Okay, that's not their headline, but the Heritage Foundation is promoting this study that does state-by-state analysis of the reduced revenue for hospitals and doctors due to the House health care plan,the  American Affordable Health Choices Act of 2009 (H.R. 3200).  For example, Virginia physicians could see a net annual income decline by $350.2 million ($14,537 per physician) with Virginia hospitals having a net annual income fall by about $2 billion (3.5 percent decline).

Isn't this good news if we are worried about reducing health care costs? Especially since those reductions will happen with MORE people having coverage-- including 71% of the presently uninsured in Virginia gaining health care coverage?

What's truly odd is that conservatives complain about overspending, yet trumpet every cut in pharmaceutical, hospital or physician reimbursements.  Isn't that the logical result of cost reductions?   Or might the Heritage Foundation not care about reducing health care costs?

If ever we needed evidence of the Cost of Empire, Floyd Norris's scary chart of Durable Goods Production from the U.S. Economy is it.

We have so hollowed out our industrial plant that the only thing we are now producing is weapons of war. The great British Historian Arnold Toynbee's theory about the decline of the Roman Empire has lessons for our current age.

The economy of the Empire was basically a Raubwirtschaft or plunder economy based on looting existing resources rather than producing anything new. The Empire relied on booty from conquered territories (this source of revenue ending, of course, with the end of Roman territorial expansion) or on a pattern of tax collection that drove small-scale farmers into destitution (and onto a dole that required even more exactions upon those who could not escape taxation), or into dependency upon a landed élite exempt from taxation. With the cessation of tribute from conquered territories, the full cost of their military machine had to be borne by the citizenry.

Read more »

Cheryl asks for comments on rebuilding the culture of the city. My experience here, knowing a lot of musicians, some writers, an artist or two, and some filmmakers, is that the culture of this place is rebuilding itself even better than the economy, and far better than, say, the political culture. Any city with the remotest claim to a culture will have responded to an event like Katrina with a flood of work, and New Orleans has complied. Aside from Cheryl's book, there have been literally dozens of novels and non-fiction accounts, poetry, and an impassioned polemic ("Why New Orleans Matters") arguing for the city's continued existence. There have also been songs, paintings, photographic exhibitions, and screenplays galore.

On a larger scale, the city made a statement early on about itself and its culture when the first Mardi Gras after the flood took place, despite the well-intentioned warnings of many that it was "sending the wrong signal". New Orleans held that Carnival--a wounded, rollicking two-week display of righteous civic sarcasm against all who had failed the city--because, as so many folks here said, "that's what we do". Our early fears that new pioneers might overwhelm and ignore our traditions had moments--like the police arrest of musicians second-lining after a funeral because new neighbors complained about the noise--where it appeared they might be true. Yet, despite the flood and the economic weakness, traditions like the Mardi Gras Indians, and places like the Backstreet Museum and the House of Dance and Feathers--which collect and display material about the street culture of the city--have survived.

Read more »

Once upon a time, TPMCafe collected the best reader posts of the week and put them together in an easily digestible round-up. Today, we're reviving that age-old tradition.

For people who like beer -- and beer puns -- this was a very good week. (Thursday's Day in 100 Seconds offers only a taste of what clever cable news copywriters came up with -- to see beer-soused media frivolity taken to an actually offensive extreme, look no further than the latest episode of the Washington Post's "Mouthpiece Theater.") For people who care about boring old issues, though, this week may have been a bit frustrating. Leave it to TPM readers to scoop up the stories that fell through the cracks.

David Seaton, like many on the left, worries that the Obama-Gates-Crowley story derailed the health-care debate at its most crucial moment. In a post that expresses frustration over the left's obsession with identity politics, Seaton argues that nothing should distract the country from the fact that millions of working Americans are suffering every day as a result of our current health-care system.

Read more »

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
John Bolton
www.thedailyshow.com
Daily Show Full Episodes Political Humor Joke of the Day

Former US Ambassador to the UN John Bolton appeared Wednesday this week on The Daily Show for a third time and got a 'friendship bracelet' from Jon Stewart for doing so.

