September 6, 2009 - September 12, 2009

Inspection- The Great Rhetorical Train Wreck Called America (Parts 1, 2 and 3)

by Ken Carman - September 12, 2009, 7:03AM

Want to see editions of Inspection that may not appear at TPM? Click HERE.

Inspection- Train Wreck: the Final Analysis

This is part three of the series. Since part two never appeared here at TPM, you will notice I have pasted part two and even part one previous to this column. Please feel free to review either or both before you read part three.

I really prefer to write columns that stand on their own. If I feel it necessary to do a two part column, I prefer to go on after that. Any topic, no matter how it's approached, can anger some. I don't know about you, but kicking a sleeping guard dog just once can be too much. Twice not advised. Three times? Jeez, how stupid can one be?

Yet this is the third part in a series. It will stand on its own for those unwilling to search the archives for part one and two.. I guess that some subjects stick to me like quills after rolling in a bed made out of porcupines. To use an old, outdated, phrase: this subject definitely "sticks in my craw."

What the hell is a craw? The dictionary definition linked to above seems to lack common sense. As did certain comments at a meeting I went to last weekend and Rep. Wilson's words when President Obama spoke this week.

Here's how the two relate...

During the meeting I went to a member of the organization spoke up, "The problem is a lot of folks here hate the railroad people..." a not unsubstantial number of those who attended the meeting are either pro-railroad or have good friends who are. Another said to the president of the organization, "No, the problem is a lot of us hate you."

Of course we all know what was said to President Obama recently. While addressing the House, a Rep called him a liar; well screamed out actually, regarding the health care initiative.

While heading out of town I spoke with one of the folks who defended the "we hate the railroad people" comment. "(The leader) needed to hear that." I'm sure the Rep. thought Obama needed to hear that some thought he was lying.

Let's sit back and think about this rationally for a moment. Does anyone really think that President Obama doesn't realize that some of the folks on the other side may think he's a liar sometimes? In the same sense, my guess is the president of any organization realizes that there's animosity towards her... or him... and when some of the policies that get pushed; actions taken, are hated too.

So my guess is any advantage to this kind of venting is limited at best: if there's any advantage at all. Another local suggested that such venting will "let it all out so things can calm down... eventually." My guess is just the opposite: such comments make those who agree more sure of themselves and more angry, and those who disagree join forces... and if they weren't angry before; they sure as hell are now.

Another question must be typed, though I loath to do so. There are some leaders who become such a lightning rod that whatever good they wish to achieve actually backfires. They become the issue. We kind of saw that with Bill Clinton. We saw less with George H W. I don't think we're anywhere close to that with Barack Obama. We were there with George W... but he and his people didn't care.

There's an interesting line between one who is a dictator wannabe and a true representative. That's when they think what they think, what they want, and whatever agendas they may have, become more important than serving large portions of the public who disagree with them. George was asked when he ascended if he knew that he was to be president of all the people, not just those who voted for him. He said he knew that.

Did he behave that way?

Hell no.

Any leader of any organization needs to constantly assess whether they have become so much the issue that this is a problem, no matter how ill-deserved the situation may be. Is that becoming true of the leadership during my meeting? I don't know. But I do believe this is something leaders must assess themselves. Just be aware that if you ever become more important than those you serve, then you, not what you work for, has become "the problem."

After eight years under someone who thought their agenda was more important and to hell with what others think, just look at the economy, the wars that supposedly were to only last a few months and pay for themselves, the torture mess and just where the Hell is Osama? Maybe under all those books and stuff that W. laughed about when looking for fictional WMD that Cheney claimed would be easy to find?

Did he even realize that thousands had died searching for those weapons? One thing that marks some of the worst, most dictatorial, leaders humanity has had is their insensitivity. This "insensitivity" can often be found in their willingness to laugh at and express scorn that's actually directed at the concerns of their subjects.

"Let them eat cake."

I would hope that Cheney, Bush, Rice and all the fellow former administration members would have rather given the next administration no wars, a booming economy, no torture problems and Osama's head with an apple in it. I wish I could believe that. Let's just say... considering unfunny moments like making fun of the search for WMD: I have my doubts, to put it mildly.

This is what happens when trains wreck. They go out of control. If we're lucky the engineer: our leader, isn't so callous. Or so busy squabbling... causing in fighting... that they're not paying attention to all they need to. One hopes they're actually paying attention to keeping the train safe and on the tracks. But it also becomes hard... if not impossible... when the passengers and those who work on the train are screaming and yelling; calling names and accusations: distracting the engineer and contributing to the wreck.

But that is what America is like today. That is also how I felt sometimes during that meeting when I listened to a long "trouble here in River City" talk and people screaming and yelling accusations.

Do you hear that?

I think it's a train whistle.

Run for your damn lives.

