Republican Senator Orrin Hatch.)

Regardless, the implication of the Thomson Reuters study is clear. The United States spends almost double the percentage of GDP on health care as other advanced economies. But while Americans are unnecessarily hemorrhaging cash for health care, they have nothing to show for it.

]]> http://www.perrspectives.com/blog/archives/001650.htm When Opting Out is Not An Option tag:www.perrspectives.com,2009:/blog//2.1649 2009-10-26T16:42:31Z 2009-10-26T20:48:36Z While the Obama White House, Senate Majority Leader Harry Reid and Congressional Democrats debate among themselves whether a so-called "opt out" public health insurance option will be included in reform legislation, Minnesota Governor and GOP presidential wannabee Tim Pawlenty has... Jon Perr http://www.perrspectives.com/ While the Obama White House, Senate Majority Leader Harry Reid and Congressional Democrats debate among themselves whether a so-called "opt out" public health insurance option will be included in reform legislation, Minnesota Governor and GOP presidential wannabee Tim Pawlenty has already weighed in. Asked if he would "lead a charge" in his state to opt out, Pawlenty replied, "I think so because I don't like government run health care."

That's easy for him to say. As it turns out, Minnesota is the exception that proves the rule of red state socialism. An increasingly blue state with the 4th best health care system in the nation, the Land of 10,000 Lakes sends far more tax dollars to Washington than it receives in federal spending in return. But for Pawlenty's fellow Republican refuseniks, leaders of red states offering dismal health care and beneficiaries of a one-way transfer of taxpayer funds from DC, opting out may not be an option.

In recent weeks, Texas secessionists and Georgia legislators have echoed Pawlenty's confused reading of the Tenth Amendment by endorsing a state veto over federal health reform mandates. But just in time for the debate over the merits of a state-by-state "opt out" of a national public health insurance option, the Commonwealth Fund has released its 2009 state health care scorecard. As in 2007, the data reveals the critical condition of red state health care. All of which could present Republican governors and legislatures with a dilemma: Will they refuse to offer lower cost insurance coverage for their residents by rejecting a system funded in part by blue state taxpayers?

Given the contentious ongoing debate in the Senate, crystal ball-gazing for any public option, whether national, opt-in or opt-out is difficult. But the Commonwealth Fund's analysis of health care indicators shows the stakes for its red state opponents. While nine of the top 10 performing states voted for Barack Obama in 2008, four of the bottom five (including Arkansas, Mississippi, Oklahoma and Louisiana) and 14 of the last 20 backed John McCain. (That at least is an improvement from the 2007 data, in which all 10 cellar dwellers had voted for George W. Bush three years earlier.)

(Here is the Commonwealth Fund's 2009 state-by-state health care scorecard. Here are links to the executive summary, the full report and PDF and Powerpoint chart packs.)

While New York Senator Chuck Schumer reported earlier this month that the "opt out" notion was gaining interest from conservative Democrats like Ben Nelson (D-NE), Republicans were unmoved:

A spokesperson for Senate Minority Leader Mitch McConnell (R-Ky.) suggests to the Huffington Post that it's unlikely that any GOPers will come on board.
"While Republicans support health care reform, they don't support a new government plan," said Don Stewart, a McConnell spokesperson, when asked about the opt-out idea.

That opposition would present a double quandary for the Republican leadership in Congress and in the states. After all, their residents not only need health care reform most. As it turns out, the funding in part would come from blue state taxpayers.

As the Washington Post noted in May ("A Red State Booster Shot"):

Health-care reform may be overdue in a country with 45 million uninsured and soaring medical costs, but it will also represent a substantial wealth transfer from the North and the East to the South and the West. The Northeast and the Midwest have much higher rates of coverage than the rest of the country, led by Massachusetts, where all but 3 percent of residents are insured. The disproportionate share of uninsured is in the South and the West, the result of employment patterns, weak unions and stingy state governments. Texas leads the way, with a quarter of its population uninsured; it would be at the top even without its many illegal immigrants.

As it turns out, health care reform spending would be little different from the overall pattern of red state socialism. That is, red state residents disproportionately benefit from the steady one-way flow of tax dollars and earmarks spreading the wealth from Washington to their states.

