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July 31, 2009

Assessing a "Public Option" for Health Care

(Photos by Robin Holland)

This week on the JOURNAL, Bill Moyers spoke with Wendell Potter, a former health insurance executive who left the industry to become an advocate for health care reform. Potter discussed the industry’s history of denying care to members and its extensive efforts to prevent the federal government from creating a “public option” for health insurance to compete with private plans. Potter said:

“The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them, that if you even consider that you're heading down the slippery slope towards socialism... I think that people who are strong advocates of our health care system remaining as it is, very much a free market health care system, fail to realize that we're really talking about human beings here, and it doesn't work as well as they would like it to... They are trying to make you worry and fear a government bureaucrat being between you and your doctor. What you have now is a corporate bureaucrat between you and your doctor... The public plan would do a lot to keep [health insurance companies] honest, because it would have to offer a standard benefit plan. It would have to operate more efficiently, as does the Medicare program. It would be structured, I’m certain, on a level playing field so that it wouldn’t [have an] unfair advantage [over] the private insurance companies. Because it could be administered more efficiently, the private insurers would have to operate more efficiently.”

The “public option” is central to many Democrats’ vision for health care reform, but it has attracted pointed criticism from supporters of the “single payer” model and opponents of federal intervention alike.

In an edition of the JOURNAL broadcast in May, Dr. Sidney Wolfe of the public interest group Public Citizen advocated for “single payer” health reform, in which a single government agency would replace and eliminate private health insurance. Wolfe told Moyers that previous experiments with the “public option” have failed:

“In seven states, ranging from Washington to Minnesota to Maine, they have tried what amounts to a mixture of a private and a public plan. And in none of the states has there been any sustained reduction in the number of uninsured. It's way too expensive. As long as you have private plans in there, everybody still has to do all the bookkeeping and everything. So, it has failed. As Einstein said, ‘The definition of insanity is doing something over and over again, and expecting to have a different result.’ We've seen the same unsatisfactory, unacceptable result, in state after state after state after state after state, why mess up the whole country with it?”

Recently, policy analyst Anthony Randazzo of the Reason Foundation, a libertarian group, argued that the “public option is an economic nightmare.” He wrote:

“If [the public option] is working then I will want to be part of it. And so will everyone else... Suddenly the public option starts pulling people away from private companies. Those companies will need to charge more for their decreased number of clients... In the meantime the public option will be overrun, and be maxed beyond its capacity... [President Obama said] that the government is not capable of running all health care in this economy, which is why his public option isn’t trying to take people from the private system. Ultimately, from an economic perspective, either the public option works and draws in lots of people until it can’t anymore, or it doesn’t work and is an economic mess. Either way, it’s not pretty.”

What do you think?

  • Do you agree with Wendell Potter’s view that the health insurance industry’s pursuit of profit has hurt patients? Why or why not?

  • Do you support a “public option” for health insurance to compete with private plans? If so, are you concerned about the objections raised by Wolfe and/or Randazzo?

  • Michael Winship: Pay-to-Play Is Washington’s Sport of Kings

    (Photo by Robin Holland)

    Below is an article by JOURNAL senior writer Michael Winship. We welcome your comments below.

    ''Pay-to-Play Is Washington’s Sport of Kings''
    By Michael Winship

    As we marvel over the depths of hypocrisy and greed currently plumbed in the health care reform debate, it may help to remember that even Honest Abe Lincoln had his share of tainted colleagues, one of the most notorious of whom was his first Secretary of War, Simon Cameron.

    According to Doris Kearns Goodwin’s TEAM OF RIVALS, when Lincoln asked radical Republican Thaddeus Stevens how corrupt Cameron was, Stevens paused and replied, “I don’t think he would steal a red hot stove.” When Cameron objected, Stevens allowed that maybe he was wrong -- implying that the cabinet secretary would steal a hot stove.

    Cameron resigned after less than a year in office, plagued by allegations of war profiteering and overall ineptitude. He’s largely forgotten now, but something he supposedly said is immortalized in the lexicon of famous sayings about money and government.

    “An honest politician,” he declared, “is one who when he is bought, stays bought.”

    The giants of the health care industry fighting legitimate reform will soon discover whether all the money they’re spent on lobbying has worked yet again and which of the politicians they have showered with campaign contributions will toe the line and stay bought, thwarting the desires of the majority of the American people.

    This week, the Center for Responsive Politics reported that in the second quarter of this year alone, the pharmaceuticals and health product industries spent $67,959,095 on lobbying, and the insurance industry $39,760,477. Another $25,552,088 were spent by lobbyists for hospitals and nursing homes. That’s a total of $133,271,660 in just three months, and that’s not even counting the lobbying money spent to fight health care reform by professional associations like the U.S. Chamber of Commerce.

    Just to further roil your ire comes news from McAllen, Texas, reported in the July 30 NEW YORK TIMES: “One of the largest sources of campaign contributions to Senate Democrats during this year’s health care debate is a physician-owned hospital in one of the country’s poorest regions that has sought to soften measures that could choke its rapid growth.

    “The Democratic Senatorial Campaign Committee collected nearly $500,000 at a reception here on March 30, mostly from physicians and others affiliated with Doctors Hospital at Renaissance, financial disclosure records show.”

