Remember the Republican hissy fit when Alan Grayson said their health care plan was "Let them die!"?

Alan Grayson famously said on the floor of Congress that the Republican health care plan was to simply let the sick die. The quote is:

The Republican health care plan for America: “don’t get sick.” If you have insurance don’t get sick, if you don’t have insurance, don’t get sick; if you’re sick, don’t get sick. Just don’t get sick. … If you do get sick America, the Republican health care plan is this: “die quickly.”

The Republican response was "He can't say that about us!!"

Now we have both Ron Paul and the studio audience of conservative Republicans confirming Grayson's statement.



Here is a transcript of the question and of Ron Paul's full response.

An interesting exchange in tonight's CNN Republican debate was prompted by the question to Rep. Ron Paul, R-Tex., about who should pay for medical care of the uninsured.

"A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I'm not going to spend $200 or $300 a month for health insurance because I'm healthy, I don't need it. But something terrible happens, all of a sudden he needs it. Who's going to pay if he goes into a coma, for example? Who pays for that?" asked host Wolf Blitzer.

Paul, a medical doctor, first responded by saying American society is primed to believe government would pay for it.

"Well, in a society that you accept welfarism and socialism, he expects the government to take care of him,' he said.

When pressed on the question, Paul responded: "That's what freedom is all about, taking your own risks," to applause from many tea party backers in the audience.

"But Congressman, are you saying that society should just let him die?" asked Blitzer, to which several voices in the audience cried out, "Yes!"

"No. I practiced medicine before we had Medicaid, in the early 1960s, when I got out of medical school. I practiced at Santa Rosa Hospital in San Antonio, and the churches took care of them. We never turned anybody away from the hospitals," said Paul to additional applause. "And we've given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves. Our neighbors, our friends, our churches would do it. This whole idea, that's the reason the cost is so high. The cost is so high because they dump it on the government, it becomes a bureaucracy," he added.

This small exchange is the key to a major debate going on with regards to health care, both President Obama's health reform law and former Massachusetts Governor Mitt Romney's own health reform law that is under attack by his Republican opponents.

Congressman Paul is wrong to assume that "they" simply decided to dump indigent health care on the government and as a result the cost of health care shot up. The fact is that the cost of health care shot up so high that individual hospitals could not continue to bear the burden without help. The result of the increase in health care cost was that the government had to step in and save the hospitals from bankruptcy. Who should fund the costs of someone in a coma kept alive for years? Who should provide the funds to give someone chemotherapy for follicular lymphoma? That costs $50,000 to $60,000 per month for six or seven months, and if successful can provide a person with many years of productive life after that.

No hospital can handle those costs today without assistance, and employers cannot continue to bear the costs of the employer insurance and remain competitive in the international market against foreign employers who have a workforce ensured by their governments. One or two very expensive cases can bankrupt a hospital and shut it down, and there are no health insurers with a large enough risk pool to handle such cases on their own. If hospitals are to be reliably funded and not risk being closed down by one or a few very expensive cases they are going to have to go to the government for financial assistance. There is no other organization large enough to bear the costs of some modern health care treatments.

Apparently Dr. Paul's medical training did not include understanding of insurance principles.

Congressman Paul and the teabaggers live in the fantasy that America is still in the 1950's. Everything that has changed since then has been a mistake and should be erased. But in those days sulfa drugs were a brand new miracle, the only treatment for depression was psychotherapy or electroconvulsive shock treatment and a diagnosis of cancer was a death sentence. Yeah, I guess that hospitals could deal with telling most of their patients there was no cure for their illness and sending them home to die at low cost to the hospital. Medicine has changed. Apparently, though, Dr. Ron Paul's medicine has not changed.

No wonder Congressman Dr. Paul had to change careers and get into politics. There are no malpractice lawsuits for incompetence against Congressmen.

Ryan offers magic to lower health care costs. Democrats offer rational system called ACA

Ezra Klein has an important posting on Ryan's health care proposals. The point he makes is that while the media has fallen in love with Ryan's vision of a new health care policy that, if implemented, would shift the increase in health care costs away from the government and onto the sick, the Democrats have an actual plan that includes many elements designed to actually lower health care costs. In short the Affordable Care Act actually includes many rational elements which will lower health care costs, Ryan offers the magic of the invisible hand and a snake-oil salesman's promise that if the insurance payments are changed, providers will change what they charge to get and keep patients well.

