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August 15, 2009

Fighting fire with fire: an email forward
Posted by Abi Sutherland at 05:01 AM *

You know those political email forwards one gets from relatives? Well, I got one from my father, but it didn’t originate from an anonymous source, exactly. I don’t know if it’s going to be effective; it looks a little too factual and verifiable to be a genuine political chain email.

Still, worth a read. It’s below the cut.

Dear Friend,

This is probably one of the longest emails I’ve ever sent, but it could be the most important.

Across the country we are seeing vigorous debate about health insurance reform. Unfortunately, some of the old tactics we know so well are back — even the viral emails that fly unchecked and under the radar, spreading all sorts of lies and distortions.

As President Obama said at the town hall in New Hampshire, “where we do disagree, let’s disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that’s actually been proposed.”

So let’s start a chain email of our own. At the end of my email, you’ll find a lot of information about health insurance reform, distilled into 8 ways reform provides security and stability to those with or without coverage, 8 common myths about reform and 8 reasons we need health insurance reform now.

Right now, someone you know probably has a question about reform that could be answered by what’s below. So what are you waiting for? Forward this email.


David Axelrod
Senior Adviser to the President

P.S. We launched this week to knock down the rumors and lies that are floating around the internet. You can find the information below, and much more, there. For example, we’ve just added a video of Nancy-Ann DeParle from our Health Reform Office tackling a viral email head on. Check it out:
Health Insurance Reform Reality Check

8 ways reform provides security and stability to those with or without coverage

  1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
  2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
  3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
  4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
  5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
  6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
  7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
  8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won’t be allowed to refuse renewal because someone became sick.

Learn more and get details:

8 common myths about health insurance reform

  1. Reform will stop “rationing” - not increase it: It’s a myth that reform will mean a “government takeover” of health care or lead to “rationing.” To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
  2. We can’t afford reform: It’s the status quo we can’t afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
  3. Reform would encourage “euthanasia”: It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
  4. Vets’ health care is safe and sound: It’s a myth that health insurance reform will affect veterans’ access to the care they get now. To the contrary, the President’s budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
  5. Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
  6. Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare “doughnut” hole to make prescription drugs more affordable for seniors.
  7. You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
  8. No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you - and the same rules of privacy will apply as they do for all other electronic payments that people make.

Learn more and get details:

8 Reasons We Need Health Insurance Reform Now

  1. Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults - 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market - were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more:
  2. Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. Learn more:
  3. Roadblocks to Care for Women: Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care. Women are also more likely to report fair or poor health than men (9.5% versus 9.0%). While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches and are more likely to experience joint, back or neck pain. These chronic conditions often require regular and frequent treatment and follow-up care. Learn more:
  4. Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more:
  5. Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured - 13 million people - are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more:
  6. The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more:
  7. Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more:
  8. The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance - projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more:


Comments on Fighting fire with fire: an email forward:
#1 ::: John Stanning ::: (view all by) ::: August 15, 2009, 06:39 AM:

Well, I guess it’s worth a try...  The message is also posted on the whitehouse web site here.

abi, the link to in the P.S. to the e-mail needs mending (the one farther down, under “Learn more and get details”, works).

#2 ::: dichroic ::: (view all by) ::: August 15, 2009, 06:39 AM:

I think it's likely real, because I did hear onthe news (CNN, probably) something to the effect that the Obama adminstration would begin doing "chain letters".

#3 ::: Mark ::: (view all by) ::: August 15, 2009, 07:01 AM:

I got the same e-mail, having gotten on the Obama campaign mailing list before the election. They're trying to use the howler monkeys' new favorite technique against them. It's a good debunker's quick reference guide, but I doubt it will have the same contagious properties as the hysterical crap ones, simply because it lacks the fnords that propel the latter.

This (non-)debate is problematic for that big reason - the fnords. You've got this seemingly irreducible segment of the population entrenched (entombed?) in poor education, class resentment and yes, racism. It may not be manifesting as outright war on the educated and non-white, but it creates a white noise of anger and fear that permeates everything and makes them fertile ground for any lie that reinforces their resentments to take root.

#4 ::: James D. Macdonald ::: (view all by) ::: August 15, 2009, 07:08 AM:

This email isn't going to get forwarded or go viral.

It doesn't have a hook. No OMG you gotta see this! in it.


#5 ::: candle ::: (view all by) ::: August 15, 2009, 07:09 AM:

I'm a little bit bothered by the section on myths: the headers for 2 and 3 are myths, but the other headers are all rebuttals.[*] If you do the exercise (which I do automatically) of reading the headers only, it begins to look as though it is either a myth that "vets' healthcare is safe and sound", or else a truth that "we can't afford healthcare". Obviously this is all made clear in the text, but it seems to be asking to be misread.

My feeling is that if you are going to have headers at all, then you should make sure they are all of the same type. I'm not sure I've explained that very well, but the layout just feels slightly clunky to me. Probably there are people here with actual experience in technical writing who can explain or correct me on this.

Sorry that this isn't a comment on the healthcare issue as such.

[*] 8 is somewhere in between, and might possibly have been a better model for the whole thing.

#6 ::: Sophie ::: (view all by) ::: August 15, 2009, 07:33 AM:

Without making any calls as to how effective this will be? I'm gonna go ahead and say that the use of 'reality check' is a hell of a nice touch.

Well played, administration. Well played.

#7 ::: Sylvia ::: (view all by) ::: August 15, 2009, 07:59 AM:

It doesn't have flashing pictures nor spiralling letters in Outlook. My father won't forward it.

#8 ::: ianracey ::: (view all by) ::: August 15, 2009, 09:02 AM:

The very first link to is broken, right beneath the introductory note from Axelrod. It has prepended to the URL.

Well, I'm assuming it's a mistake. Unless the White House really is trying to throw some traffic this way, in which case, awesome.

#9 ::: ianracey ::: (view all by) ::: August 15, 2009, 09:03 AM:

Oh, and I totally missed where that gets pointed out in the very first comment. Go me.

#10 ::: abi ::: (view all by) ::: August 15, 2009, 09:31 AM:

Ok, link fixed. I hand-formatted the email because my father's mail program is...well, weird. Or mine. Or something.

I agree that this won't go viral, though I hope it gives people some useful ammunition. But a viral email would work best with a story. As Teresa pointed out elsewhere recently, that's how we work.

I keep hoping this is the same thing we saw in the election, where Obama's two steps ahead of the game and preparing another masterstroke. We could use one.

#11 ::: Dave Lartigue ::: (view all by) ::: August 15, 2009, 10:04 AM:

There are two things I can think of that will prevent this from being terribly effective, unfortunately:

1) Supporting your stance by essentially quoting yourself (emails from "The White House" citing facts from isn't going to convince anyone who is already suspect of "either" source.

2) Nothing that the anti-health-reform OMG SOCIALISM folks have shown indicates that they're interested in facts from ANY source. They are only interested in whatever wild-assed blathering supports their own paranoid, ignorant, and, yes, racist worldview.

#12 ::: TexAnne ::: (view all by) ::: August 15, 2009, 10:28 AM:

The missing hook in this post is to be found in the post immediately below it. The Malones have a sick newborn, they're married, they're employed, and they're white...there's nothing there for the crazy people to dislike. (Although I'm sure they'll find some reason to pretend that the Malones are undeserving.)

#13 ::: Dena Shunra ::: (view all by) ::: August 15, 2009, 10:42 AM:

As Abi & Teresa have pointed out in @10 here and in (um?) elsewhere, the way to make this stick is through story.

So... can we find a story for each of the items, and add it to the email?