Bolton is a smart war-monger who is careful with words and couches his cheerleading for an Israeli strike against Tehran in lots of buffer material like calling his wanted Iran strike an "unattactive option".

Read more »

Jerusalem is back in the news. It's probable that the government of Bibi Netanyahu decided to give the legal green light to settler-support Irwin Moskowitz to build in the mostly Palestinian neighborhood of Sheikh Jarrah to strengthen Bibi's right flank. But, he is playing with fire to do this. I have an opinion piece in this weekend's Haaretz newspaper about the subject of Jerusalem:

Read more »

This summer, road trips are back, mainly because most of us can't afford to fly anywhere for a vacation, let alone pay for a resort hotel or a trip abroad. But in my book, road trips are just about the best form of vacation ever invented.

Tomorrow morning I'm heading off on my own road trip across America -- driving with my eldest son, Adam, and his huge mongrel of a dog, Herb. It's not a vacation, exactly. Adam needs another driver. But when he asked, I jumped at the chance.

Read more »

On this evening of the beer summit, I'm wondering if Cheryl and the other participants might want to address one of the biggest -- and most poorly elucidated -- issues surrounding the Katrina disaster and its aftermath: race and class. A couple of years ago I taught a college seminar on Katrina media coverage, so I got to review lots of video, print and online journalism from before, during, and after the storm. You may remember the broad outlines of what happened: for the first day or two after Aug. 29, 2005 there was no mention of race or class in reportage. Then came a flood of imagery of the mostly poor, black people trapped at the Superdome and especially the Convention Center, where there was no food or water. The issues became inescapable. Suddenly the cable TV talking heads were busting out all over with outrage and ponderous analyses about injustice in America, we got the Kanye West moment, et al. Then that quickly faded.

Read more »

Cheryl and everyone else here write (I assume) with that strange, deep, irrational love for New Orleans. I sure have it. Being back down here for one whole day has already supplied me with a dozen reasons why, most of them boiling down to the way people act here--crazy and gracious, goofy and elegant, insane and genteel. Often all at once.
Gambit Weekly posted a story that focuses on another angle of the city's uniqueness: read this story about a local pie company. Even that phrase--"local pie company"--would sound grotesquely anachronistic almost anywhere else. But the relationship between the company and the workers, the company's view of "what's enough" to keep going, the company's knowledge of its customers--all underline the New Orleanian's understanding of how much this city is not like anywhere else in America, is not, perhaps, like America itself. In the dark days after the flood, that knowledge became a suspicion that maybe the country was subconsciously trying to expel this foreign body.
P.S.: I don't even like pie.

The first time I ever visited Israel, friends gave me change to give to people in the street for 'tzedakah,' or charity. This was supposed to be a good deed-to give something to people in need in the 'holy land.' Through the years, I have come to realize that tzedakah is not an answer-instead of charity, people need 'tzedek,' or justice, not just in Israel of course, but around the world.

When people outside of Israel think about this country, they think usually of the conflict between Israel and the Palestinians, but there is another conflict internally inside Israel, regarding what kind of country it will be and how it treats workers, especially those from foreign lands.

Read more »

If the Washington Post was an Israeli daily, it would not be Ha'aretz -- the New York Times of Israel which publishes editorials and columns on all sides of the issues -- it would be the Jerusalem Post, jingoistic and, if anything, to the right of the government.

Of course, the Washington Post is not an Israeli paper so its defense of even the most indefensible Israeli policy -- the refusal to freeze settlements -- is just weird. Fred Hiatt (the editorial page editor), neocon hero Charles Krauthammer and columnist Bill Kristol consistently defend Israeli policies with a zealousness they last demonstrated when pushing for war with Iraq.

Here's today's Post editorial.

It reminds me of a song from my elementary school days called "Charlie Brown" in which each verse depicting young Charlie's sins ended with his cry "why's everybody always picking on me?"

Of course, it is obvious why from the song. He keeps making mischief. That's why.

