As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Saturday, June 20, 2009

Someone Fax This To Congress

Yet another poll shows overwhelming support for a government-run option to compete with health insurance companies.

Americans overwhelmingly support substantial changes to the health care system and are strongly behind one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers, according to the latest New York Times/CBS News poll.

The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector [...]

The national telephone survey, which was conducted from June 12 to 16, found that 72 percent of those questioned supported a government-administered insurance plan — something like Medicare for those under 65 — that would compete for customers with private insurers. Twenty percent said they were opposed.

Republicans in Congress have fiercely criticized the proposal as an unneeded expansion of government that might evolve into a system of nationalized health coverage and lead to the rationing of care.

But in the poll, the proposal received broad bipartisan backing, with half of those who call themselves Republicans saying they would support a public plan, along with nearly three-fourths of independents and almost nine in 10 Democrats.

The whole poll is here.

There remains the dichotomy of a high number of folks (77%) describing themselves as satisfied with their own health care. But given the overlap, considering that "85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt," clearly people will support a policy they believe to work for them and not for CEOs. Most important, we are starting to see the end of the Randian virtue of selfishness:

In a follow-up interview, Matt Flurkey, 56, a public plan supporter from Plymouth, Minn., said he could accept that the quality of his care might diminish if coverage was universal. “Even though it might not be quite as good as what we get now,” he said, “I think the government should run health care. Far too many people are being denied now, and costs would be lower.”

Obama needs to reassure people that their care would not suffer and is in fact already insufferable. But even if he cannot, over 70% of Americans, and you can barely find 70% to agree on the color of the sky, support government involvement in the health care system.

Health care is maddeningly complex, and defenders of the status quo exploit that complexity to spin out all kinds of theories about what this plan or that plan would actually do. It seems that the goal should be to stress how the status quo is irretrievably broken for far too many people, businesses and the government, and that as a matter of basic morality, we should offer everyone the access and opportunity to quality health care without exception. Clearly the public will be receptive.

Another point. In most people's minds, a 70-20 issue on which even Republicans offer plurality support would be among the easiest for swing-state Democratic Senators to get behind. But for some reason, that only works if the issue falls within the elite consensus. Anything remotely progressive, and the polls suddenly no longer matter.

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CA-10: First Major Candidate Forum In Walnut Creek

Given the relative ambivalence in recent special elections in California, where members of Congress have been elected with 10,000 votes or less, I'd consider it an accomplishment that hundreds of people flocked to the Walnut Creek Jewish Community Center last night, on a Friday night, to hear from six of the Democratic candidates who will seek to replace Ellen Tauscher in CA-10, once she is confirmed to an appointment at the State Department and resigns her seat. Reader dslc has a short on-site commentary here, and Lisa Vorderbrueggen has provided lots of multimedia over at Political Blotter. The audio recording doesn't seem to be working right now, but she had videos of every candidate's closing statement. In case you're just tuning in, those candidates include:

Lt. Governor John Garamendi
State Sen. Mark DeSaulnier
Assemblywoman Joan Buchanan
Adriel Hampton
Anthony Woods
Tony Bothwell

(Bothwell is a San Francisco-area attorney who doesn't yet have a campaign website, but here's his law office site.)

Sadly, this is pretty much the extent of major media coverage that exists of yesterday's event, despite several hundred residents and a Congressional race that impacts hundreds of thousands. Our dwindling press corps is definitely a problem. But based on the closing statements, you can decide for yourself who performed well last night. I'll just throw around some other links as the race really kicks into gear. As a side note, apparently Garamendi brought out the giant golden bear clearly planned as his mascot for a gubernatorial race.

Luke Thomas interviews Joan Buchanan for the Fog City Journal, and Buchanan comes of as pretty knowledgeable about the challenges we face. She foregrounded her support of mass transit and BART expansion, health care reform (she supports single payer but wouldn't commit to supporting HR 676, and thinks that a plan currently moving through the House with a robust public option could be a "stepping stone" to single payer) and the wars in Iraq and Afghanistan (she generally supports Obama's position).

• Also in the Fog City Journal, Harold Brown has an op-ed about Adriel Hampton, claiming that "SF lefties are missing an opportunity" by not rallying to his campaign.

• Anthony Woods is getting a fair amount of attention on the blogs. AR Dem profiled him in this MyDD user diary, and today, Woods took questions at Firedoglake in a live chat session with Howie Klein. I thought he served himself well.

• There's another Democratic forum scheduled for July 2 in Antioch (Antioch City Hall, Second and H streets).

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The Tragedy Of Airstrikes And Civilian Casualties

After a brief struggle over the cash for clunkers provision in the Senate, the chamber passed the supplemental war funding bill and passed it on to the President. The wars in Iraq and particularly Afghanistan have been transfered to this President. On Iraq, the Administration has not wavered from honoring the SOFA agreement, and despite continued violence there, I believe the US position is on the right path, toward a withdrawal that can hopefully force a political reconciliation through a diplomatic surge.

Afghanistan is obviously in a different place right now. The ruling regime controls little of the country, the insurgents and the Taliban can self-fund through the drug trade, and the symbiotic relationship across the Afghan-Pakistan border threatens the ability for foreign occupiers to do much about it. The population doesn't much like the Taliban but also doesn't like being murdered from above either, a practice completely antithetical to the idea of winning hearts and minds in a counter-insurgency. The airstrikes, which have intensified since the election of Barack Obama, are simply too deadly to be pinpointed and effective only against enemies and not friends.

But experiences such as the fateful May 4 airstrike show that halting civilian deaths will not be easy. Fighter pilots and air controllers at the main U.S. air base here, near Kabul, the Afghan capital, say that even the most comprehensive safeguards can fail under the stress and confusion of combat against an enemy that they say often uses civilians as human shields.

The mounting death toll of Afghan civilians from U.S. airstrikes has unleashed a tide of resentment and fury that threatens to undermine the American counterinsurgency effort. From President Obama to the new U.S. commander in Afghanistan, Army Gen. Stanley A. McChrystal, American officials have made the reduction of civilian deaths a top priority as they revamp their strategy [...]

To gauge each mission's risk to civilians, a collateral damage estimate, or CDE, is prepared.

Yet civilian deaths continue to mount. U.S. commanders have not specified how they intend to reduce them, except to continue rigorously reviewing and enforcing existing restrictions. But the nature of the war almost guarantees more accidental deaths.

When people make split-second life-or-death decisions, and face what they consider a choice between protecting their compatriots or civilians, the decisions have proved imperfect.

This powerful film shows the aftermath of civilian casualties in Afghanistan. We are undermining our credibility and the legitimacy of the mission.

One more positive note is that a New York Times reporter today escaped from the Taliban and made his way to safety. A rare bit of good news in this region.

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The Inconvenient Truth On Financial Regulations

I cannot say that I am a perfect expert about financial regulation, but I can read critically. And the consensus from those trusted sources appears to be "decent, not great, not a fundamental reshaping of the financial system." Paul Krugman:

Yes, the plan would plug some big holes in regulation. But as described, it wouldn’t end the skewed incentives that made the current crisis inevitable [...]

One thing financial reform must do, then, is bring non-bank banking out of the shadows.

The Obama plan does this by giving the Federal Reserve the power to regulate any large financial institution it deems “systemically important” — that is, able to create havoc if it fails — whether or not that institution is a traditional bank. Such institutions would be required to hold relatively large amounts of capital to cover possible losses, relatively large amounts of cash to cover possible demands from creditors, and so on.

Good stuff. But what about the broader problem of financial excess? [...]

True, the proposed new Consumer Financial Protection Agency would help control abusive lending. And the proposal that lenders be required to hold on to 5 percent of their loans, rather than selling everything off to be repackaged, would provide some incentive to lend responsibly.

But 5 percent isn’t enough to deter much risky lending, given the huge rewards to financial executives who book short-term profits. So what should be done about those rewards?

Tellingly, the administration’s executive summary of its proposals highlights “compensation practices” as a key cause of the crisis, but then fails to say anything about addressing those practices. The long-form version says more, but what it says — “Federal regulators should issue standards and guidelines to better align executive compensation practices of financial firms with long-term shareholder value” — is a description of what should happen, rather than a plan to make it happen.