Here's my go on the last of the 24 items(call it 3:8): in 2001 I insured my family for $252 a month. I had to buy the insurance myself, because I own a small business, but hey, it was affordable and covered all our needs. By 2005 the cost had risen to $800 a month for the same family, without even adding children. And the coverage with the same company shrank to 1 million lifetime from 2 million. We switched to catastrophic insurance plus an HSA. The cost of *that* is rising, too, and the coverage is dropping. Will a catastrophe make me drop insurance just to pay current bills? Like, say, the not-entirely unforeseen catastrophe of aging?

And Candle@5, I had the same problem with the mythbusting section (2:1 through 2:8).

#14 ::: Mark ::: (view all by) ::: August 15, 2009, 10:52 AM:

candle @ 5: Not a tech writer here, I just have a side-business as a freelance editor (widely mixed bag of genres including translation polishing from academic articles in Spanish). I absolutely noticed what you were talking about with the headers - consistency problems bring out my inner Ninja Editor (kill this sentence and leave no witnesses!).

Maybe I should send Axelrod's office a copy of this e-mail, red-penned to hell and gone, as a job application.

#15 ::: steve ::: (view all by) ::: August 15, 2009, 11:28 AM:

They've got the germ of something there, but if it could be rewritten as "Secret White House Plan Revealed! What they don't want you to know about Healthcare!" or similar, it would maybe have more chance of spreading into the right demographic....

#16 ::: The Raven ::: (view all by) ::: August 15, 2009, 11:49 AM:

That's pretty good. Why, promise universal coverage for a reasonable price & it would go viral.


#17 ::: Mary Aileen ::: (view all by) ::: August 15, 2009, 12:28 PM:

candle (5): That bothered me, too. The headers on that section keep switching back and forth between the myths and the debunkings.

#18 ::: Evan Simpson ::: (view all by) ::: August 15, 2009, 02:45 PM:

I like the idea of doing this up properly as a viral email. Here's my take on what that might look like. It's a Google Doc that anyone can edit: "Secret Truths About Health Insurance Reform THEY Don't Want You to Know!"

#19 ::: Mark ::: (view all by) ::: August 15, 2009, 04:16 PM:

Evan, nice job punching up the language in that piece. Since you were gracious enough to put it in Google, I just tweaked the last section lead-in to make it clear the list of problems was what the existing "system" threatens us with every day reform is put off.

#20 ::: SeanH ::: (view all by) ::: August 15, 2009, 04:20 PM:

Candle: good to know I'm not the only one who gritted their teeth on seeing it.

I've heard a few times that socialised healthcare is Unfathomably Complex And Bureaucratic. I actually work in the NHS bureaucracy, and it is extremely complex (I work for the office that controls and issues guidelines for prescriptions in my borough, including five prescription targets per quarter - this quarter we're trying to get prescriptions of one particular statin down as a percentage of overall statin prescriptions because it's less cost-effective and blah blah blah forever) - but all of this is only your problem if you actually work in the system. From the point of view of the patient, you just go to your doctor and get seen to, with nothing more complicated to think about than how often you have to take these new pills.

Here is an example (pdf) of the sort of terribly complex form you have to fill out as a patient. It's not exactly Kafka.

#21 ::: Eileen Gunn ::: (view all by) ::: August 15, 2009, 05:17 PM:

Evan @ 18: Thanks, Evan. The Alexrod text made my ocpywriting fingers itchy. Maybe he wrote it himself....

I suppose it's a good sign that this gov't is sometimes a tad clueless when it comes to writing effective propaganda.

#22 ::: James D. Macdonald ::: (view all by) ::: August 15, 2009, 06:30 PM:

Okay, is it time to start sending the New! Improved! email around?

Let your conscience be your guide.

#23 ::: David Harmon ::: (view all by) ::: August 15, 2009, 06:57 PM:

Just popping in briefly from vacation at my sister's house....

If you're going to improve the writing, or add links for story, you should send the result back to! (Even without detailed examination, I have little doubt this crew can improve it!)

#24 ::: Linkmeister ::: (view all by) ::: August 15, 2009, 07:25 PM:

I have a problem. As far as I can tell, all the people in my e-address book are already on board with health care reform (well, there's those liberals in LA who somehow are amused by Ahnold, but still).

I think I live in an echo chamber.

#25 ::: P J Evans ::: (view all by) ::: August 15, 2009, 07:35 PM:

Done. Or at least a linky to it via the WH contact page - it's too long to send directly. (What's their length limit on e-mails, about 2K?)
I sent it back as a reply to Axelrod's e-mail, too.

#26 ::: P J Evans ::: (view all by) ::: August 15, 2009, 08:06 PM:

also now sent to my e-mail-forwarding relatives. (Nice timing!)
They're about as far to the right as you can get and still be more or less sane.

#27 ::: Lee ::: (view all by) ::: August 15, 2009, 08:10 PM:

candle, #5: I had the same reaction. If I send this to anyone, I'll do a little editing on the headers first.

#28 ::: The Raven ::: (view all by) ::: August 15, 2009, 08:34 PM:

I'm feeling used, like progressives were used in the election. Is anyone else getting that Obama election feeling? That we get to fight for this because the alternative is so awful, and we will get no thanks at all, nor any real power? I don't want to support Max Baucus and Charles Grassley. I don't want to help them write a health care deform bill. What about you?

#29 ::: P J Evans ::: (view all by) ::: August 15, 2009, 08:39 PM:

Raven you're not the only one. There are a lot of us out here. We're good enough for them, when we're giving them money and making phone calls for them, but when we start wanting them to actually keep some of the promises they made to get where they are, suddenly we're the people who are out of line and asking for the moon on a silver platter.

#30 ::: James D. Macdonald ::: (view all by) ::: August 15, 2009, 08:42 PM:

What about you?

As you yourself said, the alternative is awful.

Therefore I'll do what I can.

#31 ::: TexAnne ::: (view all by) ::: August 15, 2009, 08:49 PM:

PJ, 29: Uh-oh. That's how the Republicans treat their base, too.

#32 ::: KAS ::: (view all by) ::: August 15, 2009, 11:28 PM:

Awesome, Evan! I made a few tweaks. Any thoughts as to whether this might be more effective split up into multiple e-mails? Our target audience has a short attention span, after all. Maybe an e-mail for each set of myths, and a different hook for each message...

*goes off to look for more hooks*

#33 ::: The Raven ::: (view all by) ::: August 16, 2009, 12:05 AM:

PJE, #29: thank you & sympathies. TexAnne, #31: it's how both major US parties treat their bases. Wow, do we need electoral reform.

James D. Macdonald, #30: the Senate plan, pretty much, is the health care version of the bank bailout. Lots of money for the insurance companies, maybe makes some people actually get poorer, and it's all to do again when the wheels come off. There's no House plan at all. With the wingnuts flying, who knows what the House plan will be? While I oppose the wingnut response, there's little from the Democrats for me to support. A few improvements, mostly for people who already have insurance through their employers, a big handout to the financial industry (again!), and a somewhat smaller handout to big pharma. Why would I be enthusiastic about that? Why would anyone? And if I'm not enthusiastic, how can I persuade anyone else? To get real popular support there's got to be something real there, something more than just tweaks, even good tweaks, and so far it's just not there.

#34 ::: Evan Simpson ::: (view all by) ::: August 16, 2009, 01:36 AM:

KAS @ 32: Ooh, I like that idea! Three decent emails for the price of one awkward one, plus two more hooks. It would probably take a bit more work to make them feel distinctive, so recipients don't trash the second and third thinking they've seen it already. So far, though, ripping out the clashing headers and stilted phrasing of the original has scratched my itch.

#35 ::: The Raven ::: (view all by) ::: August 16, 2009, 02:49 AM:

...further thoughts. By Odin, I will not go to the mat for policy tweaks! Propose "Medicare for All"--I can get behind that. Propose a reasonable public option or co-op system (essentially the same thing, no, Conrad's co-op proposal doesn't count)--that's enough. Wonkery, even good wonkery, just isn't inspiring.