Read more »

My last blog post on high frequency trading got a surprisingly wide reception – and was reprinted for several different audiences. The comments at Talking Points Memo were muted and did not touch the general angst about this issue. That is not surprising – that is a politics driven audience. The commentary at Business Insider was outright hostile with the general consensus being that I am an idiot. The reception on my own blog was balanced – with several people pointing out mistakes I made (and I made a few) and with most talking about the argument on its merits.

Still – one lesson – if you write an article that is not outright critical of Wall Street practice then you should expect to be called an idiot. I got endless emails asserting my stupidity.

All I wanted to really understand what the risks Goldman is taking to make all those trading profits. Sure I know most of them are fixed income – but the balance sheet is still in the trillion dollar range and this crisis has proved that ultimately these balance sheets get socialised. If taxpayers are ultimately on the hook then it is incumbent on taxpayers (at a minimum) to understand and manage the risks that they are taking through their regulatory agencies.

Read more »

Thursday is the 40th day commemoration of the martyrdom of Neda Agha-Soltan, an Iranian woman shot dead while peacefully protesting against the election results in Iran. Her murder was televised via the Internet around the world and has become a symbol for Iranians protesting Ahmadinejad's victory. Iranian opposition leaders have asked for permission to hold a mass demonstration to honor all those killed since the election but has been denied permission by the government even as the conservatives begin to turn on themselves.

Those killed by the government include Mohsen Ruholamini, the son of an adviser to the conservative presidential candidate and former leader of the Revolutionary Guard Mohsen Rezai, who died in prison after a severe beating.

In many ways, this is a continuation not only of the 1979 Revolution that overthrew the US-backed Shah of Iran, but also of the 1951 attempt to create a democratic government in Iran - ended by a US and British led coup in 1953.

Read more »

Roger Cohen, the New York Times columnist, is, in my opinion, the best mainstream media columnist on matters Middle Eastern. I've watched him grow in his position. A few years ago, he struck me as conventional in his thinking and predictable in his writing.

No more. Any doubt I had that he is the best in the business came during the Iran election aftermath when, boots on the ground and utterly fearless, he reported from the heart of darkness. No one else (except those Iranian bloggers disseminated on the web, especially by Nico Pitney in Huffpo) came close.

In the latest New York Review of Books, Cohen looks back at the stolen election and what it means. The only glimmer of hope is that the sheer blatancy of the steal almost ensures that the regime will not survive in the longterm unless, of course, Netanyahu saves it.

Read more »

Few if any who recall the uproar over Mahmoud Amadenijad's appearance at Columbia University two years ago can recall the uproar over the appearance at Columbia of Hans Luther, the first Nazi ambassador to the U.S, in 1933.

But one TPM reader could, because she'd been carried across W. 121st St. on Dec. 12, 1933 by two cops after circulating anti-Nazi handbills during the speech.

She was "a blonde, hatless, quiet, and, it seemed to me, imperturbably valiant freshman [who] stood her ground firmly but undemonstratively," wrote James Wechsler, a reporter for the Columbia Spectator, years later in The Age of Suspicion. "I knew her name was Nancy Fraenkel and that her father was a Civil Liberties Union lawyer. I saw her much more frequently after that evening which, I learned later, was her seventeenth birthday. We were married the following October."

Nancy Wechsler, who died Monday, at 93, never stopped showing how to stand your ground imperturbably in an uproar - a piece of political wisdom that grows from character and civic culture more than from intelligence or ideology.

Read more »

In addition to Cheryl's book, another book out this year, Dan Baum's Nine Lives, also examines in some granularity the experiences of New Orleanians, both before and after the disaster. Dan's reporting, also represented on a blog he wrote for newyorker.com while completing research for his book, confirms what other sources (and personal experience) report: in the absence of civic leadership and national resolve, in the face of daunting frustration from state officials and insurance adjustors, wayward contractors and outsiders who still think the city is under water, New Orleanians have adopted certain coping mechanisms.