    A June article in THE NEW YORKER magazine painted a devastating portrait of the sky high costs of physician-owned hospitals in the McAllen area and President Obama has cited it often. But money talks, and the TIMES notes that, “Thus far, physician-owned hospitals have been insulated from some of the most onerous potential restrictions in the health care legislation moving through Congress.”

    Business as usual amongst the dough-driven denizens of Washington, DC, where they may as well replace the national anthem with Randy Newman’s “It’s Money that I Love,” and Pay-to-Play is the sport of kings.

    Anything and anybody are up for sale in the capital. You’ll recall the story in early July about the intimate dinner party WASHINGTON POST publisher Katharine Weymouth was planning. Her soiree would have brought the paper’s reporters and editors covering health care reform together with officials from the White House and members of Congress.

    But she also invited CEO’s and lobbyists – at $25,000 a pop, or a quarter of a million if they wanted to underwrite a series of these intimate salons. The invitation offered, "An exclusive opportunity to participate in the health care reform debate among the select few who will actually get it done."

    The dinner was scrapped when the WASHINGTON POST invitation leaked to the press. But such exclusive events where the elite meet to eat – for a price – are standard operating procedure in DC. THE ECONOMIST magazine and THE WALL STREET JOURNAL have hosted intimate salons. Atlantic Media, publisher of THE ATLANTIC magazine and NATIONAL JOURNAL, among other publications, has been holding off-the-record, get-togethers for the last six years, with such corporate sponsors as Microsoft, General Electric, Citigroup, Allstate Insurance and the healthcare giant AstraZeneca.

    Atlantic Media is now taking it one step further, moving their exclusive party to the Internet, where NATIONAL JOURNAL has announced a new, “policy-oriented” Web site called 3121, named after the phone extension for the U.S. Capitol switchboard. It’s exclusively for members of Congress and their staffs. Well, almost exclusively.

    I can’t log onto it – and neither can you, assuming you’re not a senator, representative or somebody who works for one. But guess what? If you’re a lobbyist, you can buy your way in.
    The Web site’s marketing kit promises that you’ll be able to “build connections and start a valuable conversation with a targeted group of some of the most powerful people in the political world.”

    Yes, ladies and gentlemen, for a mere $295,000, you can be 3121’s “Premier Promotional” sponsor. That means you get, quote, “exclusive rights to all advertising on 3121 from site launch in September” through the end of the year. You’ll also be invited to the Web site’s launch party and what they’re calling “Innovation Happy Hours,” so order your hats and noisemakers now.

    What’s that you say? You can’t afford nearly $300,000? Tell you what I’m gonna do. For a mere $95,000 you can buy what they’re calling a “Research and Education” package that gives you a sneak preview of 3121 and access to Capitol Hill insiders helping out with the Web design and learning how to use it.

    At least if you buy into 3121 you know the Web site stays bought, like Simon Cameron’s definition of an honest politician. For sheer, unmitigated chutzpah, I give you the American Conservative Union (ACU), prostituting its vaunted philosophical purity in pursuit of filthy lucre.

    It seems FedEx, the package delivery megacorporation, is facing a change in law that may hurt its competitive advantage over United Parcel Service. Legislation pending in Congress would level the playing field. As columnist Thomas Frank explained in THE WALL STREET JOURNAL, “Employees of UPS are covered by one labor law – the National Labor Relations Act (NLRA) – while employees of FedEx are governed by a different one, a law that makes it much harder for them to organize a union. Lots of UPS’s employees are organized; few of FedEx’s are.”

    As Frank wrote, the idea that Congress might give FedEx employees “more of a chance to have a say about work conditions” ruffled the company’s feathers. Enter the American Conservative Union – which seeks to be "the conservative voice in Washington," according to its Web site – and which said it would back FedEx’s opposition to the legislation with direct mail, e-mail and phone campaigns, radio ads and the creation of op-ed and other articles by ACU president David Keene and members of its board.

    The ACU said it would only charge FedEx, oh, say, somewhere between two and three million dollars, maybe up to $3.4 million, for its services.

    FedEx refused to sign for the package. So without batting an eye, the ACU switched its allegiance to UPS, accusing FedEx of fighting dirty. How brave, how principled. How corrupt.

    Summer is no time to be in Washington, the sun and humidity so oppressive that someone once described the sensation as akin to living inside the mouth of a very large dog. But it’s not the heat creating the rancid aroma rising from the city. It’s the panting exhaust created by the pursuit of money, regardless of country or party or philosophy. It’s money that they love, and nothing will change until we disable the ka-ching of the giant Washington cash register and use the money to buy the Pay-to-Players a one way bus ticket out of town.

    Please note that the views and opinions expressed by Michael Winship are not necessarily the views and opinions held by Bill Moyers or BILL MOYERS JOURNAL.

    July 24, 2009

    Diagnosing Proposals for Healthcare Reform

    (Photos by Robin Holland)

    This week on the JOURNAL, Bill Moyers spoke with two leading healthcare journalists, Trudy Lieberman and Marcia Angell, M.D., seeking their perspectives on the current health reform debate in Washington. Lieberman and Angell each addressed whether the “public option” proposed by President Obama would actually serve to insure all Americans and who in the private health industry stands to benefit from the reforms under discussion.