Steven Pearlstein:

Does anyone seriously think the United States would be reduced to a second-rate economic power if there weren't any CDOs of CDOs, or if the number of credit default swaps on General Electric bonds were limited to the number of outstanding General Electric bonds, or if reasonable leverage limits were put on hedge funds, private-equity funds or structured investment vehicles?

Is there any reason ratings agencies should continue to be paid by the companies that issue securities rather than the investors who buy and trade them?

And is it too much to ask that, in a globalized economy, banks and insurance companies engaged primarily in interstate commerce be required to get federal charters and have federal officials as their primary regulators?

Robert Reich:

The plan doesn't stop stop bankers from making huge, risky bets with other peoples’ money. It does increase capital requirements and oversight, but it doesn't require bankers to take their pay in long-term stock options or warrants, and it doesn't even hint that banks should go back to being partnerships instead of publicly held corporations.

All this means traders still have very incentive to place big and often wildly risky bets as long as the potential winnings are big enough, and top executives have very little incentive to monitor what traders are up to as long as the traders are collecting large commissions on the bets [...]

In short: It's a mere filigree of reform, a sheer gossamer of government. Wall Street must be toasting its good fortune. Unless Congress shows some spine, the great Wall Street meltdown of 2007 and 2008 -- which led to the biggest taxpayer bailout in history, very likely the largest taxpayer losses on record, and the largest investor losses since 1929 -- will repeat itself within a decade, if not sooner.


Of course, you have to feel for the Administration here. Already, their pre-compromised plan has been assailed by lawmakers, mainly out of concern about the centralization of power in the Federal Reserve. I agree to an extent with those Congressmen, in that the Fed is financed by banks and asleep during the last crisis. But there's not much alternative. And surely, consolidating additional regulators and agencies would produce similar wailing. And the lobbyists are ready to gut whatever meager protections exist in this proposal. It seems like the preferred options, the ones with a chance of working, could easily get stuffed by the people that "own the place." And in addition, the regulatory structure matters, but so does the nature of the regulators and their willingness to crack down on bad practices. To wit:

The question with this package is not if it’s well-suited to a world where regulators want to regulate. It’s if it’s well-suited to a world in which they don’t. A world in which growth is quick and greed looks good. A world in which Wall Street seems to be helping Main Street buy, if not houses, then a surprising number of wind turbines. One of the lessons of the past few years is that regulation has to be impartial and disinterested because regulators, and even Fed chairman, get swept up in the cultural manias behind asset bubbles as surely as traders do.

The other issue here, the great unmentionable, is that we actually know, in a sense, how to deal with the perverse incentives of the banks, more concerned with personal financial aggrandizement than the health of their organizations. You can talk about paying for performance and bringing compensation structures on Wall Street in line with those in Silicon Valley. But in the end, there's a really easy way to deal with this problem, which is a legitimate one that expands income inequality and rewards unsustainable risk. Chris Hayes explains.

Bloated CEO salaries aren't exactly new, but why they persist is harder to explain than you might think. Every dollar paid to an executive above his or her actual worth comes from the pockets of the shareholders. And while workers may be too beaten down to fight back, investors aren't exactly a powerless class in America. Why, then, do they allow clubby compensation committees and consultants to pick their pockets?

Part of the problem is the raw difficulty of figuring out how much value a particular CEO adds to a company. There's also a legal structure that attenuates shareholder power. But there's a deeper issue. CEO pay is to corporate governance what farm subsidies are to the federal government: the benefit accrues to a small group (CEOs or big agricultural concerns like Monsanto) while the cost--whether to shareholders or taxpayers--is shared widely [...]

As needed as many of these reforms are, whatever rules are put in place, CEOs will have massive incentives to skirt them. Which is why, finally, much of the solution must be found in the tax code. In 1980, before Ronald Reagan inaugurated the supply-side counterrevolution in taxation, the top rate for individuals was 70 percent. When taxation took 70 cents of every dollar made above a certain amount, there was far less incentive to game the system for giant payouts. By 1988, though, the rate was 28 percent. It has fluctuated between 30 percent and 35 percent under the past two presidents, while capital gains and other wealth taxes have steadily declined.

During the financial services hearing, as Republican after Republican railed against the specter of government bureaucrats micromanaging pay--down to "secretaries and janitors" in the fevered imagination of Illinois Representative Judy Biggert--part of me wondered if perhaps they had a point. Regulating executive compensation might have the same balloon-squeezing effect as bonus caps. And besides, it's easier for executives to game the compensation committee and shareholders than the IRS. So maybe we should let executives make as much as they can wrangle. We just need to make sure we then tax the hell out of them.

Corporate boards hold the power on executive compensation, and that's become an old boys network. The way the federal government can manage inequality is through the tax code.

That has an odd ring to post-Reagan ears, doesn't it?

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Obama: "Stop All Violent And Unjust Actions"

Via Nico Pitney:

The Iranian government must understand that the world is watching. We mourn each and every innocent life that is lost. We call on the Iranian government to stop all violent and unjust actions against its own people. The universal rights to assembly and free speech must be respected, and the United States stands with all who seek to exercise those rights.

As I said in Cairo, suppressing ideas never succeeds in making them go away. The Iranian people will ultimately judge the actions of their own government. If the Iranian government seeks the respect of the international community, it must respect the dignity of its own people and govern through consent, not coercion.

Martin Luther King once said - "The arc of the moral universe is long, but it bends toward justice." I believe that. The international community believes that. And right now, we are bearing witness to the Iranian peoples' belief in that truth, and we will continue to bear witness.

There may be an on-camera statement coming as well.

I think this is the right thing to do. The Iranian regime escalated through violence and murder, and the President must meet that escalation. Steve Clemons thinks this is Biden's influence, and he's been something of a liberal hawk throughout his career, so that's probably right.


2.04 pm. Some attempt at perspective. From what I can tell, the regime has shown a disgusting display of rank violence and murder, but they have not massacred hundreds. The uprising on the streets was also less overwhelming than in previous days, but that's obviously because they knew they could be gunned down. Mousavi is standing firm in demanding a nullification of the election. If the reports of even more intense rooftop shouting are true, then the people of Iran remain determined not to let this moment of democracy be taken from them. So we have the makings of a tense stand-off.

Watching the videos, I'm stunned by how many people are holding up cell phone cameras and taking footage.

The media is doing a better job today.

...opposition candidate Mir Hossein Mousavi says that he has prepared himself for martyrdom.

...As expected, the Iranian regime has twisted this statement and earlier ones into a claim that Obama supports the uprising. Well, they were going to say that anyway. The question was always whether or not they would look like fools for saying it, and whether or not they would deserve the disapprobation of the President. And I think Obama's played this right.

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Paul Begala Calls Out The Media

Yesterday I wrote about the shocking video of a Congressional hearing where health insurance CEOs, having admitted to canceling customers after they turn in claims for treatment, refuse to stop doing so. I'm pleased to report that we got up to 11,644 views as of this morning, and the video is already the #30 top rated of the week in the News & Politics section of YouTube. Keep going, keep retweeting, keep using Digg and Reddit to vote it up, use the Health Care for America Now page to email it to your friends. We can get this out.

And we have an ally in Paul Begala.

It's unusual for Begala, a longtime commentator for CNN and a member of the traditional media, to excoriate his own industry so forcefully for failing to inform the public. But he does exactly that here, in writing about this specific hearing, and the relative lack of attention paid to it.

You probably have never heard of Robin Beaton, and that's what's wrong with the debate over health care reform.

Beaton, a retired nurse from Waxahachie, Texas, had health insurance -- or so she thought. She paid her premiums faithfully every month, but when she was diagnosed with aggressive breast cancer, her health insurance company, Blue Cross, dumped her.

The insurance company said the fact that she had seen a dermatologist for acne, who mistakenly entered a notation on her chart that suggested her simple acne was a precancerous condition, allowed Blue Cross to leave her in the lurch.

Beaton testified before a House subcommittee this week. So did other Americans who thought they had insurance but got the shaft [...]

It was as dramatic as congressional testimony gets. Yet it got no airtime on the networks, nor, as far as I can tell, on cable news, although did run a story. Time's Tumulty was all over it, as was Lisa Girion of The Lost Angeles Times. But the story did not make The New York Times.