One, which was almost unknown before the disaster but which became almost locally viral in the ensuing couple of years, was community organizing. Neighborhoods threatened with extinction banded together to defend and revivify themselves, civic organizations sprouted up to push for political reform, and artists began organizing to coalesce into neighborhood art districts. Most of these efforts have enjoyed at least some success, and personal experience tells me that a majority of them were spearheaded by women.

Read more »

Somewhere high in the Afghan mountains, Staff Sgt. Todd Bowers is shouting for joy, dancing, and quite possibly, crying all at once. And I assure you, it's not because Michael Vick is coming back to the NFL.

In less than five days, the Post-9/11 GI Bill will finally take effect -ushering in the education dreams of hundreds of thousands of U.S. troops and veterans, like Todd, who have put their plans on hold to serve for our country.

Todd may not be as well known as Michael Vick, but his story mirrors those of countless Iraq and Afghanistan veterans. A Marine since high school, he is serving his fourth deployment since September 11th. He is a highly decorated combat veteran and Purple Heart recipient, but at 30 years old, one goal still eludes him: a college degree.

Read more »

Former AIG Chairman Maurice "Hank" Greenberg waited outside the Ritz Carlton in a very long line of well-heeled Washingtonians waiting to be allowed by the organizers to access air-conditioning and get into the event ballroom. I clicked my iPhone weather application and it was 89 degrees outside -- high humidity. Lots of old people in that line.

The event was organized by the National Committee on US-China Relations, the US-China Business Council and a long roster of co-sponsoring groups.

Some DC political players in the line deserved the heat -- others didn't.

But what the powerful and connected were there for was the power dinner of the two day long US-China Strategic and Economic Dialogue.

Read more »

I don't think the administration is using the troops in the field.

Obama did not just win an election. He created a force of millions who were dedicated to his election and now to the success of his Presidency.

Maybe it is time to show the Congress that we are still here.

We organize a massive march for the Obama plan (and that means public option). We pick a fine fall day. We make sure that the blue dogs and other lily livered types have plenty of constituents marching and visiting their offices.

We let them know that millions of us are not going to permit them to destroy this Presidency. As one who worked on the Hill for 20 years, I can assure you that there is nothing Congressmen and Senators fear more than the idea of mass action on their turf.

Obama was elected by a movement. It's time to bring it back. It's time to scare the hell out of the hacks, the lobbyists and the legislators who believe that the purpose of being ion Congress is not to serve America but to score another term.

To the streets. for the Obama agenda.

I loved Cheryl's book. It's strange and sad and depressing and hilarious, like all the best memoirs. And it tells a story of Katrina that didn't and doesn't get told very often: not what happened during the storm and its immediate aftermath, but what happened in the weeks and months and long, long years that followed. As Katrina receded in the national memory, Cheryl reminds us, things continued to fall apart in New Orleans. But at the same time, there were more than a few brave souls who were pouring their lives and their hearts and their bank accounts into rebuilding the place anyway. (In Cheryl's case, it was a literal rebuilding, the kind with sheetrock and hammers and table saws.)

My own experience of post-Katrina New Orleans was much less intense (and less dangerous) than Cheryl's - but it was powerfully affecting all the same. I visited the city a handful of times in the spring and summer of 2008 to write an article for the New York Times Magazine about the city's school system and the enormous changes that were being made to the way the city's schools were run.

Read more »

Dr. Figley writes this:

Hurricanes are acts of God, people can actually accept it more readily. But trauma caused by people on purpose is another matter completely. Most especially terrorist-induced trauma to frighten people is very different from natural disasters. Even Katrina with all its human-caused problems, then and now, they are more manageable knowing that we can fix what went wrong. It is comforting.

Yeah, great load of comfort the people of New Orleans, of whom I am one, have experienced knowing that the Katrina-spawned flooding was not an act of God, but--according to the three forensic engineering teams that investigated the disaster--the result of design and construction flaws of the Congressionally-mandated "Hurricane Protection System", a project under the exclusive supervision and control of the US Army Corps of Engineers. How comforting to know that the very same Corps, which stonewalled those reports, while denouncing their pro-bono investigators as liars, is now doing the rebuilding of that system, and (a) choosing the "technically not superior" to at least one of the projects (the pumping systems for the outfall canals) due to an alleged lack of funds--this is in the year of the $3/4 trillion stimulus bill and (b) slow-walking a Congresionally-mandated report calling for a plan to build more robust hurricane protection, so called Category 5 protection.