As the 2007 analysis (above) of 2005 federal spending per tax dollar received by state shows, the reddest states generally reaped the most green. Eight of the top 10 beneficiaries of federal largesse voted for John McCain for President. Unsurprisingly, all 10 states at the bottom of the list - those whose outflow of tax revenue is funding programs elsewhere in the country - all voted for Barack Obama in 2008. And as the Wall Street Journal documented in March and again in July, Republican states are reaping outsized benefits from the $787 billion Obama stimulus package they so fiercely opposed.

While not ideal, Paul Krugman, Howard Dean and Nate Silver among others have argued that the opt-out public option approach has the merit of creating economic, political and behavior pressure on Tim Pawlenty's fellow Republican governors to offer their residents the same access to lower cost insurance as their neighbors in Democratic-controlled states. Should the opt out scenario come to pass, Republicans leaders will have to decide:

Will they put blue state money where their red state mouths are?

Any American who cares about the quality, accessibility and cost of health care for all Americans should hope the answer is yes.

UPDATE: CNN, Politico and Bloomberg and others are now reporting that Reid will include the "opt out" public option in the merged Senate health care reform bill.

]]> http://www.perrspectives.com/blog/archives/001649.htm Republican Malpractice Myths tag:www.perrspectives.com,2009:/blog//2.1648 2009-10-23T07:38:35Z 2009-10-23T16:07:09Z In recent days, Republican leaders have scored a series of political victories in their eternal quest for tort reform. Last week, the Congressional Budget Office (CBO) told Senator Orrin Hatch (R-UT) that an onerous package of malpractice curbs he championed... Jon Perr http://www.perrspectives.com/

In recent days, Republican leaders have scored a series of political victories in their eternal quest for tort reform. Last week, the Congressional Budget Office (CBO) told Senator Orrin Hatch (R-UT) that an onerous package of malpractice curbs he championed could save the government an estimated $54 billion over 10 years. That came on the heels of President Obama's latest offer to support limited tort reform as an olive branch to recalcitrant Republicans balking at his health care proposals, including funding for a $25 million pilot program.

But largely overlooked in the heated discussions of damage award caps, special health courts, expert panels and national compensation schedules is the inescapable truth that the medical malpractice system has only a negligible impact on overall American health care costs. Republican horror stories of a torrent of baseless malpractice suits producing "jackpot justice" that fuels rising premiums for physicians and patients alike while driving doctors from practice simply don't comport with reality. The overstated, overblown, over the top and often outright false GOP claims suggest that the Republicans' real target is not the flawed American malpractice system, but instead the nation's trial lawyers whose campaign contributions help bankroll the Democratic Party.

Here, then, is a look at Republican Malpractice Myths:

  1. An Explosion of Malpractice Litigation
  2. A System Plagued by Frivolous Lawsuits
  3. Rising Damage Awards Key to Higher Malpractice Premiums
  4. Rising Malpractice Insurance Rates Driving Doctors from Practice
  5. Medical Malpractice Reform Would Save U.S. $200 Billion Annually
  6. Defensive Medicine Costs $200 Billion a Year

Myth #1: An Explosion of Malpractice Litigation

Back in August, former Alaska Governor Sarah Palin offered her diagnosis of the medical tort system on her Facebook page:

I went my whole life without needing a lawyer on speed-dial, but all that changes when you become a target for opportunists and people with no scruples. Our nation's health care providers have been the targets of similar opportunists for years, and they too have found themselves subjected to false, frivolous, and baseless claims. To quote a former president, "I feel your pain."

Sadly, the data are clear. If anything, the United States has too few, and not too many, malpractice actions.

In 2003, the Institute of Medicine of the National Academies issued a devastating report detailing the scope and gravity of the safety of the U.S. health care system. Two studies showed that "at least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented." As the New York Times' David Leonhardt found in September 2009, "After reviewing thousands of patient records, medical researchers have estimated that only 2 to 3 percent of cases of medical negligence lead to a malpractice claim." And as Tom Baker, director of the Insurance Law Center at the University of Connecticut School of Law and author of The Malpractice Myth, noted in August, the rate of claims is going down:

"We have approximately the same number of claims today as in the late 1980s. Think about that. The cost of health care has doubled since then. The number of medical encounters between doctors and patients has gone up -- and research shows a more or less constant rate of errors per hospitalizations. That means we have a declining rate of lawsuits relative to numbers of injuries."

Myth #2: A System Plagued by Frivolous Lawsuits

Just 10 days after Palin's predictable lawyer bashing, Arizona Republican Senator John Kyl followed suit with his own indictment:

Of course, malpractice lawsuits serve a valuable purpose for those who have truly been wronged, but malpractice law is often abused by some trial lawyers who flood courts with baseless lawsuits.