    Trudy Lieberman said that Obama’s proposed “public option,” in which the federal government would set up its own insurance option to compete with private insurance plans, has not been explained in detail and would likely not be effective in containing costs:

    “From my vantage point, I don't see that the solutions for controlling costs, that will really control costs the way other countries do, are really in place... We hear about preventive care as saving costs, because intuitively it sounds like it's going to work, but the academic studies show that more preventive care actually raises costs. That doesn't mean it's a bad thing to do, but it's not a good cost saver in the system... [Obama] has been vague right from the very beginning, we have not known exactly what the Obama health plan has been... I see an administration that is trying to keep this playbook going as long as possible, and to commit to as little as possible until the eleventh hour. By then, it’s going to be too late for the American people to know what’s going to await them... As a journalist, that troubles me.”

    Marcia Angell argued that the “public option” would not create the change needed in the American healthcare system and that reformers should advocate for a “single payer” system, in which a single federal agency would replace and eliminate the private health insurance industry:

    “What [Obama] has essentially advocated is throwing more money into the current system. He's treating the symptom and he's not treating the underlying cause of our problem. Our problem is that we spend two and a half times as much per person on health care as the average of other advanced countries, and we don't get our money's worth. So now he says, ‘Okay, this is a terribly inefficient, wasteful system. Let's throw some money into it...’ Obama said in his press conference [that] the worst thing we can do is nothing, the most costly thing we can do is nothing. I disagree with that – you can throw more money into this system and make it even more costly... I think we have to start all over on this, I really do. I think we have to go for a single payer system.”

    In his recent appearance on the JOURNAL, Clinton administration Secretary of Labor Robert Reich agreed that “single payer” is the best idea, but said that it is politically impossible and that the “public option” should be enacted anyway:

    “[The public option] means that average members of the public have a choice, if they want it, of either their private-for-profit insurers like they now use or a public not-for-profit insurer. That public insurer would resemble ideally Medicare, [with] low administrative costs and it would have the economies of scale. It would be so large that it could actually negotiate low drug prices and very low premiums. That’s what the private insurers are scared of, because that means that their profits will be squeezed... Unless they are going to be genuinely pressured to reform through a public option, there is nothing that’s going to change them... The single payer system would be the best of all... Unfortunately, we can’t get there from here because the political forces are just too strong against single payer.”

    What do you think?

  • If instituted, do you think President Obama’s proposed “public option” for health insurance would be sustainable? Why or why not?

  • Is flawed health reform legislation better than nothing or, as Marcia Angell argues, even worse? Should we start over? Explain.

  • Fear and Loathing in Political Discourse

    This week, the JOURNAL reprised a report from last year examining the provocative and often hostile rhetoric used by some right-wing ‘shock jock’ talk radio and cable TV hosts to criticize liberals and liberalism.

    A year ago, a gunman with an expressed hatred of liberalism stormed a Unitarian Universalist church in Knoxville, Tennessee, killing 2 and wounding 6. Several books by right-wing ‘shock jocks’ were found in the killer's apartment, which led some to speculate that he may have been influenced by their rhetoric.

    The church’s pastor, Chris Buice, said on the JOURNAL:

    “A man came in here and totally dehumanized us. Members of our church were not human to him. Where did he get that? Where did he get that sense that we were not human?... Some have suggested that his spiritual attitudes, his hatred of liberals and gays, was reinforced by the right-wing media figures... When you hear in talk radio that liberals are evil, that they are traitors, that they are godless, that they are on the side of the terrorist, that’s hate language. You don’t negotiate with evil people. You don’t live in a community with people you consider to be traitors.”

    In April, the Department of Homeland Security (DHS) sparked controversy when it issued a report [PDF link] warning that "... lone wolves [individuals acting alone] and small terrorist cells embracing violent rightwing extremist ideology are the most dangerous domestic terrorism threat in the United States." Among other factors, the report pointed to the economic downturn, the election of the first African-American president, and fears of gun control as potential drivers for right-wing radicalization. It also warned that "disgruntled military veterans" -- with their military training and combat experience -- could be targeted for recruitment.

    The DHS later apologized to a number of veterans groups that complained about the report.

    Penn State history professor Philip Jenkins argued in THE AMERICAN CONSERVATIVE magazine that the true threat of right-wing violence and domestic terrorism has been exaggerated by partisans for political purposes. Jenkins wrote:

    “We will hear a great deal about threats from racist groups and right-wing paramilitaries, and such a perceived wave of terrorism will have real and pernicious effects on mainstream politics. If history is any guide, the more loudly an administration denounces enemies on the far Right, the easier it is to stigmatize its respectable and nonviolent critics... Paying proper attention to terrorist threats is laudable, whatever their source, and some right-wing extremists have through the years demonstrated their potential for violence: they need to be watched. Yet almost certainly, a renewed focus on the far Right will develop more out of an ideological slant than any reasonable perception of danger.”

    What do you think?

  • In your view, do right-wing ‘shock jocks’ and their rhetoric bear any responsibility for violent incidents like the shooting in Knoxville? Explain.

  • Do you agree with Philip Jenkins that partisans have used tragic events to stigmatize legitimate opposition? Why or why not?