Nor The Washington Post, which found space on the front page the morning after the hearing for a story on the cancellation of Fourth of July fireworks in Shippensburg, Pennsylvania, but not a story on the cancellation of health insurance for deathly ill Americans who've paid their premiums.

I know the right wing is outraged by ABC News airing a health care town hall meeting with President Obama next week, but isn't the real outrage that such prime-time coverage is the EXCEPTION and not the RULE? Shouldn't we have lots and lots of news and information from the biggest megaphones about a domestic policy issue that faces every single American? Shouldn't everyone have access to that debate, and all the perspectives contained therein? Since when is the fact of a television network allowing an hour of coverage on the issue that means life or death to everyone in the country something to be reviled?

And that's basically Begala's complaint here. The media is failing in their job. In a way, so is the Administration, because they need to bring the spotlight to their most important domestic issue. Robert Reich argues the same thing, that Obama needs to drop as much as possible and focus like a laser on health care in order to get it done.

Put everything else on hold. As important as they are, your other agenda items -- financial reform, home mortgage mitigation, cap-and-trade legislation -- pale in significance relative to universal health care. By pushing everything at once, you take the public's mind off the biggest goal, diffuse your energies, blur your public message, and fuel the demagogues who say you're trying to take over the private sector.

You have to win this.

But I cannot let the media completely off the hook here. The story of rescission makes the health care issue personal. It exposes the mission of insurance companies, the "murder by spreadsheet" dedication to profits over people. And until their incentives are changed, until they need to compete on price and quality instead of competing on how to get out of paying for medical care, absolutely no reform can possibly work. But that requires the facts to be delivered by a media simply resistant to them.

Fortunately, we live in an age of two-way media, where citizens can force discussions into the national conversation. And that starts with you making everyone you know aware of this video exposing the agenda of the insurance industry. I recognize that it lacks a certain amount of context; I am working on a project this weekend to provide that additional context. But I think it does make its point well enough. And when you send this to friends, you can explain it even more.

Let's keep working on this. Let's go viral.

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Wind Up The Wurlitzer

Joe Conason has a good piece on the firing of Bush Administration appointee and Americorps Inspector General Gerald Walpin, which has all the earmarks of a full-fledged hissy fit. Conason thinks the right is attempting to gin up Whitewater redux.

According to the wingnut version, Walpin is a heroic investigator who was ousted simply because he exposed misspending of hundreds of thousands of federal dollars by an Obama ally, namely former NBA star Kevin Johnson, who ran a nonprofit organization in Sacramento that received Americorps funding before he was elected mayor of the California state capital last fall. Walpin had to be removed on June 11, after he refused the president's request that he resign, because the White House was trying to cover up Johnson's wrongdoing and permit his city to receive federal stimulus money.

That simple and sinister scenario, like so many of the media descriptions of Whitewater, omits crucial facts.

It is true that Walpin found evidence of misuse and waste of Americorps funds by St. Hope Academy, a nonprofit community group started by Johnson after he retired from the NBA. It is true that Johnson and St. Hope have acknowledged that they must refund roughly half of the money that the group received from Washington. But it is also true that Walpin, a Republican activist attorney and trustee of the Federalist Society before Bush appointed him as inspector general, went well beyond his official mandate last year by publicizing supposed "criminal" wrongdoing by Johnson in the days before the Sacramento mayoral election.

And it is true as well that Lawrence Brown, the United States attorney in Northern California who received Walpin's findings, decided not to bring any criminal charges against Johnson and instead reached a settlement with him and St. Hope.

That settlement, filed last April, is a public document that reflects no great honor on Johnson, to put it mildly. But it also voided any possibility of a "coverup" by Obama or anyone in his administration. The case against Johnson had concluded months before the president acted to dismiss Walpin -- and in fact only drew attention to the case by doing so, as he must have known would happen.

Just as salient as the accusations against Johnson, however, are those brought by Brown against Walpin. A Republican named as the acting U.S. attorney by Bush, Brown filed a sharply worded complaint against Walpin with the oversight office for the federal inspectors general that charged him with ethical violations in an overzealous assault on Johnson and St. Hope. The U.S. attorney said that Walpin had "overstepped his authority by electing to provide my office with selective information and withholding other potentially significant information at the expense of determining the truth" -- in other words, Walpin had failed to provide substantive exculpatory facts to the U.S. attorney, while trying to push the government into opening a criminal probe of Johnson. During the election season in Sacramento, Brown noted that Walpin had sought publicity for his findings against Johnson in the local media before discussing them with the U.S. Attorney's Office, "hindering our investigation and handling of this matter."

Here the parallels with the early history of Whitewater seem nearly perfect. Brown's levelheaded handling of Walpin's exaggerated charges against Johnson are much like the dismissal of the original Whitewater complaints by Charles Banks, the U.S. attorney in Little Rock, Ark., and an honest Republican who refused to gin up a phony indictment of the Clintons before the 1992 election (and lost his job as a result). And Walpin's excessive zeal and lust for publicity bear a startling resemblance to the antics of L. Jean Lewis, the Resolution Trust Corp. official who concocted a series of implausible theories implicating the Clintons in the looting of an Arkansas savings and loan.

Walpin, incidentally, is a longtime movement conservative and a trustee of the Federalist Society. He obviously has plenty of friends ready to publicize his martyrdom. Already Judicial Watch has offered their aid, which again is a rerun, as they were the wingnut front organization largely responsible for so many drummed-up Clinton scandals in the 1990s. Darrell Issa, the Congressman who bankrolled the recall of Gray Davis in 2003, is trying to attack the credibility of Lawrence Brown by asking him to explain his complaint against Walpin. And Walpin himself wants Congressional hearings.

You can pretty much write the rest of this script yourself. Obviously it may go nowhere and just get relegated to the back pages of conservative fundraising newsletters and "Obama Body Count" email forwards. But at least some elements of the right are trying to turn this into a Whitewater Reunion Tour. And all we know the conservative noise machine/traditional media "jump/how high" relationship.

Keep an eye on this.

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The Massacre At Enghelab Square

The ruling regime in Iran did not allow the opposition demonstrators to assemble in Tehran. They've really cracked down on communication, but it appears that 20,000 police have blocked the streets, dispersed crowds with tear gas, water cannons and just flat-out beating. There may not be tanks in the streets, but certainly a lot of violence. Nico Pitney reports killings. And it has seemed to dampen the turnout of the protest, although they are continuing.

The regime also put together their own Gulf of Tonkin incident. A suicide bomber reportedly blew himself up near the shrine of Imam Khomeini, though that is unconfirmed outside of state-run Iranian television. This will be used, regardless of the perpetrator, to justify more repression, and lots of tweets out of Iran claim that the regime blew up the mausoleum themselves.

Khamenei warned this and he's following through. They will lose international legitimacy after an election which attempted to seek it. It will be interesting to see how the international community reacts.

With Khamenei on Friday demanding an end to the demonstrations, and the protesters apparently unwilling to back down, some senior aides to President Barack Obama say they fear a bloody crackdown as soon as Saturday by Iran's security forces.

That, they say, would force Obama to react sharply, abandoning the cautious rhetoric he's used so far and perhaps torpedoing his hopes of diplomatic engagement with Iran for a long time. Officials say they're preparing for such an eventuality. The aides spoke on condition of anonymity because of the situation's sensitivity.

Other aides cautioned that the U.S. government doesn't know what will happen next — and neither, probably, do the major players in this drama.

This from Mohsen Makhmalbaf, the Iranian filmmaker and Mousavi spokesman, is worth reading.

This is more coverage of protests on CNN than I've ever seen them cover the protests of the Iraq war over six years. But I do appreciate them taking it seriously.

...This is insightful from Juan Cole:

Khamenei seemed to me to explain one thing I had not understood, which is why the regime felt compelled to allege that Ahmadinejad had won in such a landslide, of 63% to Mousavi's 32%. I still don't find that assertion plausible. But Khamenei gave as one reason for which there could be no challenge to Ahmadinejad's victory that a margin of 11 million votes was unassailable. It would have been more plausible if Ahmadinejad had squeaked out a victory, but I now see that the down side for the regime would have been that a narrow win for the incumbent, despite being more believable, would have emboldened the challengers and put pressure on the supreme leader for a genuine recount. This way, Khamenei can just shoot down such demands. But what he does not realize is that although he has made it easier to resist a recount, he has completely undermined faith in the system on the part of millions of Iranians, who, as he said, were system insiders, not outsiders. Whether or not Khamenei succeeds in quelling the current unrest, I don't think the regime will be left untouched by this debacle in the future.