At the heart of Ryan’s budget are policies tying the federal government’s contribution to Medicare and Medicaid to the rate of inflation — which is far, far slower than costs in the health-care sector typically grow. He achieves those caps through cost shifting. For Medicaid, the states have to figure out how to save the money, and for Medicare, seniors will now be purchasing their own insurance plans and, in their new role as consumers, have to figure out how to save the money. It won’t work, and because it won’t work, Ryan’s savings will not materialize.

Even Ryan’s fans agree you can’t hold health-care costs down to inflation. But even if you grant that Ryan’s target is too low, his vision for reforming Medicare would like miss a more reasonabke [sic] target, too. Consider the program Ryan names as a model. He said his budget converts Medicare into “the same kind of health-care program that members of Congress enjoy.” The system he’s referring to is the Federal Employee’s Health Benefits Program, and cost growth there has not only massively outpaced inflation in recent years, but actually outpaced Medicare, too. Ryan’s numbers are so fantastic that Alice Rivlin, who originally had her name on this proposal, now opposes it.

Democrats don’t just have a proposal that offers a more plausible vision of cost control than Ryan does. They have an honest-to-goodness law. The Affordable Care Act sets more achievable targets, and offers a host of more plausible ways to reach them, than anything in Ryan’s budget. “If this is a competition betweenRyan and the Affordable Care Act on realistic approaches to curbing the growth of spending,” says Robert Reischauer, who ran the Congressional Budget Office from 1989 to 1995 and now directs the Urban Institute, “the Affordable Care Act gets five points and Ryan gets zero.”

So from Ryan we get promises of magic, smoke and mirrors that will lower health care costs if we just keep the government from paying for them. His magical vision is to shift all cost increases off to the patient. The magic does nothing to actually lower health care costs.

In constrast the Democrats have the already enacted and partially implemented Affordable Care Act which does the following

The Affordable Care Act’s central hope is that Medicare can lead the health-care system to pay for value, cut down on overtreatment, and cut out treatments that simply don’t work. The law develops Accountable Care Organizations, in which Medicare pays one provider to coordinate all of your care successfully, rather than paying many doctors and providers to add to your care no matter the cost or outcome, as is the current practice. It also begins experimenting with bundled payments, in which Medicare pays one lump-sum for all care related to the successful treatment of a condition rather than paying for every piece of care separately. To help these reforms succeed, and to help all doctors make more cost-effective treatment decisions, the law accelerates research on which drugs and treatments are most effective, and creates and funds the Patient-Centered Outcomes Research Institute to disseminate the data.

If those initiatives work, they head over to the Independent Payment Advisory Board (IPAB), which can implement cost-controlling reforms across Medicare without congressional approval — an effort to make continuous reform the default for Medicare, even if Congress is gridlocked or focused on other matters. And if they don’t work, then it’s up to the Center for Medicare and Medicaid Innovation, a funded body that will be continually testing payment and practice reforms, to keep searching and experimenting, and when it hits on successful ideas, handing them to the IPAB to implement throughout the system.

The law also goes after bad and wasted care: It cuts payments to hospitals with high rates of re-admission, as that tends to signal care isn’t being delivered well, or isn’t being follow up on effectively. It cuts payments to hospitals for care related to infections caught in the hospitals. It develops new plans to help Medicare base its purchasing decisions on value, and new programs to help Medicaid move patients with chronic illnesses into systems that rely on the sort of maintenance-based care that’s been shown to successfully lower costs and improve outcomes.

I could go on, but instead, I’ll just link to the Kaiser Family Foundation’s excellent primer (pdf) on everything the law does. The bottom line is this: The Affordable Care Act is actually doing the hard work of reforming the health-care system that’s needed to make cost control possible. Ryan’s budget just makes seniors pay more for their Medicare and choose their own plans — worthy ideas, you can argue, but ideas that have been tried many times before, and that have never cut costs in the way Ryan’s budget suggests they will.

So what will America get from the government in order to control runaway health care costs? Ryan's promises of magic, smoke and mirrors with no system of accountability for the effectiveness of health care services? Or the Affordable Care Act the Democrats have, at great cost, already crafted and begun to implement which takes a solid, working approach to actually improving the effectiveness and efficiency of the health care procedures themselves?