"Make no little plans. They have no magic to stir men's blood and probably themselves will not be realized."--Daniel Burnham.

#36 ::: Bill ::: (view all by) ::: August 16, 2009, 04:08 AM:

I've been finding this whole PR push very frustrating. As a libertarian, I think there are actually good arguments about why government healthcare isn't the best idea, and about why it's unlikely that the current political process will lead to well-run government healthcare even if you do like government healthcare, much less any semblance of free market healthcare instead of the current mess. But I'm not going to argue them here - I'm going to rant about the low-quality material put out by the two sides that _are_ getting press coverage. (After all, any issue that doesn't have more than two sides to it is pretty dull and boring.)

First there's the term "reform" - it means that the speaker has something he doesn't like about the current situation, and wants to assert that he's got the moral and intellectual high ground about how to fix it, but it doesn't actually have any content that you can be for or against. Other than health care, the US press most commonly uses it to refer to immigration issues - but groups claiming to favor "reform" want anything from "send all those furriners back to Mexico (even if they came from somewhere else)" to "immigration is a fundamental human right and the Immigration Bureaucracies are a bunch of slow incompetent thugs". I mean, really, who can make a speech saying that they're opposed to "reform", even though nobody knows what Obama really hopes to do because they haven't worked it all out yet?

And then there's the hopeless Right Wing. Once upon a time, American politics had some actual conservatives, such as Barry Goldwater (either the younger edition who ran for President or his older, crankier self who had the guts to say things the conservative movement didn't like if he believed in them), or Newt Gingrich's cadre who ran the Contract On America, or even Ronald Reagan (who'd give a good speech if somebody wrote it for him.) But the Bush/Rove gang kicked anybody like that out of the process - what they wanted was angry believers who'd parrot the party line and attack anyone who wasn't on message rather than having a serious discussion of issues. And now that they're out of power, there's nobody in charge any more, much less anybody providing any intellectual leadership - there's just a bunch of angry parrots stirring each other up and attacking the Democrats by making up random things and yelling a lot.

It's really sad. A competent opposition would force the Obama Administration to do some serious thinking about what to do, because it's a really large, really hard problem. Instead, they're having to defend themselves against wingnuts and dumb down their discussions with the public to avoid getting beaten up, and the political realities are that they have to Do Something reasonably quickly to avoid losing ground in the 2010 elections - so we're not going to get their best work, or anything like it. And there are lots of good issues the large pro-Obama group that put him in office could be working on, but they're also getting dragged into countering wingnuts.

#37 ::: candle ::: (view all by) ::: August 16, 2009, 08:43 AM:

Evan@34: So far, though, ripping out the clashing headers and stilted phrasing of the original has scratched my itch.

Yeah, much happier with the rewritten version, and I'm glad I'm not the only one who was pained by the headers.

David Harmon@23: (Even without detailed examination, I have little doubt this crew can improve it!)

Of course, if you really want it to go viral, and want to make use of core ML competencies, it needs to be rewritten as light verse.


#38 ::: P J Evans ::: (view all by) ::: August 16, 2009, 09:46 AM:

Actually, the House has a bill going through committees. It includes public option (although not single payer).
It isn't bad; the committee it comes through first is Waxman's.

#39 ::: Joel Polowin ::: (view all by) ::: August 16, 2009, 11:02 AM:

candle @ 37: Of course, if you really want it to go viral, and want to make use of core ML competencies, it needs to be rewritten as light verse.

If you really want it to go viral, do it as a snarky country song, and post a video of the performance to YouTube.

#40 ::: James D. Macdonald ::: (view all by) ::: August 16, 2009, 11:19 AM:

If you want to talk about Death Panels, lifetime insurance caps are it.

#41 ::: The Raven ::: (view all by) ::: August 16, 2009, 01:02 PM:

P J Evans, #38: Yes, yes. But the conservatives got the House to delay passage of the bill until after recess, so they could whip up the crazies. And we haven't seen the full effects of the propaganda campaign yet. It's going to take real guts to pass that bill when they get back.

#42 ::: Tom ::: (view all by) ::: August 16, 2009, 02:11 PM:

Raven, this is politics at its messiest. We will never get 'steak,' we will never get 'salmon,' but if we encourage and defend our representatives with enough vigor, we might get edible sausage out of the deal.

Your Daniel Burnham quote is a welcome sight. I'm a displaced Chicagoan, and I agree – it will take something Big And Mighty to displace the mythical boogeymen from the public consciousness.

#43 ::: Linkmeister ::: (view all by) ::: August 16, 2009, 02:24 PM:

Raven @ #41, slight correction. The House passed its versions out of committee. It's the Senate Finance Committee that's behind schedule and has caused this August delay.

#44 ::: janetl ::: (view all by) ::: August 16, 2009, 07:57 PM:

I posted a Facebook status about health care reform, and now my conservative-to-moderate relatives and my liberal-to-pinko friends are debating (fairly politely) in the comments. I think this is positive thing.

#45 ::: The Raven ::: (view all by) ::: August 16, 2009, 09:39 PM:

Linkmeister, #41: the House didn't have to wait for the Senate--in fact, it originally wasn't going to.

Tom, #42: oh, no! The Answer is sausage! So long as it's sausage rather than sawdust, I'm OK. But it looks like the Administration has caved. So, unless the House stands up to the crazies and the Senate, it's sawdust.

Bill, #36: the debate is content-free because there's nothing left to debate. The arguments have been made, and the field tests have been done. The USA tried a public/private solution; the rest of the developed world tried public solutions. The US solution is a dismal failure. That's why the antis are unleashing the crazies: they have no case.

James Macdonald: now what? I don't see how progressives are going to defeat the Senate conservatives without support from the Administration. It's worth keeping up the fight--there's a difference between bad and worse--but so far as I can tell we're fighting a rearguard action.

#46 ::: James D. Macdonald ::: (view all by) ::: August 16, 2009, 11:47 PM:

James Macdonald: now what? I don't see how progressives are going to defeat the Senate conservatives without support from the Administration. It's worth keeping up the fight--there's a difference between bad and worse--but so far as I can tell we're fighting a rearguard action.

What now?

Fight the rearguard action, if that's what it is. How can there be any question?

#47 ::: John K ::: (view all by) ::: August 17, 2009, 12:07 AM:

This will only go viral among left wingers. Those of us with brains will delete it immediately because it's full of lies and distortions.

Get over it - you are all losers.

#48 ::: P J Evans ::: (view all by) ::: August 17, 2009, 12:23 AM:

about #47 (first time commenter):
Projection, much?

I can haz popcorn?

#49 ::: Stefan Jones ::: (view all by) ::: August 17, 2009, 12:35 AM:

#47: Quick John, look behind you! DEATH PANEL!

#50 ::: Earl Cooley III ::: (view all by) ::: August 17, 2009, 02:55 AM:

It should be possible to create a parody of Death Panels through references to the stylish Death Note anime show.