They sacrificed long-term legitimacy for a short-term talking point.

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Filling The Doughnut Hole

Insurance companies are not the only bad actor in the health care industry. To a degree all of them are. Some doctors overtreat and order up unnecessary tests. The medical device industry pushes their products even if they have no utility. Hospitals charge exorbitant rates. The incentives in the system are entirely wrong. And of course, then there's the pharmaceutical industry. And in 2002, they negotiated with President Bush and the Republican Congress to put the doughnut hole into the Medicare Part D bill. What was that? Well, your prescriptions were covered up to the first $2,700, and then you had to pay full price until you hit $6153.75, essentially offering no benefit to the elderly who consume enough drugs to meet that lower bound. It was a forced gap put in by an industry looking to make a buck, since the consumer has no bargaining power in that doughnut hole, while the government does. And under the current President and the Democratic Congress, they returned to the negotiating table and said end this now. So the industry will.

Drug manufacturers have tentatively agreed to provide as much as $80 billion worth of discounts on medicines purchased for government programs such as Medicare, providing a bit of cash for President Obama's expensive and ambitious attempt to give health coverage to every American.

The accord, approved yesterday by the board of the Pharmaceutical Research and Manufacturers of America (PhRMA), is a voluntary pledge by the industry to reduce what it charges the federal government over the next 10 years, according to a source close to the negotiations who spoke on the condition of anonymity because of White House sensitivity about the talks.

If health-reform legislation is enacted, the agreement would bring financial relief to about 3.4 million elderly and disabled Americans who currently fall into a coverage gap known as the "doughnut hole." Medicare recipients must now pay the full price of brand-name medications after they have incurred a total of $2,200 in drug expenses, until reaching an outer limit of $5,100.

Under the proposal, U.S. drug companies would provide half-price discounts to Medicare recipients in the "doughnut hole" and provide other unspecified discounts and rebates for a total of $80 billion in savings to the government.

"This is real money on the table," the source said.

The White House put out slightly different numbers for the doughnut hole, but basically it means that Medicare would purchase those drugs in the middle, and they can get more for their money. This leads to lower costs. The President released a statement, and here's part of it:

"As part of the health reform legislation that I expect Congress to enact this year, pharmaceutical companies will extend discounts on prescription drugs to millions of seniors who currently are subjected to crushing out-of-pocket expenses when the yearly amounts they pay for medication fall within the "doughnut hole" - any payments by seniors not covered by Medicare that fall between $2700 and $6153.75 per year. The existence of this gap in coverage has been a continuing injustice that has placed a great burden on many seniors. This deal will provide significant relief from that burden for millions of American seniors.

"The agreement by pharmaceutical companies to contribute to the health reform effort comes on the heels of the landmark pledge many health industry leaders made to me last month, when they offered to do their part to reduce health spending $2 trillion over the next decade. We are at a turning point in America's journey toward health care reform.

It doesn't seem like much of a deal for the pharmaceutical companies, but if you add 30 million or so Americans to the rolls of the insured, that's a big ol' market for new prescription drugs. Plus, Medicare, the largest purchaser of drugs in America, has a certain amount of leverage. I don't mind them making a profit - but they must offer fair and equitable prices for their work and try to create products people need to alleviate pain and disease instead of hair growers and boner pills.

The doughnut hole has long been one of my biggest bugaboos about the power of industry, and I'll be happy to see it cut in half. That's a tangible benefit for seniors and something around which they can rally for comprehensive reform.

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Friday, June 19, 2009

Friday Random Ten

Cross your fingers for the men and women in Iran.

Oliver's Army - Elvis Costello and the Attractions
Auf Achse - Franz Ferdinand
Pimple Zoo - Guided By Voices
Please Don't Rock Me Tonight - Fountains Of Wayne
Revolution - Grandaddy
Treefingers - Radiohead
All The Way - Ladytron
Sick & Tired - The Cardigans
I Will Survive - Cake
Maria's Wedding - Black 47

Speaking of The Cardigans, I hear that lead singer Nina Persson is in a new band called A Camp. Anyone heard anything?

I'm going to the Hollywood Bowl for the first time this weekend, for Femi Kuti, Santigold and Raphael Saadiq. Excited.

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Before The Deluge

Tomorrow is likely to be a very sad day. Supreme Leader Ali Khamenei's speech at Friday prayers basically gave a warning today, essentially vowing violence if people went out into the streets tomorrow. The regime may not do it in public; they may use the Basiji Guard militia to round up the protestors at night after the protests during the day. That's certainly plausible in an environment where the world has its eyes trained on Iran - the protests diminish because everyone slowly gets rounded up, and the remaining protestors become demoralized, and the regime can plausibly say they petered out on their own accord.

But this doesn't exactly sound like someone who thinks he needs to do his business under cover of darkness:

Street challenges after the elections are not the right thing to do. This is, in fact, challenging the principle of elections and democracy. I want everyone to end this sort of action. If they do not end it then the consequences of this lie with them (street protestors).

The consequences of this lie with them. If they break the law they must suffer the consequences, in other words. And at this point, Khamenei has put his own credibility on the line. In a post at the Foreign Policy blog, Karim Sadjadpour says:

The weight of the world now rests on the shoulders of Mir Hossein Mousavi. I expect that Khamenei's people have privately sent signals to him that they're ready for a bloodbath, they're prepared to use overwhelming force to crush this, and is he willing to lead the people in the streets to slaughter?

Mousavi is not Khomeini, and Khamenei is not the Shah. Meaning, Khomeini would not hesitate to lead his followers to "martyrdom", and the Shah did not have the stomach for mass bloodshed. This time the religious zealots are the ones holding power.

There are scattered reports that the young people coming out in the streets day after day now how crucial tomorrow will be. This is completely heartbreaking:

I will participate in the demonstrations tomorrow. Maybe they will turn violent. Maybe I will be one of the people who is going to get killed. I’m listening to all my favorite music. I even want to dance to a few songs. I always wanted to have very narrow eyebrows. Yes, maybe I will go to the salon before I go tomorrow! [...] My mind is very chaotic. I wrote these random sentences for the next generation so they know we were not just emotional and under peer pressure. So they know that we did everything we could to create a better future for them. So they know that our ancestors surrendered to Arabs and Mongols but did not surrender to despotism. This note is dedicated to tomorrow’s children…

More like this at Nico Pitney's liveblog. It's all very dramatic.

In an interview released today, President Obama went slightly further than he has in the past, saying that "the world is watching" and "we stand behind those who are seeking justice in a peaceful way." Reiterating that we are watching is perhaps the best hope to end what seems to be coming tomorrow. Because I'm afraid of what we'll see.

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Accountability Now

Accountability is back in Washngton, as today the House impeached a federal judge. At long last, one of the legal architects of the Bush torture regime, the man who allowed the CIA to waterboard and provided the twisted legal rationale, the m- what, it was the other one?

The House on Friday impeached a federal judge imprisoned for lying about sexual assaults of two women in the first such vote since impeaching former President Bill Clinton a decade ago.

The impeachment of U.S. District Judge Samuel Kent of Texas sets up a trial in the Senate. Kent is the first federal judge impeached in 20 years.

It's never the sex, it's the lying.

This guy's actually convicted and in prison serving a 33-month sentence, and he won't resign so he can draw his $174,000 a year salary. I'm not saying it's not warranted. Hey, maybe the House can exercise this whole accountability and oversight muscle. Baby steps.

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Slightly Less Queasy On Health Care

The House health care bill has been received favorably by advocates and, more importantly, the President:

Today, the Chairs of several Committees in the House of Representatives unveiled their health care reform proposal. This proposal would improve the affordability, availability, and quality of health care and represents a major step toward the our goal of fixing what is broken about health care while building on what works.

Jon Cohn has more. At some point, Obama needs to stop giving favorable nods at the Congress and step hard into this debate. But I feel better about this today than yesterday. Doctors are nodding toward working with Obama, and they are the most respected constituency on this issue. Just getting the AMA to back off and not follow the Chamber of Commerce, wackjob Betsy McCaughey (it's amazing she's running the same shtick from 1993 all over again) and other right-wing groups who want to keep the status quo would be positive.