I'll take the output of the practical mechanic over the wild promises of the flashy "magician" any day. So will any intelligent grown up.

"Fix" Medicare? Nah, Ryan just wants it abolished.

Medical costs are climbing sustainably. No question. But America pays more than twice as much per person for health care as any other industrial nation while NOT getting as good results for what is bought as those other nations get! So what is the Republican solution as presented today by Rep. Ryan? Abolish Medicare.

Here's an excellent description of what was offered written by Josh Marshall,.

What the Republicans are proposing are not cuts. Some level of cuts and/or cost containment in Medicare are necessary because medical inflation is growing so quickly. But these aren't cuts. They're using a temporary budget crisis and the need to slow the rate of Medicare costs over long run simply to abolish the program. That's a bait and switch. It's the medical side equivalent of the "private accounts" bamboozle that President Bush used in 2005 to try to phase out Social Security.

Medicare is a federally-backed health insurance program for seniors. Why seniors? Because seniors as a group are just too sick for the private health care insurance sector to adequately provide coverage for. To rein in costs you can reduce benefits that the program provides or place more cost containment measures in place. Real pain is involved in both. But that's a legitimate area for debate. Medicare is a long term budget problem, unlike Social Security which isn't.

Or you can decide just to abolish the program altogether. Just eliminate Medicare in its entirety. This is what Rep. Ryan (R-WI) calls "fixing" Medicare, i.e., getting rid of it. Getting rid of it means abolishing the program and pushing seniors back into the private health insurance system and providing a subsidy to help pay the costs of your average 75 year old's health care. If costs go up? Well, start saving now.

This piece of Republican bamboozlement is going to get a lot of media blather in the next few weeks - even as the tea baggers shut down the federal government. But what it should get is total rejection. There is simply nothing here except a conservative primal scream shouting "We hate government except for Wars!! Government exists to Kill - kill - Kill and nothing else!!"

What no one today remembers is that when Medicare was passed in 1965 there was no insurance for anyone after age 65. If you had insurance and turned age 65 that health insurance was cancelled and there was no company in the market which would sell you a policy. People over age 65 were simply uninsurable.

This is the nature of the market that Paul Ryan wants to throw medicare beneficiaries back into.

Obama finds the ACA is a political positive for the Democrats.

Steve Benen has two interesting and fun posts up about the Affordable Care Act. First, he praised Mitt Romney for his work on health care policy as governor of Massachusetts. It's quite clear that Obama's health care plan was based largely on the system that Mitt Romney had previously installed in Massachusetts. Since Mitt is going to be running for President in the Republican Primaries, Obama's praise will create any number of right-wing attack ads against Romney.

The second post is also about Obama's efforts to implement the Affordable Care Act. Obama has announced that he is open to state-level changes in health care policy. The announcement says:

Seeking to appease disgruntled governors, President Obama announced Monday that he supported amending the 2010 health care law to allow states to opt out of its most burdensome requirements three years earlier than currently permitted.

In remarks to the National Governors Association, Mr. Obama said he backed legislation that would enable states to request federal permission to withdraw from the law's mandates in 2014 rather than in 2017 as long as they could prove that they could find other ways to cover as many people as the original law would and at the same cost. The earlier date is when many of the act's central provisions take effect, including requirements that most individuals obtain health insurance and that employers of a certain size offer coverage to workers or pay a penalty.

Steve Benen points out what this means: If the Governors can come up with an alternate system that provides health care to as many people as the ACA does without adding to the deficit and in such a way that costs are controlled as well as the federal ACA does, great! Obama will support them.

Interestingly, the only states that might develop an effective alternate that meets the requirements are Vermont and Oregon, two Democratic states, who might try to implement a single payer system.

Both of these White House initiatives put the Republicans into the position where they have to explain the value of the ACA or offer an alternative to it that is somehow better.

Massachusetts Health Care administrator supports single payer

From Massachusetts we get this endorsement of single payer health care from a guy who should know:

A senior Patrick administration health care official said Friday that a single payer system may work more effectively and efficiently than Massachusetts’s existing insurance market, a high-profile endorsement that raised eyebrows at a legislative hearing.

“I like the market, but the more and more I stay in it, the more and more I think that maybe a single payer would be better,” said Terry Dougherty, director of MassHealth – the state-run Medicaid plan that insures nearly 1.3 million Massachusetts residents – when lawmakers asked for his “personal view” on a single payer system.