Read more »

Cheryl, I enjoyed your book, which manages to be entertaining, poignant and enraging all at the same time. And on another level, it's about the nature of community in America. What happens when nearly everything we expect to have, and feel entitled to -- security, shelter, government services, well-stocked stores -- is stripped away? Obviously, on some basic level people rise to the occasion. Not everyone can, or does. But the community endures, and sometimes thrives in adversity.

But that doesn't let the broader society off the hook. And sadly, thanks to its geographical and cultural uniqueness, and its lack of political clout in Washington, New Orleans has been left largely to fend for itself for the past four years.

Read more »

Cheryl Wagner opened this discussion by soliciting comments about rebuilding a culture. Her frame of reference is New Orleans, where physical rebuilding after Hurricane Katrina is evident-but-oh-so-slow. The languid pace is gradually covering up scars caused by the massive man-made natural disaster caused by defective levees. The mental rebuilding, however, is not so good. Homeless and hungry people, hopeless people, crime victims-all still praying that the trauma they've endured for almost four years will go away. They are the people who inhabit Cheryl Wagner's book, Plenty Enough Suck to Go Around, but they don't just live within the book's pages. They can be found in 2009.

When a city is hit hard and brought to its knees, rebuilding a culture rarely is a top priority. Residents of New Orleans were left to their own devices to survive the disaster and stay sane. As New Orleanians found out, survival can never be assumed; and sanity, precarious in the best of circumstances, proves elusive.

Read more »

South Carolina Senator Jim DeMint is a popular man on the right these days, which keeps getting more demented as it retreats into its cozy old cocoon of denouncing impending socialism. At the Heritage Foundation last night DeMint was signing copies of his new epistle, "Saving Freedom: We Can Stop America's Slide into Socialism," where, according to the Washington Post, he received a "hero's welcome" from an adulatory audience. Heritage president Ed Feulner called him the "senior senator from the Heritage Foundation."

Interestingly, moderate Senators like George V. Voinovich, who is retiring, are shunning DeMint like the plague. Voinovich knows that it's the true believers that are taking down the GOP. Much of the GOP is reckoning that 2010 will be an off-year for President Obama, but it may well turn out to be the reverse, especially if the party continues to cater to the fringe.

A more reasoned opposition to Obama's health care plans, such as they are, is voiced by Martin Feldstein, also in the Post. Feldstein's argument is that we can't afford Obama's plan. Instead, Obama, he says, should be aiming to fix the economy. The most that Feldstein proposes is tinkering with COBRA payments to help the middle-class, which sounds like a really winning political strategy. Problem is that with health care slated to consume some 20 percent of GDP by 2017, or around $4.3 trillion, not doing anything, as Feldstein seems to argue, isn't a viable option--and one that, in any case, would devastate the very economy he calls upon Obama to resuscitate.

There's plenty of room for argument about the shape of the health care package and proposed tax hikes. A bill will be passed and signed before year's end, but standing aloof from it won't earn the GOP any points with most voters. It may be emotionally satisfying to denounce Obama as a socialist, but it isn't healthy for the political fortunes of the GOP. Until the party begins to grapple seriously with Obama, it will remain dependent on a system of artificial life support.

Last week's decision by the Senate to eliminate $1.75 billion in proposed pork barrel funding for the F-22 is a step in the right direction. It is rare that the military-industrial complex loses one of these battles. But there are conflicting views as to whether this is a unique event or the beginning of a more rational approach to Pentagon budgeting. My own view is that we can build on this victory if enough people get off the sidelines and fight for better budget priorities. A positive result is by no means guaranteed, but we may not get another opportunity like this for a long while, so we need to capitalize on it.