Igor Volsky has a great comparison of the three bills - the House tri-committee bill, the Senate Finance Committee and the Senate HELP Committee. If we can get it through HELP, two of them will include a public option. Basically it comes down to a freshman Democratic Senator fulfilling Ted Kennedy's lifelong dream:

With Ted Kennedy too sick to come down to DC and make the committee vote, Democrats will need every Senator on the HELP committee to produce a strong bill, a bill that fights for what Teddy Kennedy has been fighting for his entire life. The last holdout is Kay Hagan, who represents a state (NC) that is one of the worst in the country in terms of percent of people without health insurance. The insurance companies are lobbying Hagan against the bill, because they don't like having to compete with a public option. My simple question is this: Teddy Kennedy is too sick to be there, Senator Hagan, so he is relying on your vote for the issue that he has fought for passionately his entire life. Will you betray him to help the insurance companies? You need to make up your mind now.

Sounds like a simple question for Kay Hagan.

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Hey Paul Krugman, Where The Hell Are You Man

Paul Krugman just completely nails the Dan Froomkin firing. What's more, he does this as someone IN THE EXACT SAME POSITION as Froomkin - a mainstream liberal newspaper columnist, probably hated by his peers as much as Froomkin was allegedly hated by his. There's of course a difference between the editorial board of NYT and WaPo, but that's just a dangerous move by Krugman. And yet.

Not excerpting, you have to go read it.

...Conservatives are so persecuted on editorial pages like the Washington Post's, aren't they?

...By the way, on the day that Dan Froomkin gets fired, the WaPo published an op-ed from... Paul Wolfowitz. Man, talk about failing upwards...

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Who Pissed In Dana Rohrabacher's Corn Flakes?

Dana Rohrabacher has been out front in yipping about the need for the President to rhetorically confront Iran, a stupid idea given our history in the region, and the opposite of what actual Iranian dissidents and experts like Shirin Ebadi, Trita Parsi and Akbar Ganji suggest. As OC Progressive notes, he is undermining the protests and demonstrations by giving credence to the complaint of the ruling regime that foreign interests are intervening in their election. By saber-rattling, like in the passage of a resolution in support of the protests and then wielding it as a club to criticize the President for not being belligerent enough, you just play into the hands of the regime. And Rohrabacher and his colleagues never had this kind of commitment to human rights when it involved the systematic, needless torture of detainees at Guantanamo and Abu Ghraib. In fact, Rohrabacher called those cruel, inhumane and degrading tactics fraternity hazing pranks - when Dick Cheney orders them. When the Iranians or North Koreans order them, it's a whole different ballgame.

But I have to step back and admire - and kind of marvel - at Rohrabacher's comments yesterday about the Uighurs, a group of 18 Muslims held at Guantanamo for seven years without charges, despite having been proven to commit no acts of terrorism or crimes of any kind. Several were released to Bermuda this week, amidst clamoring by many conservatives, in particular Newt Gingrich. But Rohrabacher smacked the former House Speaker down pretty hard on this point, decrying him for raising needless fears. It's idiosyncratic, of course, because it's Rohrabacher, and it mostly constitutes a conspiracy theory about the Chinese government. But embedded in the madness are some true statements about Republican fearmongering and overhyping of threats.

ROHRABACHER: And also, right off the bat, I’d like to express my deep appreciation to the leader in Bermuda — it’s Premier Brown — for his courage to do what is morally right in this situation. He’s demonstrated, I think, the best of democracy. That’s what leadership is all about: being willing to take such tough stands. I’m sorry that our own leadership here at home, and even in my own party, seems lacking at this moment. [...]

Much to my dismay, some pundits in the Republican party have fallen for this bait and are lumping the Uighurs in with Islamic extremists. The Bush administration did not help matters. It held Uighurs in Guantanamo as terrorists, and they did this, I believe, to appease the Chinese government in a pathetic attempt to gain its support at the beginning of the war against Iraq, and also to ensure China’s continued purchase of U.S. treasuries. Many, if not all, the negative allegations against the Uighurs, can be traced by to Communist Chinese intelligence, whose purpose is to snuff out a legitimate independence movement that challenges the Communist party bosses in Beijing.

No patriot, especially no Republican who considers themselves a Reagan Republican, should fall for this manipulation, which has us do the bidding of a dictatorship in Beijing.

In the hall of shame, of course, is our former speaker, Newt Gingrich. His positioning on this should be of no surprise — and is of no surprise — to those of who, during Newt’s leadership, were dismayed by his active support for Clinton-era trade policies with Communist China.

Video here.

Would that Rohrabacher would listen to his own words when saber-rattling against Iran. That moment of clarity - all right, about 1/3 of a moment - ought to be repeated.

Oh yeah, and George Packer is a media royalist buffoon.

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The Little Ensign That Could

This John Ensign story just gets worse and worse for him. As it turns out, he wasn't being blackmailed by a cuckold; he was pre-empting a potential disclosure on Fox News, and a lot of people had prior knowledge about the affair, including the network and key Senators, while it was happening.

The unethical behavior and immoral choice of Senator Ensign has been confronted by me and others on a number of occasions over this past year. In fact one of the confrontations took place in February 2008 at his home in Washington DC (sic) with a group of his peers. One of the attendee’s (sic) was Senator Tom Coburn from Oklahoma as well as several other men who are close to the Senator. Senator Ensign’s conduct and relentless pursuit of my wife led to our dismissal in April of 2008. I would like to say he stopped his heinous conduct and pursuit upon our leaving, but that was not the case and his actions did not subside until August of 2008.

No wonder the Republicans don't really want to talk about this--they've known about it for over a year. Here's what Coburn had to say:

Reporters mobbed Tom Coburn of Oklahoma, who shares an apartment with Ensign on Capitol Hill. "I'm not answering any Ensign questions," he announced. "You can ask all you want."

"You don't have any thoughts?"

"I don't have any thoughts."

"Have you had a chance to talk about it?"

"I'm just not going to comment."

Finally, Coburn was badgered into making a defense. "He is a bright young man," the senator said of his 51-year-old colleague. "Lots of people make mistakes."

The details in the letter are pretty juicy. I would say Ensign's in some trouble and this won't go away. But the best take I've seen is from David Kurtz:

While Norm Coleman was battling for his political life in 2008 in a race he ultimately lost to Al Franken by a mere 312 votes, his colleague John Ensign -- whose job as chairman of the NRSC was helping GOP senators like Norm get re-elected -- was off having an affair and finding jobs for his mistress' family.


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Consensus By A Thousand Cuts

Environmentalist Henry Waxman and seeming global warming denier Collin Peterson are moving to an agreement on a climate and energy bill.

House Democrats are within sight of agreement on a comprehensive energy and global warming bill, but it is still unclear if they have satisfied enough rural and fiscal conservative lawmakers to guarantee the votes for floor passage by next week.

"I think we made some real progress," Rep. Ed Markey (D-Mass.) told reporters yesterday as he left a meeting with House Speaker Nancy Pelosi (D-Calif.), Energy and Commerce Chairman Henry Waxman (D-Calif.) and Agriculture Chairman Collin Peterson (D-Minn.). "There's still black smoke going up. The white smoke, however, we might be able to send some up, but only after we have resolved these final issues. We made some real progress in that meeting. But it's not final yet."

Waxman described a "conceptual understanding that we're now looking at in more detail" with Peterson, adding that the work now rests on staff to come up with legislative language that could be unveiled as soon as today or Monday.

Peterson also sounded an optimistic note yesterday about the negotiations. "We got a couple things resolved," he told E&E. "They came up with a new idea that has good possibilities. We're going to take a look now and see if it works."

It doesn't look like a huge set of concessions, mainly on rural electricity and carbon allowances as well as the EPA ruling on biofuels (that's going to be near-impossible to dislodge, and it's a shame), but of course we've been nicking at this thing for a long time, taking away a little something here and a little something there. I still think we have a decent bill that's worth passing, particularly because of the job possibilities in the energy space - 1.7 million jobs looks pretty good right now. But it's a far cry from what's needed.