#51 ::: michael ::: (view all by) ::: August 17, 2009, 04:19 AM:

Our President is getting his first taste of going against the insurance industry, which is, make no mistake about it, a cartel, no longer the intended business model originally created to protect in an event of a loss, with their hands in all elections, all the time and process as much money as our government and in fact controls many public policies. Currently, what the insurance industry wants, the industry gets. They feel that no one is too big for them. With profits paramount, currently running health care as well as auto collision repair in there unsuccessfully dysfunctional way with no one to challenge them, as well as crushing free enterprise with their referral systems. When US States successfully created affordable government run workman’s comp insurance for business, the system currently works extremely well, with government achieving a much higher level of service at half the cost, but not surprisingly the insurance industry attempts to abolish the program every legislation cycle. They complain about being in competition with the government, but have no regard to health care patients well being, care facilities or the collision repair stores they our putting out of business daily by pushing all the patients or damaged autos through locations they own or have interest in, aggressively via referral systems. Insures are in competition with all businesses they pay claims to. From health care to auto repair. The insurance industry is currently a competitor to businesses and crushes whom they feel like, with no Federal Trade Commissions stopping them. The insurance industry controls the largest majority of claims service rendered. Free competition is long gone but seriously needs to be restored. I believe government should not just challenge the insurance industry, but to do its job and control them. I wish a leader to challenge the cartel, not give in to greed, and win. Mr. Obama, please don’t give up. The insurance industry can and should be restored back into its intended purpose. The insurance industry currently has more money than local governments and is right behind the federal government with regards to cash flow. They have hand placed policy makers in all levels of our government, federally and local. This presents serious threats to our government and should be investigated by the Federal Trades Commission, FBI and the CIA to ensure the stability of our government.
Politics 101 is to tell the public what they want them to think. The “public support for Obamas plan” articles are noting short of insurance lobbyists getting to work to win.

#52 ::: Howard Weak ::: (view all by) ::: August 17, 2009, 07:36 AM:

I worked my ass off for this campaign and the promise of health care.

If this falls through, I will feel used and will work for a Republican canidate next time.

#53 ::: Wesley ::: (view all by) ::: August 17, 2009, 08:06 AM:

Howard Weak, #52: If this falls through, I will feel used and will work for a Republican canidate next time.

Then you'll really get to feel used.

#54 ::: Mark ::: (view all by) ::: August 17, 2009, 08:09 AM:

Howard Weak @ 52: Understand the sentiment, but that's like saying you're disappointed with your tough-on-crime candidate so you're going to work for the Mafia.

#55 ::: Pat Smitt ::: (view all by) ::: August 17, 2009, 08:15 AM:

blogging/tweeting/chatting i hear concerns: 'the bill says government and congress is specifically exempted from the universal plan'. like this, most reflect a basic distrust of government that i speculate is not necessarily related to healthcare alone or this administration in particular. It's been a difficult 103 months that has shaken our collective confidence in the government's ability to govern.

I see Barack is re-building confidence and trust with his actions. Keep it up. I don't believe you can ever have too much accurate information - so a good letter sounds great. Tip: to really help build trust - stand up for your strong public option.

#56 ::: CHip ::: (view all by) ::: August 17, 2009, 08:21 AM:

Bill@36: re just a bunch of angry parrots: yesterday's Boston Globe forwarded a story about how the Republicans are having trouble with those parrots, who are so busy screaming that even conservative Reps (a) are getting shouted down, and (b) can't figure out how to move the screamers forward. After 40+ years, their mess is catching up with them. Aw, shuckydarn.

#57 ::: Ginger ::: (view all by) ::: August 17, 2009, 10:44 AM:

Republican canidate

So, a real son of a dog, eh?

#58 ::: Serge ::: (view all by) ::: August 17, 2009, 11:11 AM:

Since we're talking about Republican canines... I found the following in today.

DeLay's going to be back in the spotlight, albeit one of an entirely different sort. He'll be on the next season of the "celebrity" reality show "Dancing With the Stars," along with fellow luminaries like Donny Osmond, Kelly Osbourne, Melissa Joan Hart and Michael Irvin.

Warp and woof.

#59 ::: The Raven ::: (view all by) ::: August 17, 2009, 01:09 PM:

James Macdonald, #46: "Fight the rearguard action, if that's what it is."


With the House and Senate in conflict, and the President unwilling to resolve the conflict in any meaningful way--and without some effective regulation of the health insurance industry there will be no resolution--, I can't see how any effective rearguard action is possible. What do you suggest?

#60 ::: Jacque ::: (view all by) ::: August 17, 2009, 02:24 PM:

michael @51: Psssst, Michael. Paragraphs? Your points will be clearer and more accessible if broken into smaller, more easily scanned chunks. I would like to read your post, but my eye just slides right off the huge, blunt mass of text.

But at a scan, it looks like I largely agree with you.

#61 ::: James D. Macdonald ::: (view all by) ::: August 17, 2009, 03:34 PM:

I can't see how any effective rearguard action is possible. What do you suggest?

The counsels of despair are never good.

Write letters to your representatives. Write letters to the editor of your local newspaper. Talk to your friends, your family, your neighbors. Go to Town Hall meetings to support the progressive side.

And next election, vote for the more progressive of the two candidates. (Two, did I say? Yes, two. I don't care how perfect the progressive credentials of some minor/fringe party candidate might be. He/she isn't in the race and can only function as a distraction.)

Don't accept defeat. Particularly don't accept defeat before you're actually defeated.

#62 ::: The Raven ::: (view all by) ::: August 17, 2009, 04:29 PM:

James Macdonald, #61: False hope can break your heart as surely as despair.

I've already done everything you suggest. My representative is a strong progressive. My senators are both Democratic conservatives. Obama's walkback makes both my representative and the senator who publicly supported a public option more vulnerable in the next election.

This isn't going to be the last concession. The astroturf anti-health-care crusade hasn't come to its finale yet. What seems most likely to me is that we'll see a health care bill similar to the stimulus bill: big handouts to the insurance and pharmaceutical companies and a inadequately-funded mandate to buy insurance that is quickly going to become a deeply hated tax in everyone's minds.

You complain this is despair. What, exactly, have we seen that leads you to believe that we will see anything better?

#63 ::: Jacque ::: (view all by) ::: August 17, 2009, 04:56 PM:

The Raven: Obama's election? Sotomayor's confirmation?

#64 ::: Lexica ::: (view all by) ::: August 17, 2009, 05:45 PM:

I don't think James is complaining that it's despair, I think he's identifying it as such. And, as somebody who has spent years struggling against suicidal depression, I agree — the feeling expressed by the statement "I can't see how any effective rearguard action is possible" is, IMO, just a variation on "there's nothing we can do about it, so we might as well lie down and die".

Maybe there's nothing that can be done. But maybe there is something. One thing that's certain is that if the belief that nothing can be done is strong enough to stifle action, nothing will be done.

If people who want reform don't keep trying, what's the alternative? Seriously, the possibilities I see are "keep trying" and "give up". What's the alternative?

#65 ::: Paula Lieberman ::: (view all by) ::: August 17, 2009, 06:13 PM:

I called my Congresscritter today and said, "I am infuriated...."
The person at the other end of the line said the Congresscritter (Rep. Nikki Tsongas) was on MSNBC this morning advocating that there be a federal option available.

#66 ::: Michael I ::: (view all by) ::: August 17, 2009, 06:21 PM:


And both Matt Yglesias and Ezra Klein pointed out last week that Howard Dean's 2004 health care proposal was considerably more modest than what's being discussed in the Senate Finance committee (let alone what's already passed the other relevant committees).

#67 ::: The Raven ::: (view all by) ::: August 17, 2009, 09:43 PM:

Jacque, how do the lessons of the Obama election & the Sotomayor confirmation apply here?

Lexica, I'm disappointed, disgusted, and angry. Why aren't you? Facing defeat strikes me as a good reason to feel that way. We definitely have to think about minimizing the damage: unless we fight it it's very likely that the mandate is going to fall hard on freelancers like my girlfriend and many of the regulars here.

#68 ::: Mary Frances ::: (view all by) ::: August 18, 2009, 12:27 AM:

Raven @ 62: It sounds to me as though you have done pretty much all that you can personally do, at this point, and more than many people. So maybe now is the time to A) pay attention in case that situation changes, B) encourage others to do as you have done, and C) yes, if all else is useless, work to minimize the damage. Saying, "we're facing defeat" doesn't mean "we should just stop working/stop thinking about this issue"--but it can be read that way by an awful lot of people.