-30-

Inspection is a column that has been written by Ken Carman for over 30 years. Inspection is dedicated to looking at odd angles, under all the rocks and into the unseen cracks and crevasses that constitute the issues and philosophical constructs of our day: places few think, or even dare, to venture.

Inspection- The Great Rhetorical Train Wreck at Beaver River Station... (Part 2)

"We have become a society which argues by extreme; absurd, hyperbole... and that has become the standard for 'rationale' discussion. Those who disagree with us are cast in absurd stage lights while we toss rotten tomatoes: personal insults and mischaracterizations, at them. Many of these comments are no more than mere smears that would make Boris Badenov seem more human: more real. Of course another factor here is the tendency to portray whatever those who disagree with us believe in as always resulting in worst case scenarios, while whatever you believe in will always result in best case scenarios."

"Worst and best case scenarios almost never come true."

Beaver River Station is a quiet hamlet in what some refer to as "The Central Adirondacks." It's a bit more southwest than "central," but years ago someone... maybe Mr. Cohen or Adirondack French Louie: I'm not sure... started calling the area "central" and it has super glued itself to the region since at least my great Grandfather was a guide.

There are no roads to Beaver River Station; not since the Flow, as it used to be called, was flooded near the turn of the previous century. But there is a railroad going right through the center of town. On a rare occasion I will see a train, or maintenance crews with railcars: trucks really, riding the rails past my retirement home.

There also is a controversy surrounding this railroad which is a great rhetorical train wreck on a very small scale.

When we bought our place there in 05 I longed to return to the peaceful, quiet; "get out of Dodge while going to Dodge City" town I first fell in love with in the early 60s. The kind of place where a stranger: a teen, could sit at a restaurant and play cards until past midnight with the owner's wife and the parents of many locals... some who are now on opposing sides in this train wreck.

This sometimes rather nasty divide is over whether to rip out the rails and create a recreational trail out of what is used for snowmobiles when the train isn't operating in the winter... or support the railroad's efforts to hopefully have regular passenger service that passes through the Station. There's an added incentive: a necessarily limited ability to ride the rails with a railcar.

Ever had a controversy where you feel you're on a rack and screw and you'd rather not have one side pulling on your arms, or the other stretching your legs? This is the way I feel about this issue. I can see advantages and disadvantages either way in this debate. But what I do see is what this issue might do to my beloved Beaver River Station. As fellow Beaver River-ite Bill Partridge and I agreed a few years ago...

"This town doesn't need, and is too small, for this kind of %$#@!."

(I provided the "color" to our comments, to clear Bill of any foul language there may have been.)

Like all issues, we should return to some rather obvious observations from the previous Inspection...

"Worst and best case scenarios almost never come true."

Those who favor the train often address this issue as if the railroad will live up to all expectations and regular service will be common. The tracks will never again lay rotting; unused, as they did for many years after the last trains used them.

Those who favor ripping out the tracks and making a trail point to how the train disappeared, how it competes with local business while using funds accrued through their taxes. They say decisions are being made for the community by people who have other; less than local, fish to fry. They address the train as if all it will do is wind up being is yet another massive drain on taxpayer's pocket and hurt business.

Worst case scenario.

Those who favor the trail address the trail as if there would be few problems tearing out the tracks and it will be little but a boon to the area... yet the trail is painted by those who oppose it as if it will automatically bring in an army of Visigoths; the most rabble-ish of the rabble... destroy the very heart and soul of what we all love about Beaver River Station.

Yet another worst case scenario.

Does any of this sound like the debate on health care, or Iraq, or...?

Both are wrong.

To repeat:

"Worst and best case scenarios almost never come true."

Both are right: these are concerns that must be addressed.

Mostly they are between.

Oh, God... and the more I listen, the more I understand both sides. Why is it so much harder when you care about people on both sides of a very divisive issue? Both have a right to support their own side, of course. It's just unfortunate how such issues divide any community in very personal ways. Being a very tiny, and quite isolated, community we need each other. Walking down Park Avenue in New York City it's easy to come to the false conclusion that we really don't need each other with so many strangers passing us by, so when we disagree being dismissive is obviously easier.

But in tiny place like Beaver River? I don't understand.

If the tracks are ever torn out there can be little doubt that there will be abuses. Hell, I was one of those kids who rode the trails with my 125 Harley Rapido in the early 70s: a system of trails established for snowmobiles. Not quite legal, to say there least, though it was quite the adventure traveling back to where my father lived out the Depression running trap lines and living in lean-tos at well below minus zero.

Just like traveling the tracks takes those of us who can to where old forgotten towns once were and allows us to see sights few do.

What an adventure; just like my trail bike riding in the 60s and 70s.

One might say that if we apply the same system used to regulate snowmobiles to such a rail trail: problem solved. Not really.

During the winter the snowmobiles noisily buzz about and there is an elaborate system of licensing, trail grooming and patrolling these trails. The trains don't use the tracks that time of year. Even given the winter time system enforcement of the tracks and the trails there are still problems, tragedies and vandalism. Irresponsible behavior is very hard to control on any massive wilderness trail network.