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We need 10 million views of this YouTube by next week

I mentioned earlier John Dingell bringing up the hearing in the House on rescission, the practice of insurers dropping people the moment they get sick, sometimes for technical violations on their applications like misspelling their name.

I know a fair bit about rescission, because in California, it's become a major issue. Former LA City Attorney Rocky Delgadillo has doggedly pursued those companies, like Blue Cross, who have engaged in the practice, and to date insurers have agreed to pay over $37 million dollars in fines. Another case is about to go to trial. Blue Cross encouraged this with performance bonuses for employees who found a reason to cancel coverage for the sick.

Now check out what these insurance CEOs said after being confronted with all of these examples of them denying coverage to sick people.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period [...]

Late in the hearing, Stupak, the committee chairman, put the executives on the spot. Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show "intentional fraud."

The answer from all three executives:


Rep. John Dingell (D-Mich.) said that a public insurance plan should be a part of any overhaul because it would force private companies to treat consumers fairly or risk losing them.

"This is precisely why we need a public option," Dingell said.

Here's the YouTube of that hearing. It should have 10 million hits by the end of next week.

Here's a Splicd version of the moment where they all refuse to commit to stop rescinding people when they get sick. In the above YouTube, that comes in around 4:47.


Here's the Twitter message I put up about this.

Health insurance CEOs refuse to stop screwing their customers: please RT! #publicoption

Email this to everyone you know. Retweet. Put it up on Facebook. Do whatever you can to get this in front of people's eyeballs. Without a public option, we give our health care future over to people who have vowed not to cover you if you're sick. Politicians can stand with people, or with these insurers.


...Health Care for America Now has a page up with this incredible video. You can forward an email to a friend with the video using their page.

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Let's Not Give The People What They Want

Blanche Lincoln just can't get behind a public option in health care.

U.S. Sen. Blanche Lincoln, D-Ark., says she prefers private insurance cooperatives to a government-run provider that would compete with the private sector in reforming the nation’s health care system.

“We want to keep what works in the private industry and make it better,” Lincoln told Arkansas reporters in a conference call today. “There’s a lot of discussion about what else we might need that we can’t get from the private sector.”

The senator left the door open to supporting a government-option, though she acknowledged she has reservations.

“One of our biggest concerns is that it doesn’t need to be a government plan that usurps that ability to compete in the marketplace, which I’m concerned that a totally government-run option would do,” she said.

This really doesn't make any sense, other than in the sense that Blanche Lincoln values corporate contributors over her constituents, and doesn't feel that the public can hold her accountable as long as she raises enough money. Because the public plan is wildly popular. In most cases, a wildly popular issue would be precisely the one that could yield bipartisan support. But if that issue is in any way progressive, suddenly, public opinion doesn't matter anymore.

And not only is the idea of a public option popular in the abstract, the inclusion of a robust public option would save a lot of money and thus allow the congress to minimize its reliance on unpopular measures like tax increases. But suddenly here public opinion becomes irrelevant. You never hear a Blue Dog say “my seat is so vulnerable that I can’t afford not to back a super-popular public plan.” Ben Nelson’s not talking about how if Democrats want to stay viable in red states they need to robustly back a 70-20 issue like the public plan. The WSJ doesn’t run a headline saying “Opposition to Public Option Spells Political Trouble for Republicans.” Public opinion, in other words, can be a reason to eschew sound progressive policy but never a reason to enact it.

Exactly. There are these etched in stone "political realities," designed by elites, that say you just cannot cross corporate power. And so we hear nonsense about "fiscal responsibility" as a means to deny the most fiscally responsible option. And we hear that we "have to protect the free market" while denying the choice that would strengthen that market. The public option is nothing so much as trust-busting. And the elites want to keep together the trust.

Meanwhile, the three committees working on this in the House have really stepped up. They released a discussion draft based on the work of all of the relevant Chairmen, which includes a robust public option to keep insurers honest and allow for experimentation in the marketplace. Initially, the plan utilizes Medicare bargaining rates to ramp up, and then will use cost control plans to provide better coverage and more effective care.

I would prefer a single-payer system. But this actually is a significant step, and worth fighting for: a health care plan that offers lower costs, higher quality and better choice. During the press conference (on C-SPAN 3, not cable, because who gives a crap about health care, right?), John Dingell brought up the hearing in the House on rescission, the practice of insurers dropping people the moment they get sick, sometimes for technical violations on their applications like misspelling their name.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period [...]

Late in the hearing, Stupak, the committee chairman, put the executives on the spot. Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show "intentional fraud."

The answer from all three executives:


Rep. John Dingell (D-Mich.) said that a public insurance plan should be a part of any overhaul because it would force private companies to treat consumers fairly or risk losing them.

"This is precisely why we need a public option," Dingell said.

Here's the YouTube of that hearing. It should have 10 million hits by the end of next week.

Here's a Splicd version of the moment where they all refuse to commit to stop rescinding people when they get sick.


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Rosen's Redemption

Remember that lady nominated to join the Supreme Court? Sonia something-or-other? Funny, it doesn't seem like the GOP wants to talk about her much anymore. They're on to Democracy, Whisky, Sexy in Iran, and even the wingnut welfare machine of groups making money off of the Sotomayor nomination have started to lay low.

I would guess that somebody read a poll, particularly one including Hispanic voters. And they recognized that going to the mats against her would be completely counter-productive. And now everyone's zipped their lips. Hell, Kenneth Starr endorsed her yesterday.

That doesn't let off the hook those who charged her as a racist and tried to leverage the "white man's burden" theory of politics to make her toxic. It doesn't let off the hook people like Jeffrey Rosen, who lent credence to a bunch of anonymous smears designed to damage her reputation. Rosen is trying to rehabilitate himself with a more measured piece, explaining that you can find bold language and hints to her style in her dissents, not the technical decisions where she upholds settled law. He tries to roll back this charge that she isn't a big thinker by pointing out certain flourishes.

One would hope that everyone has a long memory about Rosen.

...I'm not at all sanguine about whether Sotomayor's presence on the Court can change this dynamic at all, but the current Court really sucks rocks.

Here’s a beaut of a decision from the increasingly brutal and inhumane conservative-dominated Supreme Court. Not content with gutting anti-discrimination legislation, a 5-4 majority has decided that if people are wrongfully convicted they should be punished anyway because, hey, tough on crime!


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Listening To The Serious People

Mike Lux says what needs to be said about Tom Daschle's el foldo move against the public option, and it has weight because Lux worked for Daschle for many years. Caving to Republicans and the insurance industry in the name of getting "health reform" passed just won't work, particularly because you will lose every ally on the left and end up with absolutely nothing. And taking out the most popular part of the bill and the most tangible expression of reform that people can touch, feel and see would have the effect of turning it into dust.

It doesn't surprise me that a man who essentially is an industry lobbyist would side with industry over the people. But the other element here is this irrational fear of Republicans, who have lost almost all of their support in the country, are actually less popular than Dick Cheney, and yet must be placated in the good name of bipartisanship. I believe the metaphor that the President uses is "we will extend a hand if you unclench your fist."

Behold the unclenched fist of the leader of the Republican Party.

"Day to day, there is no health care crisis in this country"

And if you don't think Limbaugh is the leader of the GOP, here's the leader of the RNC, with his opinion of what health care reform would necessarily mean:

STEELE: Well you’ll get issued, Doc, you’re gonna issue, to your patients, a health care card that’s gonna be part of a national ID system that, you know, every time I charge something or use that card, it’s going to show up on a grid what I’ve done and what I have failed to do, according to the government plan. So the government will know whether or not I’ve had my physical at the appropriate time and then probably some health police will come knocking on my door telling me I’m now costing the system money because I haven’t, you know, gone and done my preventive care.

He thinks there's going to be a health care police. And the 76% of Americans who support a public option have to be pushed aside, because Michael Steele is just more serious.

It's important to recognize the undemocratic nature of the Senate, where Dianne Feinstein and Barbara Boxer represent 36 million people and have the same amount of votes as Mike Enzi and John Barrasso, who represent 500,000. That absolutely has a bearing on how the Senate does not listen to its constituents. But In this case, Democrats have the votes; they only need 50 to pass health reform. But they think they have to listen to clowns instead of the people.

...Ezra Klein has an interview up with Daschle where he tries to walk back his opposition to a public plan.