Read more »

So here's what Senate structures and the filibuster has reduced us too-- a bipartisan group of Senators from six of the smallest and whitest states in the country are holding health care hostage on the Senate finance committee. As the New York Times reports today, three Dems and three GOPers are negotiating to gut Obama and the House's health care bills. And who are the six?

• Max Baucus of Montana (pop 935,670- 89.2% white)
• Kent Conrad of North Dakota (pop 636,677- 90.1% white)
• Jeff Bingaman of New Mexico (pop 1,928,384- 42.8% white)
• Michael B. Enzi of Wyoming (pop 509,294- 88.8% white)
• Charles E. Grassley of Iowa (pop 2,966,334- 91.5% white)
• Olympia Snowe of Maine (pop 1,321,505 - 96% white).

Altogether, this rump group of negotiators represent just 8.3 million Americans or less than 3% of the population and only 1.6 million non-whites. Subtract Bingaman and that last number drops to just 521,000 non-whites represented by this group of Senate negotiators deciding the fate of health care for a diverse population of almost 300 million Americans.

Structurally, this is what bipartisanship means. The tyranny of tiny states and the exclusion of non-white concerns.

This is the structural racism built into a Constitution two hundred years ago to exclude the voting power of slaves and to this day privileges the power of a handful of small, mostly white states to undermine the will of the majority in our nation.

I read Cheryl Wagner's essay and, like her book, it reminded me of the unbelievable resilience demonstrated again and again by New Orleans people. Her final paragraph of her book, though somewhat confusing when quoted out of context, is a haunting reflection of so many here:

Was I going to tell someone? Was I going to remind them? Was I going to write it down? Yes, I said. Yes and yes and yes. Hopefully it would help.

My faculty appointment is through the School of Social Work, though I am a trauma psychologist. I am treated to being around social work educators who, throughout their courses, lessons plans, and supervising, who train the next generation of social workers to care about social justice, the rights of everyone, and understand the multiplicity of people, families, cultures, and city.

Cheryl's essay and book are about survival in the face of catastrophe, the worse disaster in US history. As someone who has studied disasters for more than 30 years, I would like to make two observations: (1) New Orleanians underestimates the long-term and cumulative strain caused by the storm and levy failures and (2) Telling your trauma story is important either because you are uncomfortably bothered by your trauma memories or you want to learn as much as possible about the past. However, telling it too soon or against your better judgment is unwise.

Read more »

"Sounds depressing," the woman at the antiques fair in Alameda said. She wrinkled her nose like a moldy smell had wafted in off the San Francisco Bay. The sun was still out, and many yoga moms shopped on in a heady blue daze on a perfect June afternoon alongside the water. And yet. Amidst the aesthetically-pleasingly rusted doohickeys and vintage purses, a stink had been unleashed to soil the day. And the stink was me. Why, oh why had my friend brought up the book reading that brought me to town?

My name is Cheryl Wagner. And I am a (reluctant) disasterholic. I wrote Plenty Enough Suck to Go Around: A Memoir of Floods, Fires, Parades, and Plywood. I did not choose to flood, but I did choose to tell the story of three bizarre years rebuilding my flooded life in New Orleans. I wanted people to see what I saw happen to my friends, neighbors, and family along the way.

Read more »

This week at Cafe, Cheryl Wagner joins us for a discussion of her book Plenty Enough Suck To Go Around: A Memoir Of Floods, Fires, Parades, and Plywood. With her unforgettably distinct voice, Cheryl tells the story of how Hurricane Katrina wrecked her Mid-City house in 2005 and the three-year arduous journey of rebuilding her life.

As a Louisiana native myself - born and raised in Alexandria, Louisiana, later moving to Shreveport for college - Cheryl's intensely personal story hits home in more ways than one. I've never read a more honest and accurate portrayal of the beautiful, tragic city of New Orleans, and despite the account of its last few years of struggle, she finds the perfect places to inject humor (as a New Orleanian would). I will never forget the time I put in at homeless shelters in both Shreveport and New Orleans, the heartbroken and sometimes resilient people I met, and going back to the Crescent City as often as I could, seeing people rebuild weeks, months, and still years later.