Dougherty’s comment, made during a budget hearing at the Boston Public Library, prompted his boss, Secretary of Health and Human Services JudyAnn Bigby, to interject: “That’s his personal opinion.”

Dougherty noted that MassHealth, by far the largest program in state government, spends just 1.5 percent of its $10-billion-a-year budget on administrative costs – compared to about 9.5 percent by the private market, according to studies by the state Division of Health Care Finance and Policy. That figure won plaudits from several lawmakers on the panel, including some who have supported implementing a statewide single payer system.

After his remarks, Dougherty told the News Service that he’s learned to appreciate “elements of single payer” during his 30 years in health care.

“It’s got to be better than this devil-may-be marketplace,” he said. “We don’t build big buildings. We don’t have high salaries. We don’t have a lot of marketing, which makes, to some extent, some of the things that we do easier and less costly than some things that happen in the marketplace. Overall, my point is, we have individuals who work in state government in MassHealth ... who are just as smart, just as tactile, just as creative as people who work in the private sector, but they work for a lot less money.”

A single payer system would replace the state’s patchwork of nonprofit and private insurers with a single, public insurer through which all health care dollars would flow to hospitals, doctors and other health care providers. Supporters say it would eliminate administrative waste and ensure that all residents receive adequate coverage.

So - no fancy buildings and the money that is wasted on excessive salaries is instead spent on providing health care. What's not to like - unless you are a health insurance executive drinking excessively from the health care teat.

The best argument yet that we should support the public option.

It has long been clear that private and for profit health insurers cannot and will not provide quality reliable health insurance for everyone. The best and lowest cost solution is the single payer government financed system actual delivery of health care in the hands of a mixture of private and public institutions.

That's been off the table because the Obama administration compromised before even starting the health care debate. Jeff Neffinger explains why that was the wrong strategy.

This is the best rational for single payer I have seen yet.

How do we, the public, get Obama to act on what we need?

Do you really wonder what effects we, the public, can have on Obama and his policies? Consider the conditions he is operating in.

The government bureaucracy operates the way the law is written and was previously implemented. The President can only change that by decree around the edges (by Executive Order.) Making changes to those procedures and processes is a slow, painstaking process no matter what it might look like or what politicians promise. That's what protected most of America from the great mischief that Bush, Cheney and Rumsfeld conducted for as long as it did.

Only those things that are high priority get changed. That is true for both good and bad changes. If the President doesn't put the spotlight on a change they want and hold the light there, the change does not happen. By law, tradition, and operational necessity the bureaucracy will revert to the previous methods unless continually pressured. Routine always predominates in EVERY large bureaucracy, public or private. Since the President and his staff have limited time, energy and expertise to expend on making those changes only the highest priority items get their attention.

The job of making changes is most difficult for the federal government. The federal government is the largest bureaucracy there is. That's why big organizations are not as innovative as smaller ones are.

That inertia in bureaucracy is what protected most of America from the great mischief that Bush, Cheney and Rumsfeld wanted and conducted for as long as they did. But they had eight years to conduct their mischief, so they were able to do a lot of damage. Besides, starting a war is something that could be done rather quickly by the President. Note that the media focuses on the changes. The things that stay the same aren't reported on, so all we in the public learn of are the changes and sometimes the big failures. That makes the operations of the President seem a lot more dynamic than they really are.

What's that mean to Obama and the many things we want from him? Don't forget that Obama was handed two badly prosecuted wars and a level of economic collapse unforeseen this time last year to deal with. Those HAVE to be his top priorities right now, followed by getting health care passed. He doesn't really have a lot of leeway to take care of items of lesser priority to the nation as a whole.

So what can we do to get Obama to change things? We have to flood his office with demands that the change be made. That way we get to change the priorities of the Office of the Presidency. That's what FDR meant when hesaid "Maam, I want to do those things, but you must make me." If we don't change Obama's priorities, then lobbyists, his kitchen cabinet and other politicians will.

Good "AMA" health care commercial

Watch this "commercial" by Bill Maher. The AMA will hate it - particularly because it is true, just exaggerated.



Also, Digby makes an excellent point about this "greatest health care system in the world." Free lancers, students, and self-employed individuals have to avoid going to the doctor because if the doctor finds something that is recorded as a "preexisting condition" and you then move out of state or even just out of the network area, you are dropped by your old insurance company and have to find a new one in that great free market that McCain was going to throw us all into.