You made headlines the other day for dismissing the need for a public plan. Want to talk a bit more on that?

I don't know where that came from. We've been pushing back on that all day. I didn't say that. I have said emphatically I support a public plan. A Medicare-for-all public plan. Any federal plan. For all the reasons that have been made for years. It's important for cost, for choice, for competition, for popularity. I strongly support it.

What I did say is that I'm willing to compromise on most things to bring the package across the line. The plan we agreed to yesterday was that states could offer public plans with a federal fall back. That's not my first, second, or third choice. But given the concessions my colleagues made on universal coverage and an employer mandate and everything else, that's the essence of compromise.

To focus on that for a moment, for all the controversy around this issue, I think a lot of liberals don't understand why they should have to sacrifice it. After all, private insurers aren't exactly covered in glory, and a Wall Street Journal poll just today showed that three-fourths of Americans support the policy.

This is one time when it makes good politics and good policy. There are two groups primarily opposed to it. Many of the stakeholders view it as real cost cutting. As a result, they're worried about that competition. A lot of other stakeholders are concerned about feeling the effects of a cost constraint. I've said this, and no one has ever disputed it, that I've never seen a study that didn't say the public plan would reduce costs. And we hear so much about costs, and here we are taking it off the table.

The other group is this ideological group of Republicans and conservatives who see it as government intrusion they simply can't support. It's an ideological basis that I will never understand but that that's what it is.

Oh well! It is what it is!

...I can get behind this: Go Away, Tom Daschle

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Crackdown Ordered Up

Ali Khamenei's speech during Friday prayers do not bode well for the protestors in the streets. Here's Jim Sleeper:

Ayatollah Ali Khamenei's speech gives a virtual green light to the thuggish -- and massive -- Basij militia. It also raises the "moral" and Iranian constitutional ante on future demonstrations. From now on, demonstrations aren't legitimate petitioning for redress of grievances. They're civil disobedience - and, in Iran, something worse.

In civil-disobedience, you break a law non-violently and accept the legal penalty, to show that it's the unjust law that has betrayed the constitution, not your breaking a bad law publicly in order to defend the very rule of law. But in Iran, demonstrating will now require even more moral and physical courage than it did yesterday, or than civil disobedience does here. It will be cast as disobedience to the constitution itself - to the "Supreme Leader."

Watch the first 20 seconds of his speech and see his listeners' quintessentially fascist salutes, and you know what's coming.

To say that Khamenei warned the protestors is kind of an understatement. He's probably just going to expand the tactics that have already been put into place in the smaller cities where there is no international media.

However, Juan Cole sees green shoots:

AFP estimated the size of the demonstration as similar to the one on Monday. Some reporters thought a million people came out on Monday, though I prefer to be conservative on crowds, since it is easy to overestimate their size. Several hundred thousand, perhaps half a million, would be impressive enough. Such massive numbers of discontented urbanites tell you that change may well be in the air. The 2006 demonstration by an estimated 500,000 people in Los Angeles against immigration restrictions on Latinos (a la Tom Tancredo et al.) was in retrospect a harbinger of big trouble for the Republican Party in national US politics [...]

The clerical hierarchy is itself increasingly split. It might have been expected that disgraced Grand Ayatollah Husayn Ali Montazeri, now under house arrest, would issue a letter in support of the protests. (Montazeri was once heir apparent to Imam Ruhollah Khomeini but his criticisms of regime practices and of clerical dictatorship led to his marginalization and ultimately arrest.) But former president Akbar Hashemi Rafsanjani is alleged to be trying to drum up support for Mousavi among senior clerics in the holy city of Qom. There are persistent rumors that reformist Ayatollah Yusuf Sani'i has given legal rulings that Mahmoud Ahmadinejad is not president of Iran [...]

The regime, surely fearing a popular revolution of the sort that toppled the shah in 1978-79, is using carrots and sticks to try to deal with an unpredictable situation. So far, however, both inducements and crackdowns have been a pittance. Several hundred protest leaders have been arrested, but when you've got hundreds of thousands out in the streets every day, a few hundred arrests don't mean much and clearly aren't intimidating anyone. In fact, they backfire by angering the protesters and ensuring they return the next day. The arrest of ailing former foreign minister Ibrahim Yazdi at his hospital was particularly cruel. Some rumors have it that the regime was forced to release him back to the hospital, so poor is his health.

Babak Rahimi, in Tehran, sees the situation as being as unpredictable as that of fall 1978 when it was not apparent whether the shah would survive or the regime would fall.

I'd like to think that this could tip in the way of popular reform, but Tiananmen seems more likely to me.

Meanwhile, at the same time that Iranian regime leaders are accusing the US of meddling and making themselves look foolish, the US Congress plans to meddle with a nonbinding resolution today supporting the demonstrators, which seems somewhat benign but just plays into the hardliner's hands. NIAC explains.

This measure is almost guaranteed to pass–probably with an overwhelming number of votes–which will unfortunately put the Congress directly at odds with the White House in responding to the crisis in Iran. Up to now, the President has been very cautious not to be seen as choosing one side over the other in the election dispute, saying he doesn’t want the US to become the story inside Iran. But the Congress seems poised to speak out more vocally on the subject, choosing to come down squarely on the side of the dissidents [...]

As we’ve been saying for some time now, the President has it right here. Though of course everyone supports free and fair democracies, Iran is a country in flux at the moment. If US political figures come out in strong support for Mousavi, then what? Won’t Ahmadinejad just use that to declare Mousavi is a puppet of the West? That certainly won’t do much to help the cause for reform in Iran.

This isn't about it. We shouldn't offer the opportunity to make it that way.

...Henry goddam Kissinger supports the President's stance, ferchrissakes.

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Most Transparent Government In History

The Obama Administration has really taken to this executive power and official secrecy thing. Duck, meet water. This has all happened in the past week:


The Obama administration is fighting to block access to names of visitors to the White House, taking up the Bush administration argument that a president doesn't have to reveal who comes calling to influence policy decisions.

Despite President Barack Obama's pledge to introduce a new era of transparency to Washington, and despite two rulings by a federal judge that the records are public, the Secret Service has denied's request for the names of all White House visitors from Jan. 20 to the present. It also denied a narrower request by the nonpartisan watchdog group Citizens for Responsibility and Ethics in Washington, which sought logs of visits by executives of coal companies.

The Guardian UK:

A rift has opened between the Obama administration and some of its closest allies - Democratic leaders and environmental organisations - over its refusal to publicly disclose the location of 44 coal ash dumps that have been officially designated as a "high hazard" to local populations.

The administration turned down a request from a powerful Democratic senator to make public the list of 44 dumps, which contain a toxic soup of arsenic and heavy metals from coal-fired electricity plants, citing terrorism fears.

The LA Times:

He was appointed with fanfare in December as public watchdog over the government's multibillion-dollar bailout of the nation's financial system. But now Neil Barofsky, inspector general of the Troubled Asset Relief Program, is embroiled in a dispute with the Obama administration that delayed one recent inquiry and sparked questions about his ability to investigate without interference.

The Treasury Department contends that Barofsky does not have a completely independent role. That claim prompted a stern letter from a Republican senator, who warns that Obama administration officials are encroaching on the integrity of an office created to protect taxpayers.

The Washington Post:

A federal judge yesterday sharply questioned an assertion by the Obama administration that former Vice President Richard B. Cheney's statements to a special prosecutor about the Valerie Plame case must be kept secret, partly so they do not become fodder for Cheney's political enemies or late-night commentary on "The Daily Show."

U.S. District Judge Emmet G. Sullivan expressed surprise during a hearing here that the Justice Department, in asserting that Cheney's voluntary statements to U.S. Attorney Patrick J. Fitzgerald were exempt from disclosure, relied on legal claims put forward last October by a Bush administration political appointee, Stephen Bradbury. The department asserted then that the disclosure would make presidents and vice presidents reluctant to cooperate voluntarily with future criminal investigations.

The Plum Line:

On Friday, there may be a major development in the torture wars: The CIA is set to release portions of a 2004 report that reportedly found no proof that torture foiled any terror plots, which would dramatically undercut Dick Cheney’s claims that torture worked.

But a news story this morning raises the question: Is the CIA trying to keep chunks that would undermine Cheney under wraps?