Cheryl's work has appeared in The New York Times Magazine and Harper's, among others, and she is also a contributor to public radio's This American Life.

Joining the discussion are Paul Tough, a New York Times Magazine editor who has written about the post-Katrina school system in New Orleans and author of Whatever It Takes: Geoffrey Canada's Quest to Change Harlem and America; Al Kennedy, historian and author of Big Chief Harrison and the Mardi Gras Indians and Chord Changes on the Chalkboard: How Public School Teachers Shaped Jazz and the Music of New Orleans; Charles Figley, the Dr. Paul Henry Kurzweg distinguished chair and professor of disaster mental health in the School of Social Work at Tulane University; John McQuaid, journalist and former writer for The Times-Picayune of New Orleans and author of Path of Destruction: The Devastation of New Orleans and the Coming Age of Superstorms; and Harry Shearer of "Simpsons" fame, who has written extensively about Katrina and the aftermath of rebuilding New Orleans for The Huffington Post.

One of the "wonderful legacies" of the Reagan Administration was the Prescription Drug Marketing Act of 1987. You can thank Ronnie and his deregulatory economists for the flood of erectile-disfunction ads on TV. In 1988 there was a total of $7 million spent on Direct to Consumer (DTC) prescription drug ads. Things have changed since then.

In 2008, pharmaceutical manufacturers spent about $4.8 billion on direct-to-consumer television, radio, magazine and newspaper advertising, according to Nielsen Media Research.

Now some lawmakers including Jerrold Nadler of New York are suggesting that the drug industry no longer get to deduct their DTC ad expenses from their taxes. Personally, I think they should not be allowed to advertise at all, because it's a doctor's choice what medications he prescribes. Somehow, even though they had no right before 1987 to DTC, Big Pharma has turned this into a First Amendment Issue.

"On First Amendment grounds, I am not going to say we will ban" drug advertising, said Mr. Nadler, who represents parts of Manhattan and Brooklyn. "But they should not be able to get taxpayers to subsidize it."

I have one simple question that might clarify this. Who do you think pays for the $4.6 billion of advertising?

You and me.

As part of his health care package, President Obama proposed creating an independent commission of medical experts that would determine the medical procedures for which Medicare will pay. The reason is that patients now receive many costly procedures that provide little or no medical benefit. If we can reduce this waste, we can have large savings, while possibly even improving health outcomes. President Obama describes this as promoting good medicine.

He has a case, but there is one problem with this picture. If the plan is to promote good medicine, why are we just doing it for the elderly receiving Medicare? Why don't we want good medicine for everyone?

Specifically, the government could apply the experts' judgments on appropriate procedures to any insurance plan that receives government support.

Read more »

Tel Aviv. The Americans have landed. George Mitchell, Sec'y Gates, Dennis Ross and more-they are all here this week to meet with Israeli government officials and try to secure an agreeement to get the peace process back in gear. While the street is quiet in Israel, everyone I talk to who supports the peace camp says that they are 'waiting for Obama.' There is support for what the President wants to do, but it hasn't jelled yet, at least not as action on the street.

Read more »

Every day that goes by without a vote in the House or Senate on universal health care makes it less likely that major reform will occur, because (1) opponents have more time to stir up public anxieties about it; (2) Democrats up for reelection next year come ever closer to the gravitational pull of the midterms, and grow increasingly worried about voting for a bill that could be a political liability in a year when unemployment may well reach double digits and the electorate is restless and unhappy; and (3), as a result of the first two, proponents increasingly have to rely for support and cover on industries like Big Pharma and insurance, as well as physician specialists and equipment suppliers, none of whom have any interest in fundamental reform but all of whom see possibilities for making more money out of whatever bill emerges.

In other words, next fall we get something called "universal health insurance" that still leaves millions of Americans uninsured and doesn't substantially slow the meteoric rise of health-care costs. That would be a tragedy.

What should be done now to avoid this?

Read more »