As it turns out, not so much.

As Baker noted, epidemiological studies on medical malpractice in the 1970s, 1980s and 1990s found about one serious injury per 100 hospitalizations, with only about only 4 to 7 percent of those injured bringing a case.

The myth of rapacious trial lawyers and their greedy clients filing baseless malpractice claims was also debunked by a May 2006 study from the Harvard School of Public Health. The report, which appeared in the New England Journal of Medicine, exhaustively examined 1,452 medical malpractice cases "to determine whether a medical injury had occurred and, if so, whether it was due to medical error." In a nutshell, the study found that by and large the American system of medical personal injury compensation works, with valid claims receiving compensation and frivolous ones not:

Most of the claims that were not associated with errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not result in compensation; most that involved injuries due to error did (653 of 889 [73 percent]). Payment of claims not involving errors occurred less frequently than did the converse form of inaccuracy - nonpayment of claims associated with errors.

Myth #3: Rising Damage Awards Key to Higher Malpractice Premiums

In an October 20, 2009 press release in which he proclaimed, "We all work for the American people, not the trial lawyers," Senator Kyl announced:

"To help guard themselves from ruinous lawsuits, physicians must purchase expensive medical liability insurance - often at a cost of $200,000 or more for some specialists, such as obstetricians and anesthesiologists."

But the data show that on average, inflation-adjusted physician insurance premiums declined in the 1990's from their mid-1980's peaks before the accelerating increases of this decade. Something other than dubious lawsuits and jury awards must be behind the fluctuation.

That something, as Baker suggests, lies with the insurers' underwriting cycles.

Numerous studies have consistently shown that increasing damage awards from malpractice explain only a small portion of the rapid rise in health care costs. A January 2004 study by the Congressional Budget Office (CBO) found from 1986 to 2002, malpractice insurance premiums jumped 15% per year, while the average damage award rose only 8% ($95,000 to $320,000). The jump in malpractice premiums has been almost double the rate of increase in health care costs per person, and roughly four times the rate of inflation. The CBO report also points out that "although the cost per successful claim has increased, the rate of such claims has remained relatively constant. Each year, about 15 malpractice claims are filed for every 100 physicians, and about 30 percent of those claims result in an insurance payment." As the CBO concludes, GAO data shows that about half of the increase in doctors' malpractice premiums is due to the drop in annual investment returns by the top 15 insurers. Recent low profit rates and market consolidation among insurers is creating additional upwards price pressure.

In The Malpractice Myth, Tom Baker's analysis supports the CBO's conclusion that insurance underwriting cycles, and not more malpractice lawsuits or larger damage awards, are largely responsible for the increase in physicians' insurance premiums:

"It's not crazy to think that malpractice lawsuits are the reason for the insurance premium hikes...Not crazy, but not right, either...The insurance industry goes through a boom-and-bust cycle that creates malpractice insurance crises like this pas one. Lawyers, judges and juries have little or nothing to do with it."

All of which suggests Orrin Hatch's push for a cap of $250,000 on non-economic damages - mirroring laws in Texas, Mississippi, Arizona and other states- is both the wrong diagnosis and the wrong prescription.

Myth #4: Rising Malpractice Insurance Rates Driving Doctors from Practice

Back in 2004, President George W. Bush in his famously garbled declaration decried malpractice lawsuits and premiums he claimed were driving physicians from the business:

"Too many OB/GYNs aren't able to practice their love with women all across this country."

And on this point, the University of Connecticut's Baker found some confirmation in the data for some regions, primarily rural areas, and for some specialties, including obstetrics. (It is worth noting that the South and West have experienced "long-standing supply problems in rural areas" due to "inadequate financial opportunities for doctors" coupled with a lack of health insurance among the people there.)

So, it comes as no surprise that a cavalcade of Republican leaders, including Sarah Palin, Rick Perry, John Cornyn, John Kyl cited the same study showing malpractice awards caps enacted in 2003 in Texas fueled an increase in the number of physicians in the Lone Star State:

According to the Pacific Research Institute, medical licenses in Texas have increased 18 percent in the last four years, with 7,000 new doctors moving to the state.