That last one may concern the CIA, but I'm pretty sure they work for somebody in the White House. And that's just from this week, there are countless other examples of using the state secrets privilege to shut down lawsuits, breaking a campaign promise to post every bill passed by Congress on the White House website for public comment before signing, and on and on and on.

Progressives battled George W. Bush and Dick Cheney on their unprecedented offical secrecy on the merits, but also out of a recognition that there is such a thing as Presidential precedent. If one President can get away with aggrandizing their power, the successor would certainly watch and learn. Which is exactly what has happened.

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Coalition Of The Killing Health Care Reform

I'm officially worried about health care reform because of the hands in whom the reform rests. Max Baucus has reverted to his old self. Spooked by a CBO price tag of around $1.6 trillion dollars over ten years for his initial version of a reform bill, he scaled it way back, limiting the subsidies that people would receive to pay for insurance and eliminating the public option (here's the draft). If the best you can call it is comprehensive incrementalism, that's not exactly the slogan on which you can stir people to action.

The numbers tell the story. In that plan, subsidies reached 400 percent of poverty. In this plan, they've been cut to 300 percent. In that plan, Medicaid eligibility was as high as 150 percent of the poverty line. In this plan, it's 133 percent for pregnant women and children, and 100 percent for childless adults. In that plan, the "gold" coverage was 93 percent of a person's estimated expenses, and "bronze" coverage was 68 percent. In this plan, those numbers are 90 percent and 65 percent, respectively. That means people with a low-cost plan might be covered for only 65 percent of what they're likely to need.

You're talking about forcing people to pay for health insurance, giving them less than what they need to afford it, and providing penalties if they don't. It's no surprise that this tracks perfectly with the plan from the health insurance industry. In fact, it's actually WORSE. And Baucus is actually looking to weaken it further through blessed bipartisanship.

Seven senators have formed a bipartisan group to find consensus on health-care reform legislation, a sign of fresh momentum after a week of setbacks.

The group, dubbed by its members as the "Coalition of the Willing," includes Finance Chairman Max Baucus (D-Mont.) and the ranking Republican on the panel, Sen. Charles Grassley (Iowa). Others who attended the first meeting this afternoon in the Capitol included Sen. Jeff Bingaman (D-N.M.), Senate Budget Chairman Kent Conrad (D-N.D.), and GOP Sens. Orrin Hatch (Utah), Olympia Snowe (Maine), and Mike Enzi (R-Wyo.), the ranking minority member of the Senate health committee.

As Atrios notes, "The last coalition of the willing helped cause the deaths of hundreds of thousands of innocent people in a war based on lies."

Here's the paradox. I'm guessing that the CBO score rose because health care costs continue to rise and we really can't wait to bend that cost curve. But there's a simple reason that the initial health care reform plan got a bad CBO score. That's because it didn't include the kind of rebust public option that could drive down costs 20-30%. Or the kind of comparative effectiveness research that could reduce overtreatment and put costs in line with effectiveness. And so the options for Baucus, when faced with a bad score, was to do less or actually to do MORE. Because the MORE reform that you enact, the MORE savings you get in the long run.

When the Lewin Group looked at various health proposals last year, it turned out that the one that did the best at controlling costs was Pete Stark’s bill:

Creates a new public health insurance program administered by the federal government to provide everyone with multiple choices for health coverage. Under the Stark bill (H.R. 1841), employers would either offer their employees coverage or pay into a fund to cover their employees through the new public program.

This doesn't mean all is lost, actually. In the House, Nancy Pelosi has repeatedly called for a public option, and the three committees working in tandem on the bill will provide one when they roll out their legislation. In fact, Pelosi has intimated that no legislation could pass the House without a public option, because "if it’s not real, it’s no use doing." Donna Edwards said the same thing here:

CENK UYGUR: Representative Edwards, of course you don't speak for the entire house, but you are inside the Democratic caucus. And what is your sense of the caucus? Will they insist on the house signing on the public option, or is that still negotiable?

DONNA EDWARDS: Well, I have, we've had a number of conversations in a variety of caucuses, you know that the tri-caucus, which is the Black caucus, the Hispanic Caucus, I mean, Asian Pacific Islander caucus, actually came up with a set of ideas and principles for healthcare reform, as did the progressive Caucus and a strong public option was part of that. Well if you add the numbers together, those caucuses, if you don't have those in the fold, then you don't have a bill.

CENK UYGUR: All right, that's pretty clear. And let me ask you one last thing, if somehow the bill does pass through without a public option and Barack Obama declares victory. "Hey, we got healthcare reform. Yeah we didn't get the public option, but we got healthcare reform overall." Is it a sham?

DONNA EDWARDS: Well I think it will be doggone near impossible to define reform as real reform, lasting reform for the American people if it doesn't have a public option. And I'm coming from a standpoint where I actually believe that we ought to have a single-payer healthcare system and I think that it's been very unfortunate that in some ways that has been taken out of the game, and off of the table. As a result, we are here scratching and clawing for a strong and robust public option. And I'm willing to do that, but it must be strong, it must be robust, it must cover everybody, and it must cover prevention, and it's got to be competitive.

However, clearly the Senate bill is in terrible hands, and there's still the nagging problem of how to pay even for a $1 trillion dollar bill. The various ideas run up the flagpole just don't seem to have broad support. For reasons of bipartisanship, Democrats in the Senate are destroying whatever merits the bill could have, to make the bill palatable to the kind of health industry CEOs that live to steal. You can see how this might go. Senators stiff-arm real reform. The House stiff-arms any half a loaf. And nothing happens.

That would be unacceptable to the President. And so his mission must be to sell the damn bill. He was elected in large part on this kind of plan, and he needs to impress that upon weak-kneed Senators who live in perpetual fear. Without tangible reform, people are just going to give up on the Democrats and it would be hard to blame them.

It simply amazes me that Democrats could last eight years of frantically chasing whatever the hell Republicans want to talk about that week as if the Earth will crash into the sun if America don’t solve whatever problem right now and act as if they slept through the whole thing. Remember how putting aside whatever you were doing for what felt like a solid month to argue whether we should invent some new government power to stop one man in Florida from letting his brain dead wife pass on? Then there was the time Republicans convinced a swath of America that stretched from Fred Hiatt to Tom Friedman to Matt Yglesias that if we didn’t attack Iraq tomorrow Saddam Hussein might hit the east coast with radioactive al Qaeda terrorists dropped from remote control planes powered by biological weapons! You know how they did that? Sales. Whatever crappy policy the Republicans wanted to pass, they sold the hell out of it. We can agree that Republicans couldn’t govern their way out of a room with no walls, no floor and no ceiling, but god knows they could sell.

Watching Democrats try to fix health care I see a photo negative of the Bush years. Here is an issue with obvious urgency. Setting aside our shameful infant mortality rate, uninsured rate and other statistics, medical bills are by far the leading cause of personal bankruptcies. Insurer misconducy wrecks lives every day in every city in America. The right options are obvious and relatively few in number. Huge majorities support doing the right thing [...]

Democratic politicians have dropped on this issue. I hear that Obama supports the public option. That would mean more if it felt even a little more urgent than his idea that we should have a college football playoff series. Ted Roosevelt didn’t call it the bully pulpit because it lets you chat on the radio for five minutes a week.

Congressional Democrats who wet their trousers at the thought of legislating without permission from Republicans are an order of magnitude worse. The liberal media is AWOL. When was the last time you saw a third party ad on TV that made you feel anything at all?

Anyone who can find evidence of message coordination on this issue wins a prize. Hell, I’ll give partial credit for proof that Democrats went into this with a coherent sense of what they want. Belaboring the obvious, people who care about what they’re doing normally enter negotiations with some firm goal in mind. Most would agree that it is moronic to make negotiating itself the point. Yet how is that any different from kicking off a ‘health care reform’ initiative without any firm idea of what the reform will entail? Reform is a process. Pick a goal and fight for it.

In my opinion, if Democrats cannot treat even a half-victory like the public plan as more important than Mitch McConell’s anguished, fake tears then they don’t deserve to win.

Mike Lux says this is just part of the troubles and it can smooth over. And Nate Silver believes that if the President takes hold of the debate we would see some rapid movement. I wish I shared their optimism.

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