If you have a preexisting condition on your record then even if you can find new insurance then the premiums will be sharply jacked up. Very frequently that means people are trapped in one location or job just to keep their health insurance.

Universal health insurance with a single rating pool and with everyone paying into the system whether they are healthy or not ends that, even with private insurance companies. It's just that everyone pays and since everyone is in the same universal rating pool, preexisting conditions do not exist. Neither do jacked-up premiums, since the insurance company does not have to ensure that they are only administering insurance and paying for people in their own private rating pool.

The insurance companies, even in a private system, are paid on a per-capita basis. They collect the same premium as every other insurance company per person insured. If someone is especially expensive, then the individual companies themselves pay for loss insurance for themselves. Excessive losses are "reinsured." It's like a gambling casino. For a pool large enough, the losses are quite predictable.

Of course, the high executive salaries are no longer justified. That's why they want to kill universal health care and leave 50 million Americans uninsured. They make much bigger profits that way.

Countering the myths about Canadian health care

I am a strong proponent of single payer universal health care provided as a human right. We already try to provide health care to everyone who needs it, at least on an emergency basis, but this is both inefficient, misses a lot of people, fails to provide care to a lot of people with chronic conditions, is ridiculously expensive, wastes tons of money on unnecessary administration that is required so that the company who receives the premiums can't shift the payment off to some other entity, and causes physicians to spend too much time as administrators, thus wasting their extensive medical training.

People who oppose single payer health care offer two major arguments. One is that it is "socialized" medicine. This argument is ridiculous on the face of it, and is not to be considered as a serious objection. The second and somewhat more serious argument is that the Canadian system is single payer and has failed to provide the care the American ("lack-of") system does. The second argument is not much more serious than the first one, but requires more facts to counter. Those who use that argument never provide facts, just anecdotes. A system cannot be built on anecdotes. Facts are required before it can be determined which stories matter and which do not.

So Sara Robinson has provided an excellent article that lays out the details of the Canadian health care system, with both its advantages and its disadvantages.

Here are the facts. Go read the article.

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Bet you thought I was going to write about yesterday's Super-Tuesday primaries this morning, didn't you? Nope, not yet.

I can't provide any breaking news, and it is too soon to know what really happened. We'll just need to collect more information and see what the outcomes from the day are before any analysis that matters can be expected. It's enough for right now to recognize that yesterday was a really important day for America. It will be interesting to see how.

More proof the market can't be trusted with health insurance

From the Los Angeles Times:

California's top insurance regulator has accused Blue Shield, one of the state's largest health plans, of 1,262 violations of claims-handling laws and regulations that resulted in more than 200 people losing their medical coverage.

Calling the allegations "serious violations that completely undermine the public's trust in our healthcare delivery system and are potentially devastating to patients," Insurance Commissioner Steve Poizner said he would announce today that he would seek a $12.6-million fine.

Blue Cross complains that the violations are "for nonsubstantive issues," but for 200 people the company simply dropped their insurance rather than pay the expenses that those people had purchased the insurance for and that Blue Cross had committed to pay when required.

Those 200 are just the tip of the iceberg. California has active regulators of the insurance, and probably misses a lot more cases than they catch. Here in Texas Blue Cross would never have been caught. The regulators may be paid by state warrant, but they work for the insurance companies.

If we just ignore medical bankruptcy, no insurance companies need be hurt

Elizabeth Warren describes the manner in which the highly paid defender of the current health care status quo defends the present lack of system against all attacks. He ignores any study he disagrees with, refuses to acknowledge a powerful individual story of personal disaster caused by the current system as "single-anecdote photo opportunity" and offers no research of his own to refute the research he rejects.

Americans can hope that he is beginning to find it harder to earn the large sums of money the Insurance industry is paying him to be an 'expert witness' and defend their profits.

The strongest argument for national health care.

This (from Kevein Drum) looks like the strongest economic argument for a national health care system:

"Matt Yglesias on one of the upsides of a national health care plan:

There seems to me to be decent evidence that labor market flexibility leads to employment growth. It also seems clear that America's health care system generates substantial labor market rigidities as people with medical histories need to maintain a seamless web of insured-ness in order to remain insurable. [The] economic costs here seem potentially quite large, but obviously you'd need some really smart people to take a look at it.