  • What are your ideas for bringing more civility into political discourse?

  • Bill Moyers & Michael Winship: Obama's Health Care Struggle – Waterloo or Water Down?

    Push finally came to shove in Washington this week as the battle for health care escalated from scattered sniper fire into all-out combat. If it all seems to be getting more and more confusing, join the club. It’s hard to see what’s happening through all the gun smoke.

    The Republicans have more than health care reform in their bombsights – they want a loss for Obama so crushing it will bring the administration to its knees and restore GOP control of Congress after next year’s elections. In the words of Republican Senator Jim DeMint, “If we’re able to stop Obama on this, it will be his Waterloo. It will break him.”

    The “Waterloo” of DeMint’s metaphor, of course, is not the 1974 ABBA hit but the battle in 1815 that ended Napoleon Bonaparte’s rule as Emperor of France – a humiliating defeat and a turning point in European history. Right wingers like Glenn Beck see Obama as Napoleon incarnate, a popular emperor who must be stopped.

    Here’s what Beck said on his television show Monday, July 20: “I’m telling you, this guy is dangerous. He’s never lost before. He won’t understand… like, ‘Who are you to question me?’ I mean, this guy is practically an imperial President now. When he starts to lose and people start to question him and push him back against the wall, he’s not gonna know how to react.”

    The Republican strategy is almost identical to the way they turned health care into Waterloo for Bill and Hillary Clinton in 1993. Back then, one of their chief propagandists, William Kristol, urged his party to block any health care plan for fear that Democrats would be seen as “the generous protector of middle class interests.” Now he’s telling the GOP to “go for the kill… throw the kitchen sink… drive a stake through its heart… We need to start over.”

    So in lockstep are the Republicans that when strategist Alex Castellanos issued a memo outlining their battle plan, party chairman Michael Steele parroted large sections of it word for word in a speech at Washington’s National Press Club. Asked a health care-related question that took him off script, Steele replied, “I don’t do policy.”

    As the Republicans fired away, big business stepped up the attack, too, their lobbying and advertising guns blazing. The Chamber of Commerce, for one, announced a major campaign of rallies and print and Internet ads to crush the White House plan for a competitive public option allowing consumers to choose between a government plan and private health insurance. In key states where members of Congress remain on the fence, the airwaves are vibrating with television commercials aimed at shifting hearts and minds away from any change that might threaten profits.

    President Obama rejected the Republicans’ Waterloo metaphor and mounted a massive media counteroffensive of his own. But the President has already run into booby traps of his own making and minefields laid by members of his own party, exacerbated when the Congressional Budget Office reported that reform plans, instead of controlling costs, would send the national debt further into the stratosphere.

    Meanwhile, supporters who want to scrap the present system for fundamental change are staring glumly though the fog of war at a battlefield in total disarray. They fear that in the White House’s desire to get a bill – any bill – passed by Congress, it will have been so compromised, so bent to favor the big interests, that it will be less Waterloo than water down, a steady diluting of the change they had hoped for and that America needs.

    The big drug companies are already so pleased with what they’ve been promised that they’ve brought back Harry and Louise – the make-believe couple who starred in TV ads that helped torpedo the Clinton health care plan – but this time they’re in favor of reform.

    According to the Associated Press, the drug industry’s trade group PhRMA (the Pharmaceutical Research and Manufacturers of America) and the drug company Pfizer “reported spending more money than other health care organizations on lobbying in the second quarter of this year” – $6.2 million from PhRMA, $5.6 million from Pfizer.

    “Including its latest report, PhRMA has now spent $13.1 million lobbying so far this year. Pfizer has reported $11.7 million in lobbying expenses for 2009.”

    This is part of the reason, as Alicia Mundy and Laura Meckler recently wrote in THE WALL STREET JOURNAL, that “the pharmaceuticals industry, which President Barack Obama promised to ‘take on’ during his campaign, is winning most of what it wants in the health-care overhaul.”

    Their story describes “a string of victories” plucked from the Senate Finance Committee by drug company lobbyists, including no cost-cutting steps, no cheaper drugs to be allowed across the border from Canada, and no direct Federal government negotiations with the pharmaceutical companies to lower Medicare drug prices.

    And that’s not all. The Senate Health Committee is giving the biotech industry monopoly protection against competition from generic drugs for 12 years after they go on the market.

    No wonder the cost of reform keeps going up and up and up. Could it be that Harry and Louise are happier because, this time, they’re in on the deal?

    July 17, 2009

    How Should America Respond to Global Warming?

    (Photo by Robin Holland)

    This week on the JOURNAL, environmental advocates Mary Sweeters and Erich Pica joined Bill Moyers to discuss their disappointment with President Obama’s environmental policies and pending congressional legislation intended to address global warming. On June 26th, the House narrowly passed the Waxman-Markey climate bill, collecting crucial votes through extensive negotiation and compromise. The Senate is scheduled to debate its own climate bill in the coming weeks.