Personally, I'm going to focus on the paying attention part, to see if there is anything else I can do--anything that I haven't already done, or that I might consider trying again--to bring about the outcome I desire; the situation is still pretty fluid, after all, and things can change very quickly in politics.

#69 ::: James D. Macdonald ::: (view all by) ::: August 18, 2009, 01:26 AM:

False hope can break your heart as surely as despair.

I've already done everything you suggest.

Who said anything about false hope?

This may be a rearguard action, as you said. If you're in the rearguard and the sergeant hands you a machine gun and says "Hold this intersection," and you say "How long?" and he says, "Just hold it," there is no hope. False or otherwise. But do you know what you do? You fucking hold it.

Now get on your feet and get to work. You've written letters? Write more. You've talked to people? Talk to them again.

Did someone tell you this was going to be easy?

#70 ::: Lee ::: (view all by) ::: August 18, 2009, 02:03 AM:

Shorter Jim: "Soldier, shut up and soldier."

(Not criticism, just that's what it made me think of.)

#71 ::: Terry Karney ::: (view all by) ::: August 18, 2009, 02:17 AM:

This may be a rearguard action, as you said. If you're in the rearguard and the sergeant hands you a machine gun and says "Hold this intersection," and you say "How long?" and he says, "Just hold it," there is no hope. False or otherwise. But do you know what you do? You fucking hold it.

And you ask for someone to set up a crossfire.

So, back to the rattle of the keyboards. More letters, more comments, more posts.

These are the barricades, and we have to man them; the other side is already storming them.

#72 ::: Kathryn ::: (view all by) ::: August 18, 2009, 02:39 AM:

You know, it is a battle, one of many in a long war for the progressive left. It is intensely political in a way that trumps idealism, or altruism. There is a great post by AKMudflats, who is attending netroots nation this week, on Bill Clinton responding directly to a shout out question on DADT -- and it's really worth reflecting on, in terms of the ideal and the political reality. scroll down to the Netroots Nation -- Bill Clinton post.

We have to come to terms with this, and soldier on. We'll vote for Obama again in 2012, even if it seems more like "the same old crap" instead of "change we can believe in" because at the top of the ticket there's only so much the president can do. The challenge is to stay positive and involved, stepping up to the next battle time and again.

In a way it reminds of Kierkegaard and The Sickness Unto Death. Existential despair, the thing that haunts you even if you don't know it. And the antidote is faith -- and that's true here and now as well. I have faith in my vision of the world, and maybe it coincides with others' and maybe not... but I do have ways to push that. Mid-term elections and a greater dem majority. Cash if even in small amounts in those races that need it, against blue dogs and corporate shills if possible (Rahm Emanuel can bite me), and staying firm in the face of dem waffling. The bridges and activist relationships we make now will come in handy in 2016 -- the battle goes on and on, and is really such an adventure and it can be the best roller coaster ride ever....

#73 ::: The Raven ::: (view all by) ::: August 18, 2009, 03:07 AM:

James, Lee, Terry: it's not like I haven't tried to join up. But there doesn't seem to be an army to join. We're a ragtag militia, there's the Redcoats marching in order, and Washington is nowhere to be seen. (And, despite mythology, the Redcoats were damned effective soldiers.) We need a political organization that can challenge the Senate conservatives, the big money, and the media owners, and, though there has been and continues to be real progress towards such an organization, we are clearly not ready for this battle yet. The only real hope was that the Obama administration might fight to swing the Senate, and they aren't doing it.

In terms of what this means...I think it's time to push hard for government support of any mandated insurance purchases. Three times the Federal poverty level is around $30,000/year, and the step from that to purchasing your own insurance (= marginal tax rate) is going to be huge. Some softening of that step would be a great help to individuals buying their own insurance. The same people who weakened the stimulus bill, and their supporters who are wrecking California, will fight that. If we can get some insurance regulation, even weak regulation, written into the bill, that would help a lot, too, but the insurance industry is fighting that tooth and nail. At this point, it looks like we're set for a showdown in conference, though it is possible the House Democrats will cave. I'm interested in hearing from the blogospheric leadership in how we handle that. I think that there does have to be some sort of bill; passing nothing will be a political loss for our side, and a victory to the radical right. So fight, I suppose, but be prepared to retreat on orders. Only, who gives the orders? Not Reid. Pelosi? More likely someone whose name none of us have heard yet.

In the longer term, I hope we can be ready when the wheels come off the bodge jobs. The banking system is set for a second catastrophe. Probably health care will be, too, but I think a bit later. The 2012 election promises to be interesting!

#74 ::: Dave Bell ::: (view all by) ::: August 18, 2009, 04:01 AM:

Rearguard actions, that's when you find out who the good soldiers are.

But haven't there already been too many?

I don't want this to be taken literally, but sometimes you have to shoot one of the officers for giving the orders. But, as Father Brown observed, one more body on a battlefield doesn't get special attention.

#75 ::: Toucan Sam ::: (view all by) ::: August 18, 2009, 10:22 AM:

I'm still confused by this entire debate. On one hand, I think that those who can't afford health care should be entitled to it, but at the same time, why do I have to foot the bill?

I bust my ass working and I already pay taxes and support welfare families, etc.

I understand that in society, you have to help those less fortunate, but where does it end?

#76 ::: abi ::: (view all by) ::: August 18, 2009, 10:45 AM:

Toucan Sam @75:

One thing to keep in mind as you contemplate these issues is that you're already paying for the consequences of a broken system, in many ways:

  • people who can't afford preventative care end up going to the Emergency Room, the most expensive place for medical care, which has to treat them regardless of ability to pay. That money comes from people who can pay, in some cases, and taxes in others.
  • people who are permanently disabled to the point of being unable to work because of lack of medical care end up living off of SSI. Those same taxpayer dollars could have gone a lot further getting them care before, say, a stroke or untreated diabetes robbed them of the ability to earn their own livings.
  • without good medical care, many children will never grow up to reach their full potential (kids with cavities don't concentrate well in school; kids who can't see the board don't learn too well). Those are people not driving the economy, contributing to the tax base, and paying for your retirement.

And that's just off the top of my head during a brief coffee break. I'm sure others can add a few more.

The US system is stupidly, horrendously, wastefully expensive, in both lives and money. And it's getting costlier all the time. It's not going to get cheaper or more efficient on its own.

I understand that in society, you have to help those less fortunate, but where does it end?

A fundamental question of political philosophy, that. We each have to examine our hearts and our consciences and make our own choices. How comfortable are you with people dying for lack of medical care which we could provide if we fixed this system?

It may be worth remembering, of course, that if you're a typical American, you're one catastrophic illness or accident away from being one of the less fortunate yourself. A cancer diagnosis, or even a cancer scare. A bad car accident on your way home from work. Illness in your children or your spouse. Anything that gives your insurance provider the excuse to pull your coverage and stick you with bankrupting bills. (Or, if you're lucky, disallow the charges but keep you on. I hear the nice ones do that sometimes.)

#77 ::: James D. Macdonald ::: (view all by) ::: August 18, 2009, 10:48 AM:

You're framing the question wrong, Toucan Sam.

Everyone is entitled to health care. Those more fortunate than you, and those less fortunate than you, and you and your family too.

The current health care system isn't about providing health care. It's about making the stockholders and the executives of insurance companies rich.

Why should we be making them rich, while denying health care to you, to me, and to millions of other working stiffs?

Where it ends is here, and when it ends is now.

#78 ::: Toucan Sam ::: (view all by) ::: August 18, 2009, 10:51 AM:

Alright, so answer me this first question:

How does the government propose that this health care reform get funded?

A lot of great questions got raised at the town hall that happened around here (Maryland)

#79 ::: abi ::: (view all by) ::: August 18, 2009, 10:55 AM:

Toucan Sam @78:

How does the government propose that this health care reform get funded?