I don't know the size of this effect either, but I certainly know of people who are basically stuck in their jobs forever because they have an expensive, chronic condition that wouldn't be covered during their first year at a new job. Policies vary, but it's not uncommon for pre-existing conditions to get limited (or no) coverage during an initial period under a new group health plan. As for taking a year off to go to school, or leaving to start a new business, you can just forget it if you have a chronic condition that's too expensive to risk losing coverage for."

This labor mobility is in addition to the greater freedom for business to focus managerial efforts on their own business, rather than the peripherals of employee health care.

Ask GM, Ford, and the Japanese firms who prefer to locate in Canada rather than the U.S. because in Canada the costs of health care are standard for every firm. Managerial time and effort is a rare commodity, and should be focused on the business rather than such unrelated items as negotiating with health insurance companies and trying to supervise health insurance contracts.

Is one reason a lot of firms fight universal health care because they will have to work harder to keep employees? Sort of like the way the electric utilities, mobile (and regular) phone companies and cable TV demand two year contracts so that a customer can't easily switch to a better offer?

And I'll disagree with Kevin. The current U.S. system wastes a minimum of 25% of every health care dollar in unnecessary overhead. Universal health care should easily be able to provide better general health care at sharply lower overall cost. Nearly 40 other countries provide total coverage at sharply lower costs per patient and get better overall results than the U.S. does.

Michael Moore's film "Sicko" to impact health insurers.

If you haven't seen Michael Moore's film Sicko about how bad private insurance for health care really is, here is the confidential memo (.pdf) written by on blue Cross/Blue shield executive to tell you.

Essentially health insurers exist today to skim 25% or more off the top of all health insurance payments, then to deny paying benefits to save money for themselves. The insurers themselves provide no useful innovations that improve health care. They are simply a form of redirecting money from one pocket to another and collecting as much off the top as they can in the process. Medicare and the Veteran's administration have both demonstrated that they can do a much better job at sharply lower cost and still pay health care providers the going rates in their community.

Don't believe me? See Sicko.

Health care financing is one place the free market has failed. It is time to implement national single-payer health insurance in America. Remember, though. This is about financing health care benefits. It is NOT about making the health care suppliers into government employees.

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A friend says he downloaded "Sicko" from bit torrent. Apparently a popular movie can be recognized when it has several hundred download seeding sites. Sicko has over 9,400 seeding sites, and 1,683 active sites actually downloading when checked. Not a misprint. Over nine thousand download sites.

Such downloading of movies is, of course, illegal. I point these numbers out to show the impact the movie has already had.

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Addendum - 9:58 PM
It looks like "Sicko" is having a rapid and significant impact on Americans generally. See Sicko builds a movement.

I understand that "the theater lobby—at a Dallas, Texas suburban cineplex" mentioned in the article I referred to was in Arlington, TX. Arlington is far from the most liberal city in the otherwise extremely conservative Texas. It is, for example, the largest city in the United States with no public transportation at all, and has been the single city between the Dallas and Fort Worth which has repeatedly prevented a direct rail connection between those two cities. The voters there voted down funds to provide for flood control on Johnson Creek which runs through the center of the city - although they approved city sales tax financing to build a baseball stadium for George W. Bush's losing "Texas Rangers." They also approved the use of eminent domain to remove homeowners who wanted a fair price for their homes, so that the very wealthy and powerful men building the baseball stadium would have to pay too much. Then they gave the stadium to those wealthy people. Next, they did the same thing voting for for sales tax funding and eminent domain in order to build the new sports palace fir the super wealthy Jimmy Jones to hold his "Dallas" Cowboys football team.

Last week the rains overfilled Johnson Creek and flooded a large section of Arlington. Again. The wealthy Republicans who control Arlington could care less. They are getting their dollars from the peons. They can make a lot more money with a professional sports team than they can with building communities and providing health care for the peons. Especially if they can get the peons to approve sales taxes to pay the costs of fielding the sports teams. The peons can always get jobs parking cars or selling hot dogs at the stadiums - as long as their health holds out. No health insurance, of course.

Ain't America great? Anyone can become a multimillionaire owner of a professional sports team, and to Hell with everyone else.

Can we get healthcare reform on the agenda?

Here is the experience of one individual who went to see SiCKO at a (Gasp!) Dallas suburb recently.