    Many environmental groups have endorsed the Waxman-Markey climate bill as an important first step that will hopefully be strengthened over time. The Natural Resources Defense Council, for instance, issued a press release that said:

    “The House of Representatives has made a dramatic breakthrough for America's future by choosing to create jobs, move to clean energy, and reduce global warming pollution. The passage of this legislation, which was almost unimaginable six months ago, will help set our country in a new direction by shifting to a clean energy economy and reducing the carbon pollution that causes global warming... But the work is far from over. Now, the bill will move to the Senate where it needs to be strengthened, so we can reach the full potential of our clean energy future and avoid the worst impacts of climate change.”

    Erich Pica listed the reasons why groups like Friends of the Earth and Greenpeace oppose the legislation:

    “One, the bill doesn’t reduce global warming emissions in the United States fast enough and the emission reduction targets are just inadequate... Two, it strips away the [Environmental Protection Agency’s] authority under the Clean Air Act to regulate greenhouse gas emissions, which is a key tool that environmentalists have been using to shut down coal plants. Three, it gives away a tremendous amount of money, hundreds of billions of dollars to the polluting companies that have essentially caused the problem of global warming... Four, and this is kind of overwhelming the entire system, is that it relies on Wall Street to help solve the problem of global warming by allowing them to manage the trading system that’s created underneath this bill... Wall Street is going to work feverishly to erode any of the standards and protections that are put into this bill to prevent Wall Street from gaming the system.”

    Although the NRDC and groups like Friends of the Earth and Greenpeace disagree about the Waxman-Markey climate bill, they agree that the United States should forge ahead in passing federal policy to reduce emissions of greenhouse gases. Others argue that U.S. emissions cuts are not worthwhile unless the rest of the world can commit to doing the same. Writing in the WASHINGTON POST, economics professor Martin Feldstein said that the legislation is “all cost, no benefit:”

    “The proposed legislation would have a trivially small effect on global warming while imposing substantial costs on all American households... Americans should ask themselves whether this annual tax of $1,600-plus per family is justified by the very small resulting decline in global CO2. Since the U.S. share of global CO2 production is now less than 25 percent (and is projected to decline as China and other developing nations grow), a 15 percent fall in U.S. CO2 output would lower global CO2 output by less than 4 percent. Its impact on global warming would be virtually unnoticeable. The U.S. should wait until there is a global agreement on CO2 that includes China and India before committing to costly reductions in the United States... The proposed cap-and-trade system would be a costly policy that would penalize Americans with little effect on global warming.”

    What do you think?

  • Do you support the Waxman-Markey climate bill? Why or why not?

  • How do you think the U.S. should respond to global warming? What measures do you think are politically feasible?

  • Religion and the ''Moral Axis of the Universe''

    (Photo by Robin Holland)

    In this week’s JOURNAL, Bill Moyers spoke with author Robert Wright, who discussed his vision of how various cultures’ notions of God have evolved throughout history. Wright suggested that, at their best, religious traditions have aligned their adherents with a transcendent “moral axis of the universe” that encompasses values applicable to all of humanity:

    “I believe there’s a purpose unfolding that has a moral directionality – I have barely the vaguest notion of what might be behind that and whether it could be anything like a personal God or an intelligent being or not... Whatever is behind it, if something is, is probably something that’s beyond human conception... Given the constraints on human cognition, believing in a personal God is a pretty defensible way to go about orienting yourself to the moral axis of the universe... [The] conscience, which certainly is imperfect as natural selection shaped it, is not by itself a reliable guide to moral conduct, I think... If we want to secure the salvation of the global social system and of the planet – in other words, if we want salvation in the Hebrew Bible sense of the term – we do have to move ourselves closer to what I would call the moral axis of the universe, which means drawing more of humanity into our frame of reference, getting better at putting ourselves in their shoes, [and] expanding the realm of tolerance.”

    What do you think?

  • Do you believe, as Wright does, in a “moral axis of the universe” based on common values of expanding tolerance? Why or why not?

  • In your view, is religion necessary to build a more ethical society?

  • Bill Moyers & Michael Winship: Oysters for Health Care

    This is a story of health care and two Americans; a tale of two citizens, if you will.

    This week, Regina Benjamin was nominated by President Obama as our next surgeon general, charged with educating Americans on medical issues and overseeing the United States Public Health Service. She was the first African American woman to head a state medical society, a member of the board of trustees of the American Medical Association and last year was named the recipient of a MacArthur Foundation genius award.

    But more important, she’s a country doctor, a family physician along the Gulf Coast of Alabama, serving the poor and uninsured – white, black and Asian. After Hurricane Katrina destroyed her clinic – the second time a hurricane had done so – she mortgaged her own home to rebuild it. The day it was to reopen, a fire burned the clinic to the ground. Moving to a trailer, Dr. Benjamin and her staff never missed a day of work.

    Stan Wright, the tobacco-chewing mayor of Bayou La Batre, the small shrimp-fishing community in which Dr. Benjamin practices, told National Public Radio, “She’ll do whatever she’s gotta do to make sure everyone’s taken care of.”

    Benjamin will no doubt bring that same ethic to the fight for health care reform. When President Obama announced her nomination in a Rose Garden ceremony Monday, Dr. Benjamin said, “These are trying times in the health care field, and as a nation, we have reached a sobering realization. Our health care system simply cannot continue on the path that we're on. Millions of Americans can't afford health insurance or they don't have the basic health services available where they live.”

    Although the clinic has not been able to give Dr. Benjamin a salary for years – Mayor Wright says she’s owed over $300,000 – she buys medicine for her patients out of her own pocket.