Answered here. I found that in less than a minute from the post that started this thread.

If you want to know more about what the government proposes, click on the links in the post. The information is right there. Have fun.

#80 ::: Serge ::: (view all by) ::: August 18, 2009, 11:00 AM:

abi @ 79... Answered here. I found that in less than a minute

You assume that Toucan really is interested in an actual discussion. If he were, he'd have easily found the answer you gave. Notice too how some people always ask about the funding when it comes to helping the less fortunate, but not when it comes to big manly wars?

#81 ::: abi ::: (view all by) ::: August 18, 2009, 11:03 AM:

Serge @80:

Ease off, please. We're all in this together, the skeptical and the frightened, the lied to and the angry as well.

I won't spend all my joy on someone who's asking merely to sneer or to waste my time. But I'll assert that Sam is worth the effort till he's proven otherwise. He hasn't yet.

#82 ::: Serge ::: (view all by) ::: August 18, 2009, 11:13 AM:

abi @ 81... Fair enough.

#83 ::: The Raven ::: (view all by) ::: August 18, 2009, 11:23 AM:

Toucan Sam, #75: "On one hand, I think that those who can't afford health care should be entitled to it, but at the same time, why do I have to foot the bill?"

Because you get bad care if you don't. The US system delivers worse care than the British system, even to the wealthiest. This is consistent internationally: health care systems which don't deliver decent care to the poor also don't deliver the best care to the rich. Apparently, it is not cost-effective, or even possible, to fund a high-quality health care system which shuts a substantial group out, which is why the various systems of national care work so well. I don't have have the cites to hand. But I've seen them, and they seem valid.

Also, you are already paying more in taxes for uncertain and spotty care than the citizens of places with national systems pay for certain and comprehensive care.

None of this is news. It hasn't been news since 1980, and perhaps earlier. Why don't you know it?

#84 ::: The Raven ::: (view all by) ::: August 18, 2009, 11:30 AM:

Dave Bell, #74: thank you. There aren't any officers to shoot, unfortunately--there don't seem to be many officers, period. The past decades have not been a time for great progressive leaders. Many progressives hoped Obama would be the great progressive general, hoped for Caesar Obama. He has so far declined the position and, perhaps, could not have come so far had he done so alone. In the long term, Obama's refusal to rule as imperial President is hopeful. In this generation, though, it leaves us to the tender mercies of the Senators, the wealthy elite, and their pet media.

#85 ::: Toucan Sam ::: (view all by) ::: August 18, 2009, 11:31 AM:

Serge, why the war monger remark? I entered into the conversation to find out more about a subject that is confusing.

Why assume I am a big manly man who loves war and red meat and hates Democrats?

#86 ::: abi ::: (view all by) ::: August 18, 2009, 11:36 AM:

Toucan Sam @85:

Because we do at times get drive-by commenters who start as you have started and end in spittle-flecked rants. After a few iterations of that, it's easy to assume the worst.

Please don't pursue the matter. I'm a moderator here, and I'll ensure that things stay civil, if you'll do your part.

#87 ::: Toucan Sam ::: (view all by) ::: August 18, 2009, 11:37 AM:

No problem, I came here seeking answers, a friend had suggested the site

My questions aren't meant to incite, only to seek knowledge.

#88 ::: TomB ::: (view all by) ::: August 18, 2009, 11:51 AM:

Correction Notice - Department of Military Metaphors
(It points that way)

The insurance companies and the remnants of the Republican party are fighting a desperate rearguard action. We need to keep pressing the attack. Victory is almost within reach.

#89 ::: The Raven ::: (view all by) ::: August 18, 2009, 12:11 PM:

Toucan Sam, Physicians for a National Health Program has a bibliography that answers some of your questions. The authors cite many peer-reviewed papers. PHNP is not a neutral source, but the research is real.

TomB, if the opposition is fighting a rearguard action, how come they keep winning?

#90 ::: TomB ::: (view all by) ::: August 18, 2009, 12:20 PM:

The insurance companies are not winning. They make a lot of money off of us. They make a lot of noise. But they are not gaining anything new. They successfully fought a rearguard action against the Clinton health care reform. They are trying to do the same thing again. But they are not going to hold out this time, because it has become much more clear how their system is unsustainable for everyone from individuals to the big auto companies.

#91 ::: Stevey-Boy ::: (view all by) ::: August 18, 2009, 01:16 PM:

I was trying to write a post in which I would lay out my pay packet breakdown to show healthcare costs, but realized that doesn't include my employers contributions and my co-pays etc...

I am almost certain that the taxes I paid as National Insurance contributions etc... in the UK were way less (as a percentage) than I'm already paying now in the USA (not including my employers contributions).

I'd also have to say the healthcare provided is by no means superior. In fact BECAUSE healthcare is paid for by everyone for everyone in the UK, preventative care is preferred to keep costs down.

I've posted in the other healthcare thread RE: my son's healthcare experiences. I can't attest that UK healthcare would have done as good a job, but we would not have had to rely on a charity to pay our healthcare bills.

//ends rant

#92 ::: Terry ::: (view all by) ::: August 18, 2009, 02:00 PM:

Not to sound like I'm defending the "wing-nuts" but they aren't all crazy tools of Fox News zombies. The level of fear over the Health Care plan can't entirely be explained by media astroturfing. The folks complaining the loudest remember what happened last year with the Bank Bailout. According to Network World, last September, the email servers in the Capitol were overwhelmed with more messages from voters angry about the Bank Bailout than they had ever before processed, and were unreachable for hours. 80% of the messages were urging them to vote down the bill. It worked for about a week, but congress ended up passing the bailout anyway.

Health Care will probably be the same story. 60% to 75% of email messages sent to Washington will be against the plan, just as most citizens attending the Town Hall Meetings sound like they are opposed, but Congress votes according to the instructions they receive from the people who pay them the most. We the People are not in that club.

And the plan we'll end up with won't make anyone happy, even if you support universal health coverage for all. You know the old saying about legislation and sausage factories...

The Pharma companies are controlling the debate and encouraging the media to ridicule the crowds of people disrupting the normally boring Town Hall Meetings that representatives regularly put on as carefully scripted dog and pony shows. It would be far more effective if the people speaking in these meetings were more skilled at arguing a position without sounding like a hysterical "wing-nut." Something like the essay linked below would be far more effective at persuading these powers that they are much more than a crowd of screaming senior citizens bused into these events by special interests.

And after all, as we get older, we become the primary market for the products maufactured by these companies. Those of us older than 50 are a hugely lucrative herd of Cash Cows whom they can continue to milk as long as they can keep us alive. Lots of senior groups now organize "drug cruises" to Mexico and British Columbia just to buy cheap prescription drugs from the countries with socialized medicine programs. Could this be the real reason we can't travel to Cuba to enjoy the cheap pharmaceutical phruits of the "workers' paradise"? If the embargo could be lifted, I might be on the very next boat to Havana.

#93 ::: John L ::: (view all by) ::: August 18, 2009, 02:01 PM:

The insurance companies are more than willing to spend billions of their (our!) dollars if it means they can keep their healthcare monopoly.

Yes, it's a monopoly. How many health insurance plans does your employer offer? I'll bet the answer is one. You have two choices, take it or leave it. Oh there may be different options, but it's still the same plan.

A government backed program would introduce competition that the insurance companies could not influence or absorb; they would be forced to rethink their entire philosophy of "how much can we gouge the businesses/employees for?" while reducing coverage. Of course they are fighting this, with their willing allies the GOP.

Here in NC, insurance premiums have doubled since 2000, and are expected to double again by 2015. Our wages have increased only by less than 20% in that time period (mine a lot less than that); how much more of our money are we willing to give them before we say "enough is enough"? 30%? 50%? 75%?