The health insurance companies will be presenting wall-to-wall ads against this movie and its clear policy implications very soon now.

Cuba's medical foreign aid vs. American's military foreign aid.

If you want to make friends with the top government leaders of a nation, you will rarely go wrong giving them military foreign aid. But Cuba has shown that there is a way to get the people of foreign nations to be our friends. This is from Steve Clemons (as I promised a while back):

Cuba used to export soldiers, weapons, and the ideology if not entirely the reality of Fidel and Che style revolution.

Today, Cuba exports doctors. More on that another time -- but just as a quick aside, Cuba has exported tens of thousands of doctors to some of the poorest and most remote parts of Latin America as well as other parts of the world. Cuba actually maintains a highly successful bartering arrangement of doctors for oil with Venezuela. This is clearly a page out of the 'spirit' of the John F. Kennedy initiated Peace Corps. (For other dimensions of Cuba's international medical "public diplomacy", a great resource is MEDICC.)

President Bush, in contrast, offered during his recent trip through Latin America to those in medical need some treatment on the USNS Comfort, an American warship outfitted to provide medical support at "ports" that the ill would need to travel to.

Specifically, the USNS Comfort will make port calls in Belize, Guatemala, Panama, Nicaragua, El Salvador, Peru, Ecuador, Colombia, Haiti, Trinidad and Tobago, Guyana, and Suriname. President Bush's offer is a somewhat commendable, first step -- but in contrast, Cuban doctors are deployed in small villages and remote mountain regions. They are embedded in countries much like Peace Corps staff are. But American style relief comes on a war ship with the needy making their way to us, not us doing more to reach them.

While too much of American foreign policy has become over-militarized, Cuba's, quite remarkably, has become more humanized and more reflective of the hard gains that can come from Joe Nye's notion of "soft power."

The only nations that need military aid are those with aggressive neighbors and those who want to use the military to protect their government form their own people. But almost all nations need additional health care services, and those services are best provided close to the customers.

There is also the fact that military equipment and personnel are a drain on every nation that pays for them. They provide nothing positive economically. This is very unlike spending on health care services. A healthy populace is a highly productive populace.

This looks like a really good idea to me. Of course, American conservatives will hate it. They don't like people helping others. All they like is leaders helping other leaders oppressing and otherwise ignoring the hoi polloi.

An agenda for recovery from Bush.

Talkleft extracted the elements from the NY Times article entitled "The Must-Do List." Here is the list of things that have to be done to recover from the Bush/Cheney/NeoCon administration.

• Restore Habeas Corpus
• Stop Illegal Spying
• Ban Torture, Really
• Close secret prisons,
  
• Account for the ghost prisoners,
  
• Ban extraordinary rendition,
  
• Tighten the definition of enemy combatant,
  
• Fairly screen prisoners,
  
• Ban secret and tainted evidence,
  
• Better define "classified evidence" and
  
• Respect the right to counsel.

Those are mostly all recovery efforts to problems caused by the Bush administration adn the conservatives. I'd also add:

• Get us out of Iraq and quit wasting American lives there.
• Get serious about the world-wide Counter-Terrorism effort ASAP.
  
• Start cleaning the NeoCon moles out of the Federal Government.
• Reinstate the "Fairness Doctrine" for all broadcast media.
  
• Get serious about taking care of the disabled military veterans, physically, mentally, and financially. Their families also.
  
• Audit and investigate the contractors who have had contracts with the military or the Intelligence Agencies active since 1994.
• Ensure that the systems of taking voting results and tabulating them are as close to tamper-proof as possible.
  
• Provide more serious support for training in college and work training for life.
  
• Implement a health-system that includes government guaranteed 100% coverage. Base this on community pricing instead of exclusions for prior health conditions so that along with 100% coverage, everyone pays the same premiums.
  
• Standardize the systems for applying for health care services so that clerks have to learn only one system to get reimbursement.
• Develop a general nationwide system that provides medical information on everyone similar to the one used by the VA system.
  
• Reestablish corporate income taxes, progressive individual taxes for the high income and the estate tax to pay for these programs.
  
• Follow the above up with getting control of spending and approach balancing the budget. [Note - the above healthcare reforms are expected to throw off extra funds that can be used to pay for them after the initial costs.]

This is only a start. A lot more needs to be done.