    In fact, many of the folks in Regina Benjamin’s bayou town are so poor that sometimes she’s paid with a pint of oysters or a couple of fish. She’s fine with that. And she makes house calls.

    Now meet H. Edward Hanway, the chairman and CEO of CIGNA, the country’s fourth largest insurance company. At the beginning of the year, CIGNA blamed hard economic times when it announced the layoff of 1100 employees, but it reported first quarter profits of $208 million on revenues of nearly $5 billion. Mr. Hanway has announced his retirement at the end of the year, and the living will be easy, financially at least. He made $11.4 million in 2008, according to the Associated Press, and some years more than that.

    That’s a lot of oysters, although he lags behind Ron Williams, the CEO of Aetna Insurance, who made $17.4 million last year, or John Hammergren, the head of McKesson, the biggest health care company in the world. His compensation was $29.7 million.

    Here’s the difference. To Dr. Regina Benjamin, health care is a public service, helping people in need with grace and compassion. To Ed Hanway and his highly paid friends, it’s big business, a commodity to be sold to those who can afford it. And woe to anyone who gets between them and the profits they reap from sick people.

    That’s what Wendell Potter, the former CIGNA executive turned health care reform advocate, told us on last week’s edition of BILL MOYERS JOURNAL.

    “Just about every time there has been significant legislation before Congress, the industry has been able to kill it,” he said. “Yeah, the status quo works for them. They don't like to have any regulation forced on them or laws forced on them. They don't want to have any competition from the federal government, or any additional regulation from the federal government. They say they will accept it. But the behavior is that they will not.”

    As we reported last week, that behavior includes spending nearly a million and a half a day to make sure health care reform comes out their way. Over the years they’ve lavished millions on the politicians who are writing and voting on health care reform. Now it’s payback time.

    Proposed legislation finally is coming out of House and Senate committees, and Thursday’s LOS ANGELES TIMES reported “signs that the debate was moving into a more bruising phase in which insurance companies, hospitals and others fight to shape the details of legislative provisions that affect them.”

    It’s going to get ugly, especially now that some Democrats, according to ABC News, are contemplating new taxes on health insurance and phamaceutical companies to help pay for reform, perhaps as much as $100 billion worth.

    In other words, no more Mister Nice Guy. Those TV commericials you’ve been seeing from the health care companies about their generosity and miracles of modern medicine are about to change, as the opposition shifts gears from charm to alarm. It’s the war against the Clinton health care plan all over again.

    This time, don’t let them scare you. “It should not be this hard for doctors and other health care providers to care for their patients,” Dr. Regina Benjamin said when she was nominated this week. “It shouldn’t be this expensive for Americans to get health care in this country.”

    July 10, 2009

    Bill Moyers & Michael Winship: Some Choice Words For "The Select Few"

    If you want to know what really matters in Washington, don't go to Capitol Hill for one of those hearings, or pay attention to those staged White House "town meetings.” They’re just for show. What really happens – the serious business of Washington – happens in the shadows, out of sight, off the record. Only occasionally – and usually only because someone high up stumbles -- do we get a glimpse of just how pervasive the corruption has become.

    Case in point: Katharine Weymouth, the publisher of THE WASHINGTON POST – one of the most powerful people in DC – invited top officials from the White House, the Cabinet and Congress to her home for an intimate, off-the-record dinner to discuss health care reform with some of her reporters and editors covering the story.

    But CEO’s and lobbyists from the health care industry were invited, too, provided they forked over $25,000 a head – or up to a quarter of a million if they want to sponsor a whole series of these cozy get-togethers. And what is the inducement offered? Nothing less, the invitation read, than “an exclusive opportunity to participate in the health-care reform debate among the select few who will get it done.”

    The invitation reminds the CEO’s and lobbyists that they will be buying access to “those powerful few in business and policy making who are forwarding, legislating and reporting on the issues…

    "Spirited? Yes. Confrontational? No." The invitation promises this private, intimate and off-the-record dinner is an extension “of THE WASHINGTON POST brand of journalistic inquiry into the issues, a unique opportunity for stakeholders to hear and be heard.”

    Let that sink in. In this case, the “stakeholders” in health care reform do not include the rabble – the folks across the country who actually need quality health care but can’t afford it. If any of them showed up at the kitchen door on the night of this little soiree, the bouncer would drop kick them beyond the Beltway.

    No, before you can cross the threshold to reach “the select few who will actually get it done,” you must first cross the palm of some outstretched hand. The WASHINGTON POST dinner was canceled after a copy of the invite was leaked to the Web site Politico.com, by a health care lobbyist, of all people. The paper said it was a misunderstanding – the document was a draft that had been mailed out prematurely by its marketing department. There’s noblesse oblige for you – blame it on the hired help.

    In any case, it was enough to give us a glimpse into how things really work in Washington – a clear insight into why there is such a great disconnect between democracy and government today, between Washington and the rest of the country.

    According to one poll after another, a majority of Americans not only want a public option in health care, they also think that growing inequality is bad for the country, that corporations have too much power over policy, that money in politics is the root of all evil, that working families and poor communities need and deserve public support if the market system fails to generate shared prosperity.