The actual impact of the Texas law, however, remains in dispute. The state's rising population, its 48th place ranking in physicians per capita, its staggering percentage of uninsured, its lack of an income tax and the 147% jump in malpractice premiums in 2003 alone make gauging the unique contribution of malpractice caps difficult to assess. Regardless, health care costs in Texas have continued their upward spiral.

What seems beyond dispute is that other malpractice cap states like Mississippi have not seen an influx of new doctors. The Jackson Free Press took exception to Governor Haley Barbour's claim that tort reform meant that physicians "have quit leaving the state and limiting their practices to avoid lawsuit abuse":

But non-partisan facts show that doctors were never really leaving the state in the first place. A 2003 Government Accountability Office report, "Medical Malpractice: Implications of Rising Premiums on Access to Health Care," took a hard look at five medical "crisis" states--Mississippi, Nevada, Pennsylvania, West Virginia and Florida--and dismissed reports of doctor emigration from states.
Information compiled by the American Medical Association--which supports tort reform and President Obama's vision of health reform--shows that the number of physicians in Mississippi rose steadily in years leading up to tort-reform legislation in 2004, and even slowed its increase following 2004.
From 2004 to 2005, the state actually recorded no increase over the 5,872 doctors counted in 2004, and added only 18 new physicians in 2006. The year 2007 reflected an increase of 71 physicians--still less than the 145-increase between 2000 and 2001 and the 99-doctor increase between 1998 and 1999. Even the time between 2002 and 2003--arguably the years of the worst tort abuse, according to tort-reform proponents--experienced a growth in the state doctor population of 140.

Myth #5: Medical Malpractice Reform Would Save U.S. $200 Billion Annually

On October 4th, Senator Kyl made this wholly unsubstantiated claim to CNN's John King:

"Almost everybody agrees that we can save between $100 billion and $200 billion if we had effective medical malpractice reform."

By "almost everybody," John Kyl meant the leading lights of the Republican Party and its amen corner in the right-wing media.

The mythical $200 billion figure has its genesis in a 1996 paper by Daniel McKessen and Mark McClellan, who later worked for President Bush. Looking only at heart patients in hospital settings, the paper concluded that "malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications." Extrapolated to the entire $2 trillion U.S. health sector, the hypothetical savings from that magical 9% would catapult to $200 billion a year.

For the mouthpieces of the right (and even some, like Bill Bradley, on the left), that figure became the gospel truth. For her part, Sarah Palin lifted the fuzzy math directly from Dr. Stuart Weinstein, with the American Academy of Orthopedic Surgeons:

"If the Kessler and McClellan estimates were applied to total U.S. healthcare spending in 2005, the defensive medicine costs would total between $100 billion and $178 billion per year. Add to this the cost of defending malpractice cases, paying compensation, and covering additional administrative costs (a total of $29.4 billion). Thus, the average American family pays an additional $1,700 to $2,000 per year in healthcare costs simply to cover the costs of defensive medicine."

But as FactCheck.org, Media Matters and a host of others documented, both the GAO and the CBO itself long ago rejected that very extrapolation. The Congressional Budget Office found "no evidence that restrictions on tort liability reduce medical spending" and concluded:

"In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency."

In 2006, the CBO examined the links between tort limits and health care spending, with results it deemed "inconsistent" and "mixed." That followed CBO's findings two years earlier which documented the minimal impact that increases in medical malpractice insurance premiums have on overall health care costs. As Media Matters noted:

A 2004 CBO report concluded that capping awards at $250,000 for non-economic damages in medical malpractice lawsuits "would basically save only 0.4 percent of the amount that's spent now" on health care. According to the report, "[M]alpractice costs amounted to an estimated $24 billion in 2002, but that figure represents less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small."

Myth #6: Defensive Medicine Costs $200 Billion a Year

Given the comparatively insignificant direct costs of the malpractice justice system itself ($30.4 billion in 2007 for damage awards, lawyers' fee and administrative costs, according to the actuarial consulting firm Towers Perrin), the question of savings from tort reform proposals hinges on so-called "defensive medicine." This represents the extra procedures, tests, doctor referrals and hospitals visits physicians order just to protect them from potential future litigation.

Estimates of such wasteful spending vary. As the Times' David Leonhardt noted:

Amitabh Chandra -- a Harvard economist whose research is cited by both the American Medical Association and the trial lawyers' association -- says $60 billion a year, or about 3 percent of overall medical spending, is a reasonable upper-end estimate.