That's not even addressing the lack of portability, the tendency to get dropped for the slightest reason, the failure to pay for services they said they'd cover, or women who find that pregnancy is not covered by their policy. The costs are going to eat us all alive; small businesses can't already afford the premiums. Soon that will be larger ones as well if something isn't done.

#94 ::: abi ::: (view all by) ::: August 18, 2009, 02:27 PM:

Stevey-Boy @91:

I was trying to write a post in which I would lay out my pay packet breakdown to show healthcare costs, but realized that doesn't include my employers contributions and my co-pays etc...

By stunning coincidence, I was just putting together a post to talk about rough and ready international comparisons.

Nothing too revealing, of course, and far too rough to be of any substantive use. But I realized I didn't have a good picture of what it costs to live where, and I like facts. Even messy ones.

#95 ::: Dave Bell ::: (view all by) ::: August 18, 2009, 02:27 PM:

toucan, there are some comparison figures about UK and US healthcare here. They're at the end of the article: you don't need to read the rest.

This New Yorker article on US health costs is also worth reading.

You can still worry about the cost: I'd be wary of claims by a government that some new scheme will reduce costs and improve service. But the USA doesn't have to copy the NHS to be able to afford health cover for everyone. You're already spending enough through your government to pay for it.

There's a pretty obvious reason for the stories about the NHS being put about. There are people making a huge amount of money from the current US system, and, as the second article shows, that money isn't going to better health care.

And, yes, the NHS has problems. Dentistry is one: there aren't enough NHS dentists in some places.

I'm rather glad that some of these insurance industry shills in the USA are spouting their lies about the NHS. It's forcing our politicians to stand up and be counted. And I think we may already be seeing a few political suicides over it.

Good riddance.

Whatever happens, there's no magic wand to change things. The transition is going to be rough. But I can't see how the USA can afford not to make big changes.

#96 ::: James D. Macdonald ::: (view all by) ::: August 18, 2009, 02:36 PM:

Yo, Raven, here's something positive you can do:

Go over to winger sites, pretend to be a winger, and start whispering about how they (you'll say "we") have already lost, that it's time to give up, stay home, do nothing.

#97 ::: Terry Karney ::: (view all by) ::: August 18, 2009, 02:55 PM:

Raven: Miitia is a good analogy.

You enlist by taking part.

You drill by joining discussions like these, and gaining facts, and honing rhetoric.

You stand in the line and shoot by going forth and making comment.

You take aimed shots by sending notes and calls to your reps/senators/mayors/presidents/governors/newspapers about the issue.

You establish a base of fire by telling other peope about places where reasoned debate may sway a few people, where you are tired, or worn out, or not quite up to the task.

Dave Bell: We need to shoot some officers. Sestak in Penn. is just such an attempt. Lamont in Connecticutt was such an attempt (and the present officer corps rallied round the scumbag). Primary challenges are the ticket. So too is small scale activism. Take over the school boards, the city councils.

Strategy is carried out with as the aggregate of tactics.

Toucan Sam: It's paid for by taking the huge amounts we spend now, and pooling it to a single payer. The most efficient systems in the US are run by the feds. Taxes pay for them. The most efficient private systems are run on similar models (the Mayo Clinic) and can surpass the Medicare/VA models. But they aren't as profitable to stockholders, so they are much harder to get started.

We already have real death panels... they are called "reviewers", and they pass sentence on thousand of people (myself among them. Without the VA I am almost certainly never going to be insured).

Insurance companies take money, and then refuse to pay what was contracted for. An NHS won't do that. The wait for surgeries here is sometimes less than in e.g. Germany, but the surgeries there are more timely.

Why? Because it's rare for a hip-replacement to be sudden. So there is a six-month wait to get it done. THe doctor sees that in the next year, or so, you will need one. She puts you on the list, and you get it.

Here? The insurance company decides, basically, if it's too expensive.

Recall the book/movie, "The Rainmaker"? That's SOP for a large slice of the industry. Recission is a way to take money for services which will never be delivered. Then the victims are blamed, and the nation suffers.

Why do I say that? Because those are people who fall out of the system. If they were healthy they would be a gain to, not a drain on, the economy.

Yes, Brits, and Canadians, and Germans pay higher taxes. I've been in all three places, and the "quality of life" seems about the same; and roughly equivalent to the middle classes here. Based on the things they worry about (or better yet, don't) they are happier.

I want to be happier too.

#98 ::: Bruce Cohen (Speaker To Managers) ::: (view all by) ::: August 18, 2009, 05:21 PM:

What can we do? If you've already sent an email or a phone message to your representative and your senators, do it again. The media are trying to tell us that the US voters are turning against health care reform because of the deathers* and the teabaggers, and the scum-of-the-airwaves. We need to make it clear to our elected representatives that we, who have the power to un-elect them, haven't really been moved by all that hot air, that we understand our own good better than our putative masters think we do.

And what Jim MacDonald andTerry Karnes, and especially Lee, who shortened it eloquently, said. Remember that the Forlorn Hope is still a hope; sometimes rearguard actions do more than just hold the line for a time. But even in the most likely event; if you don't try to hold the rear you're going to lose a whole lot more that if you do. Retreating in good order lets you fight again; breaking and running makes you a casualty or a non-combatant.

* Screamers of 'Death Panel!'; I think it's a nice parallel with 'birthers'.

#99 ::: Mez ::: (view all by) ::: August 18, 2009, 06:00 PM:

Tax comparisons are tricky. It's obvious and fairly simple to compare income tax rates, and fairly obviously and simply wrong.

As a home owner, I pay council rates and water rates (part of rent if I'm not). At a State government level, if I sold land or some other property there's Stamp Duty, an employer pays Payroll Tax, owning property other than my home makes me liable for Land Tax, but most people don't do these. State Sales Taxes, per se, have been replaced by the Federal Good & Services Tax (GST, like VAT elsewhere). Leaving the Income Tax, and Medicare Levy.

But there's a bunch of rebates and deductions in that. As a child-free widowed orphan, an employee with clerical-style duties, not a primary producer, I don't get family tax rebates, carer or unemployed/low-income allowances, or deductions for tools, special clothing, vehicles, fuel and such. The one-third rebate of my ~$AU1,000pa private health insurance is taken at source by MBF.

So working that out, and finding, then comparing, what's an equivalent person's amount in different systems, like the USA, Netherlands, UK and so on, is not that easy. Unfortunately, a lot of the comparisons I do see are done with an obvious bias towards showing one or another system is worse, rather than disinterestedly comparing the ratio of your earnings you give in tax and the kind of infrastructure and social support you benefit from in return.

#100 ::: Nick B ::: (view all by) ::: August 18, 2009, 06:33 PM:

It would help if a *trustworthy* source tried to debunk the other side. At this point, if a politician says something I assume they are lying, and my rate of error is terrifyingly low. The truth is almost always somewhere between, though hard to pin down exactly.

I say we go with the New York Times standard, 935 lies, then OFF WITH THEIR HEAD! It will make reelection so much simpler!

#101 ::: Michael I ::: (view all by) ::: August 18, 2009, 06:36 PM:

Bruce Cohen@98

Another point is that it isn't entirely clear that the events of the past couple of days have actually reduced the chances of getting a health reform plan with a good public option through Congress.

Noam Scheiber today in his "The Stash" blog at

"Around the conference table at TNR, we've been saying for weeks that what Obama really needed was a group of equally vocal, equally zealous critics on the left, pulling the debate's center of gravity in the other direction. And, wouldn't you know, that's exactly what's happened over the last 48 hours. We've now got a pole on the left to match the intensity of the pole on the right. (Don't get me wrong: I'm not suggesting a moral equivalence between the two. As far as I'm concerned, the critics on the left are basically right and the critics on the right are either insane or deeply cynical.) From a sheer tactical perspective, I think the White House and the Democratic leadership in Congress have dramatically improved their position."