    But when the insiders in Washington have finished tearing worthy intentions apart and devouring flesh from bone, none of these reforms happen. “Oh,” they say, “it’s all about compromise. All in the nature of the give-and-take-negotiating of a representative democracy.”

    That, people, is bull – the basic nutrient of Washington’s high and mighty.

    It’s not about compromise. It’s not about what the public wants. It’s about money – the golden ticket to “the select few who actually get it done.”

    When Congress passed the Helping Families Save Their Homes Act, "the select few” made sure it no longer contained the cramdown provision that would have allowed judges to readjust mortgages. The one provision that would have helped homeowners the most was removed in favor of an industry that pours hundreds of millions into political campaigns.

    So, too, with a bill designed to protect us from terrorist attacks on chemical plants. With “the select few” dictating marching orders, hundreds of factories are being exempted from measures that would make them spend money to prevent the release of toxic clouds that could kill hundreds of thousands.

    Everyone knows the credit ratings agencies were co-conspirators with Wall Street in the shameful wilding that brought on the financial meltdown. But when the Obama administration came up with new reforms to prevent another crisis, the credit ratings agencies were given a pass. They’d been excused by “the select few who actually get it done.”

    And by the time an energy bill emerged from the House of Representatives the other day, “the select few who actually get it done” had given away billions of dollars worth of emission permits and offsets. As THE NEW YORK TIMES reported, while the legislation worked its way to the House floor, “it grew fat with compromises, carve-outs, concessions and out-and-out gifts,” expanding from 648 pages to 1400 as it spread its largesse among big oil and gas, utility companies and agribusiness.

    This week, the public interest groups Common Cause and the Center for Responsive Politics reported that, “According to lobby disclosure reports, 34 energy companies registered in the first quarter of 2009 to lobby Congress around the American Clean Energy and Security Act of 2009. This group of companies spent a total of $23.7 million – or $260,000 a day – lobbying members of Congress in January, February and March.

    “Many of these same companies also made large contributions to the members of the Senate Environment and Public Works Committee, which has jurisdiction over the legislation and held a hearing this week on the proposed ‘cap and trade’ system energy companies are fighting. Data shows oil and gas companies, mining companies and electric utilities combined have given more than $2 million just to the 19 members of the Senate Environment and Public Works Committee since 2007, the start of the last full election cycle.”

    It's happening to health care as well. Even the pro-business magazine THE ECONOMIST says America has the worst system in the developed world, controlled by executives who are not held to account and investors whose primary goal is raising share price and increasing profit – while wasting $450 billion dollars in redundant administrative costs and leaving nearly 50 million uninsured.

    Enter "the select few who actually get it done." Three out of four of the big health care firms lobbying on Capitol Hill have former members of Congress or government staff members on the payroll – more than 350 of them – and they’re all fighting hard to prevent a public plan, at a rate in excess of $1.4 million a day.

    Health care policy has become insider heaven. Even Nancy-Ann DeParle, the White House health reform director, served on the boards of several major health care corporations.

    President Obama has pushed hard for a public option but many fear he’s wavering, and just this week his chief of staff Rahm Emanuel – the insider del tutti insiders – indicated that a public plan just might be negotiable, ready for reengineering, no doubt, by “the select few who actually get it done.”

    That’s how it works. And it works that way because we let it. The game goes on and the insiders keep dealing themselves winning hands. Nothing will change – nothing – until the money lenders are tossed out of the temple, the ATM’s are wrested from the marble halls, and we tear down the sign they’ve placed on government – the one that reads, “For Sale.”

    July 2, 2009

    Faith, Justice, and Society

    (Photos by Robin Holland)

    This week on the JOURNAL, Bill Moyers spoke with academics Gary Dorrien, Serene Jones, and Cornel West about what faith traditions can tell us about building a more just society. The trio recently taught a class together, “Christianity and the U.S. Crisis,” at Union Theological Seminary in New York City.

    Gary Dorrien explained his view that democracy is intrinsic to a just society:

    “I think that economic democracy is essentially an attempt to serve as a kind of brake on human greed and will to power, which are virtually universal, so I’m not talking about anything that requires some kind of idealistic idea about human nature or what we’re capable of. My main argument is the same that Reinhold Niebuhr had about democracy – that the human capacity for greed makes democracy possible, but it’s precisely the human capacity for evil that makes democracy necessary.”

    Serene Jones suggested that communities can help overcome any single individual’s shortcomings:

    “Sin, for me, describes the fact that we are born thrown into this world and we are, no matter how hard we try, because of the complexity of how we’re put together, destined to make massive mistakes. The best we can hope for is that we’re in a community of people that continually remind us that, in fact, we don’t understand everything and we are not the center of the universe. That’s sin, the inevitability of that. I think it’s central to democracy – we have checks and balances.”

    Cornel West argued that people’s commitment to their faith is best demonstrated in service to others:

    “We don’t want to get too obscure in our discourse and not really just put on the table something that’s very simple: how deep is your love? What is the quality of your service to others? Are you concerned about those on the margins, or do we define a catastrophe only when it relates to investment bankers and Wall Street Bankers as opposed to the precious children in chocolate cities or white children in Appalachia or red children in Navajo reservations?... What costs are we willing to actually undergo? You can’t be a Christian if you’re not willing to pick up your cross and, in the end, be crucified on it. That’s the bottom line.”