Not to be outdone, writing in the Wall Street Journal Philip K. Howard put the figure slightly higher. Make that three times higher:

"Eliminating defensive medicine could save upwards of $200 billion in health-care costs annually, according to estimates by the American Medical Association and others."

On this point, the CBO weighed in two weeks ago. As Director Douglas Elmendorf wrote on his blog, the CBO has revised its earlier analyses to peg the savings from reductions in defensive medicine due to Hatch's proposed tort reform at $11 billion a year:

Because of mixed evidence about whether tort reform affects the utilization of health care services, past analyses by CBO have focused on the impact of tort reform on premiums for malpractice insurance. However, more recent research has provided additional evidence to suggest that lowering the cost of medical malpractice tends to reduce the use of health care services.
CBO now estimates that implementing a typical package of tort reform proposals nationwide would reduce total U.S. health care spending by about 0.5 percent (about $11 billion in 2009). That figure is the sum of a direct reduction in spending of 0.2 percent from lower medical liability premiums and an additional indirect reduction of 0.3 percent from slightly less utilization of health care services.

A billion here and a billion there and pretty soon, as the saying goes, you're talking about real money. Just not anything that resembles the jaw-dropping figures routinely spouted by Republican leaders. As Tom Baker concluded regarding the malpractice myths propagated by GOP sound bites on tort reform:

"It's a red herring. It's become a talking point for those who want to obstruct change. But [tort reform] doesn't accomplish the goal of bringing down costs."
]]> http://www.perrspectives.com/blog/archives/001648.htm Bush to "Replenish the Ol' Coffers" as Motivational Speaker tag:www.perrspectives.com,2009:/blog//2.1647 2009-10-21T18:43:18Z 2009-10-21T19:10:33Z Back in September 2007, George W. Bush revealed his plans for life after the White House. First, Mr. Bush said, "I'll give some speeches, just to replenish the ol' coffers." The following July, Kathryn Jean Lopez, one of his bath... Jon Perr http://www.perrspectives.com/

Back in September 2007, George W. Bush revealed his plans for life after the White House. First, Mr. Bush said, "I'll give some speeches, just to replenish the ol' coffers." The following July, Kathryn Jean Lopez, one of his bath water drinkers at the National Review, suggested, "Wouldn't George W. Bush make an awesome high-school government teacher?"

Now, as it turns out, President Bush, a man Lopez deemed "a likable guy in love with his country with some history and experience to share" is combining the two paths as a motivational speaker.

In Fort Worth this month and again in December in San Antonio, Bush will join the likes of Terry Bradshaw, Zig Ziglar, Rudy Giuliani, Colin Powell and Robert Schuller in a special guest appearance for the Get Motivated! seminar series. As TPM notes in amazement, an entire office can attend the arena events for a mere $19, which according to its organizers promises:

Our world-renowned speakers appear LIVE ON-STAGE to provide you a full day of hundreds of proven ideas, formulas and success keys. GET MOTIVATED! is guaranteed to help you and your organization reach new heights of success. You'll be inspired, enlightened, motivated, trained and entertained by America's foremost success experts!

Bush's success expertise, as Jim Hightower once claimed, was being born on third base and claiming he hit a triple. A serial failure in the oil business who narrowly avoided charges of insider trading thanks to his father's connections at the SEC, Bush turned a tidy profit as general manager of the Texas Rangers baseball team in part due to a dubious taxpayer-funded stadium deal. Judged among the worst presidents in U.S. history, Dubya's cataclysmically low approval ratings led him to his first paid speaking gig north of the border in Canada. If nothing else, the nation's first MBA President serves as a horrible example to others.

Ms. Lopez' National Review colleague Mark Hemingway noted in 2007 that "Bill Clinton does gigs for Tony Robbins's competing organization at $300,000 a pop--but only in Canada." Already worth over $20 million in 2007, George W. Bush told biographer Robert Draper he could make "ridiculous" money on the lecture circuit. But for his part, Bush made clear to Draper that he had no interest in following in Clinton's footsteps:

He told Draper he could see himself shuttling between Dallas and Crawford. Noting that he ran into former president Bill Clinton at the United Nations last year, Bush added, "Six years from now, you're not going to see me hanging out in the lobby of the U.N."

That's for sure. But you will see George W. Bush next week - at the Fort Worth Convention Center Arena.

]]> http://www.perrspectives.com/blog/archives/001647.htm