#102 ::: Lee ::: (view all by) ::: August 18, 2009, 07:36 PM:

Bruce, #98: Thank you, but I can't take credit for that one; Heinlein said it, in the character of Sgt. Zim. What Jim said reminded me of it.

#103 ::: P J Evans ::: (view all by) ::: August 18, 2009, 09:12 PM:

Keep writing letters, keep calling your congresscritters, keep writing the White House (yes, they need to know what we think - even if all they do is put another tickmark on their tally sheet, it counts). If one of your congresscritters has a closed mind, and won't change it even if Ghu comes down and uses a clue-bat on them, you're permitted to not write them - but don't vote for them next time they're on the ballot, either, and try to get others to not vote for them.
Write your local newspapers when they misinform readers about what the proposed plans will do; talk to people when you can (you'd be surprised how many people are unhappy with the current system).
Use Evan Simpson's letter, linked way upthread, and send it to people.

#104 ::: The Raven ::: (view all by) ::: August 19, 2009, 01:49 AM:

James Macdonald, #96: Croak! But they are already in despair--that's why they're acting so crazy.

Terry, #97: as often, I agree with you pretty much down the line. I do want to emphasize the need for strategists and leaders, however--we seem to be short on those.

BTW, best news I've heard all day is that it appears the Senate Democrats and the administration, after egregious abuse by Republicans, have decided to throw over bipartisanship. On the other hand, they seem to focusing on the so-far useless co-ops as an insurance competition model. Progress. But I don't think we progressives can claim any credit for it--I think they just got tired of hugging cacti. And the direct attacks on Obama have to have rankled.

#105 ::: Terry Karney ::: (view all by) ::: August 19, 2009, 01:51 AM:

Sgt. Zim wasn't the first, he wasn't the last. I've said it, Jim has said it (or it's equivalent, he was in the Navy).

It's also important to remember, this isn't a rearguard. The fight against torture seems to be rearguard (in that we keep reminding people the moral issues and the practical issues are intimately related).

This is a response to counter-attack. The battle was being won, then they got a delaying actionl; held the line, so it looks as though the bill won't be really voted on until Sept.

So they took advantage of that to counter-attack. If we push back hard enough (and we can, if we post in places other than this blog), the bulge will be pinched off.

This Guardian piece is good ammo... someone who left the US, because the insurance companies' "death panels" have already condemned her, and did it before she was a teenager (feed that to the people who try to mention the NHS and Stephen Hawking), is good for that.

Take as wide a variety of links as you can find. Use my story (it's why I told it) and every other anectdote you can find (because the plural of anectdote is data, the rigor of the data is the real issue), and keep tossing it at the walls. Some of it, for someone, will stick, and then that person isn't against it anymore.

If you do it right, they will be converted to the need, and they will join the clamoring horde.

To quote the Boss, "No defeat baby, no surrender."

To quote Zevon: "This time I would rather break then bend."

To quote Martin Luther, Hier stehe ich. Ich kann nicht Anders tun. Gott hilfe mir. (Here I stand, I cannot do otherwise, God Help Me.)

These are interesting time, and this is a great battle, it's nasty, and gritty and scarifying, and seems petty. That's what battles are. Decades from now, when the histories are written we can look back and say, "wow... we did that?", but today, it's the struggle to keep hope alive, and the flesh and spirit willing.

Yes, I'm being purple, but I was pissed, and depressed and thinking it was not merely a forlorn hope this morning, but a lost one. It's not.

It's just another grind up Hamburger Hill.

I'll close with Robert Frost:

"Only where love and need are one, and the work is play for mortal stakes/ Only then is the deed ever truly done, for Heaven, and the Future's sakes"

#106 ::: Serge ::: (view all by) ::: August 19, 2009, 10:08 AM:

Barney Frank during a townhall meeting, to a protestor carrying a poster of Obama as Hitler.

"When you ask me that question, I'm going to revert to my ethnic heritage and ask you a question: On what planet do you spend most of your time?" Frank asked. "You stand there with a picture of the president defaced to look like Hitler and compare the effort to increase health care to the Nazis ... Trying to have a conversation with you would be like trying to argue with a dining room table. I have no interest in doing it."
#107 ::: Lexica ::: (view all by) ::: August 19, 2009, 05:13 PM:

The Raven @ 67: Lexica, I'm disappointed, disgusted, and angry. Why aren't you?

Who said I wasn't disappointed, disgusted, and angry? I am all of those.

What I am not, at the moment at least, is despairing. I'm not saying things like "I can't see how any effective rearguard action is possible."

My comment was counseling against despair and against giving up, not against getting disappointed, disgusted, or angry. People should be disappointed, disgusted, and angry. But the sentiment "there's nothing we can do about it" is a very short distance from "so why even try", which is half a step from "we might as well give up".

Given the choice between "keep trying and hope to come up with something effective in the process" and "accept that we can't do anything and give up", I choose option A.

#108 ::: Bruce Cohen (Speaker To Managers) ::: (view all by) ::: August 19, 2009, 05:52 PM:

Lexica @ 107:

To put it another way, my reaction to what's going on in the health care "debate" is, "I'm angry as hell, and I'm not going to take it anymore." That's a long way from despair.

#109 ::: Hector Owen ::: (view all by) ::: August 19, 2009, 10:19 PM:

Serge @ 106: Had the young woman with the poster of Obama as Hitler answered Barney Frank's question, she would have had to say, "Planet LaRouche." Those posters are a LaRouche production. "" is clearly visible on the poster here. If you actually go to that site, the Nazi stuff is explicit. This LaRouche supporter had a four-hour drive to get to that town hall meeting. And four more hours home again, afterwards. I do not understand the LaRouchies at all, but they do seem to be worked up about this.

I'm not fond of Barney Frank, but to give him credit, he answered that one right.

#110 ::: Serge ::: (view all by) ::: August 19, 2009, 10:47 PM:

Hector Owen @ 109... he answered that one right

I don't know why you normally aren't fond of Barney, but, yes, it's about time someone outright said what many of us have been thinking. It's not as if diplomacy has done us a lot of good.

#111 ::: janetl ::: (view all by) ::: August 20, 2009, 01:19 AM:

Right now, I'm so madly in love with Barney Frank that I'm going to doodle his name on my notebook all during school tomorrow.

#112 ::: The Raven ::: (view all by) ::: August 20, 2009, 01:57 AM:

Lexica, haven't you ever faced real defeat? Take a look over at Firedoglake. Over the past few days, they've been spelling out in detail what I've been croaking out. And then there's Krugman. "Actually, I really don’t even want to think about health care right now. It’s too painful." Are you going to tell all these people that they're in despair and they need to change their attitudes?

I'm not "quitting" in the sense of abandoning the issue. But I'm not expecting Max Baucus to suddenly turn into a progressive, either.

#113 ::: The Raven ::: (view all by) ::: August 20, 2009, 02:53 AM:

BTW, I think Patrick's Onion link, "Congress Deadlocked Over How To Not Provide Health Care" may just deserve my "Croak of the Year" award.

#114 ::: Earl Cooley III ::: (view all by) ::: August 22, 2009, 03:10 AM:

I am afraid that we're going to get a system that "reforms" health care in the same sense that the USA PATRIOT Act "reformed" national security.

#115 ::: David Harmon ::: (view all by) ::: August 30, 2009, 09:25 AM:

And it looks like the GOP is suing to prevent the White House from gathering the misinformation....

#116 ::: Lee ::: (view all by) ::: August 30, 2009, 11:55 AM:

David, #115: And, like any other troll, using the "freedom of speech" argument in a completely inaccurate, magic-word fashion.

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