    What do you think?

    How does your faith or moral code inform your views about politics and society?

    Michael Winship: My State Legislature's Crazier than Yours. Oh Yeah?

    (Photo by Robin Holland)

    Below is an article by JOURNAL senior writer Michael Winship. We welcome your comments below.

    ''My State Legislature's Crazier than Yours. Oh Yeah?''
    By Michael Winship

    California should just be done with it and rename the entire state “Neverland Ranch.”

    This serves several useful purposes. It would be the ultimate tribute to Michael Jackson, pleasing his most ardent and bereft fans. Further validate the state’s Cloud Cuckoo, fairy tale reputation, thus probably promoting additional, revenue-generating tourism. Stand as an accurate metaphor for the state government’s airheaded inability to cope with its current financial disaster.

    On Wednesday, Governor Schwarzenegger announced that California’s deficit has grown to $26.3 billion and proposed billions of additional cuts to education. He declared a fiscal emergency, triggering an automatic 45-day deadline for the state legislature to come up with a plan to cover the shortfall and balance the budget. If that fails, they’re banned from considering any other legislation until they come up with a solution.

    Arnold also signed an executive order forcing the state’s 220,000 employees to take a third, unpaid furlough day every month. This, after weeks of failed proposals, threatened vetoes, political contortionism, suspended social programs – a fiscal train wreck of such proportions that on Thursday the state planned on starting to pay its bills with IOU’s instead of cash.

    It’s “an institutional breakdown,” according to State Treasurer Bill Lockyer, a Democrat. Lockyer has called for professional mediation to unjam talks between legislators and Governor Terminator, and even a two-tiered budget system that would raise taxes and allot resources differently for different parts of the state.

    That may sound crazy, but this is California. Besides, we in New York State are in no position to cast stones. Our State Senate has degenerated into a slaphappy free-for-all that resembles a drunken demolition derby more than anything remotely like a deliberative body.

    On June 8, two Democratic state senators, both of whom are under investigation on an assortment of charges, defected to the other side of the aisle, giving the Republicans a 32-30 majority. Then one of the Democrats changed what was left of his mind and went back, creating a 31-31 split and deadlock.

    Under normal circumstances, the lieutenant governor, who also serves as Senate president, could break a tie. But currently, we don’t have one of those. David Paterson had the job until he was elevated to the top spot when Governor Eliot Spitzer was caught engaged in commercialized bedhopping and resigned.

    Last month’s legislative coup has led to name-calling, accusations, general inertia and circumstances under which, among other assorted wackiness, the guy who the Republicans say is the current Senate president has claimed that because there is no lieutenant governor, he should have two votes.

    Because neither side can come up with the requisite 32 members for a quorum, the Senate disintegrated into a series of alternating, one-party sessions during which nothing could be accomplished. Although on Tuesday, when Democrats spotted Republican member Frank Padavan walking through the rear of the chamber, they seized on the moment, claiming a quorum, and started ramming through legislation, which the Republicans say was illegal. Padavan says he was just taking a shortcut for a cup of coffee.

    Imagine West Side Story meets Duck Soup, with the Marx Brothers playing the Sharks and Jets, using whoopee cushions instead of switchblades, and you get the general idea. With the backing of a court order, Governor Paterson is trying to force all 62 members into the chamber for daily “extraordinary” sessions at which he hopes a deal can be cut that will get the Senate up and running again. He says he’ll keep them coming right through the Fourth of July weekend. Some are refusing to attend. Watch this space.

    Because, despite all the foolishness, as in California, this is serious stuff with potentially dire consequences. As The New York Times reports, June 30 “was the expiration date of more than a dozen statutes that authorize local governments to carry out their everyday duties, from planning budgets to collecting taxes. And as Democrats and Republicans in the Senate continued… to argue fruitlessly over who controlled the chamber, officials around the state were left to ponder contingency plans that they never thought they would need.”

    What’s also infuriating is the way certain enabled individuals consciously are helping stymie any possible breakthrough. In California, it’s Governor Schwarzenegger, whose veto threats, blocking of short-term loans, and refusal to raise any tax or virtually any fee have thrown additional wooden shoes into the works. In New York, it’s not the governor, who has tried to break gridlock but whose efficacy is virtually nil and popularity is south of “get lost.” It’s upstate billionaire businessman Tom Golisano, a gadfly who, according to the Times, helped broker the defection of the two NY Senate Democrats that precipitated the current mess. Apparently, he did so out of pique over proposed tax hikes on the wealthy.

    It’s all a nasty game that puts cronyism, partisan bickering, and corrupt, despicable self-interest above the needs of increasingly desperate citizens. Especially abhorrent as we celebrate the country’s independence and commemorate that long ago struggle against abuses of power.

    At least Brooklyn Democratic Senator John Sampson, when asked this week if he was embarrassed about the situation, had the grace to reply, “Embarrassed? That’s an understatement. We’re ashamed.”


    Please note that the views and opinions expressed by Michael Winship are not necessarily the views and opinions held by Bill Moyers or BILL MOYERS JOURNAL.

    A Companion Blog to Bill Moyers Journal

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