The problem with a rail trail; minus tracks, is similar to the problem we already have with snowmobile trails. The yahoo quota goes up. My uncle; a cop for many years in the biggest Adirondack town nearby: Old Forge, had a large photo book filled with accordion snowmobiles minus the mobilers. You didn't want to see what was left of them. I know at least one family at the Station who has been touched by this kind of tragedy. This past winter there was one specific accident in Beaver River Station area involving reckless behavior and snowmobiling and the tracks... what I think may have been a race out to the Flow where alcohol was most likely involved. (Probably a "I'll get to Scotland before ye" type challenge.) I think it pretty obvious that any rail trail would add to the carnage year round.

Plus...

Some trail supporters claim that selling the scrap metal would pay for pulling the tacks, and then some. Some track supporters claim it would prohibitive to even attempt to do it.

I think the only way we'll know for sure is over the long haul. Despite best of intentions... things, and people, change. There is no perfect, or obvious, solution here.

But let's bounce back to the other side...

Railroads are expensive endeavors to fix and maintain, so I can't imagine the trail being as expensive as the railroad, since both have bills the public pays to a certain extent. Will the rail ever pay for itself? I have serious doubts.

Also, to be honest, one must mention: all of this is dependent upon the whim of those who run the train, and whether the State decides to keep investing. We could, once again, wind up with little more than a rotting track system and therefore useless railcars. Even if the railroad opens up all the way to almost the Canadian border and has no stops and starts as it has had in the past, it could roll right by us if those who run the railroad decide that's best.

As an aside, I notice there's been a hubbub recently regarding high speed rail in Upstate New York. From my admittedly limited understanding this is more Mohawk Valley/Syracuse oriented. One hopes. I would surmise that high speed rail would most likely limit rail usage by railcars, but other than that it would probably mean to Beaver River-ites comments on the approaching train would sound a bit like the following...

"Here it comes!!!!

There it ggggooooooooooeeeeesss!"

I think the only way we'll know for sure is over the long haul. Despite best of intentions... things, and people, change. Once again... there is no perfect, or obvious, solution here.

Is there ever on any issue?

Either way we are talking about greater access with less control: more lethal accidents...

...or less access with, perhaps, too much control in the hands of those who may not always have our best interests at heart no matter howkind those in control may be now. The kind of access that allows outsiders to put up gates that block access to someone's camp... until they relent and give a key to the blocked owner. Or not, if less compassionate and understanding souls are in comtrol in the future.

Or, on the other side, the kind of access that may create sometimes lethal results.

(Not that railroads are by any means 100% safe, but there is less of a safety concern for the most part I would think.)

What bothers me here, though, is how relations at the Station have gone to hell because we are having a problem discussing such things; or at least just getting along when we do disagree. I have been visiting web sites where fellow Beaver River-ites discuss such things and... well, it's much like the content of much of our "debates" these days.

We have a not so funny, funny, way to discuss issues these days. We paint anyone who dares to disagree with broad brushes then continue on as if our painting is "fact." And what I just typed above pretty much goes for any debate; certainly not just this one.

We must ask ourselves, again, as we did during part one of this topic, what exactly does strong sarcasm, name calling, and conveniently proclaiming you know the "true motives" are of those who you disagree with, achieve?

Especially in a small town, will it make relations better?

Will those you disagree with just go away, no matter how clever your insults are, or will they be more determined to oppose you?

Will it all escalate?

If you think the actions, opinions or words of those you disagree with might be very wrong headed, just how much good will handling such conversations in a very confrontational way achieve?

Usually? The single answer here is...

"Will make it all worse."

Getting to Beaver River Station always has been... and most likely always will be... an adventure. I think most of us like it that way. Well, actually, love it.

One upon a time; many years ago, that included the tracks. But if we think the dreams of the pro-railroad group will come to full: complete reality without any serious hitches or snags, we have to remember that there is an obvious history here: many stops and starts; reorganizations. I have recently read that the State has lately been questioning how much, and if, they are willing to continue fund the project. So just how likely is it that service will be regular and a boon to the Station without stops, starts, maybe even being abandoned again? Oh, probably almost as unlikely as the tracks will ever actually be torn out; especially...

"...without any serious hitches or snags..."

What we have here is an issue that is being argued over much like we argue most of our issues these days. This who hold opposing positions on issues often look at their own stance in a very idealistic way, and very stark when it comes to the other side. And as one poster recently mentioned, it would be grand if we could do all this face to face, rather than via the net: especially when some hide their identity as they tend to do on the net. But this is part of the great rhetorical train wreck that is America, that has careened out of control over and over again.

I am cursed when it comes to this issue, fellow Beaver River-ites. I truly see both sides, and while I lean back and forth, I believe the true curse is that we can get so damn angry and, sometimes childish, over issues. Insulting someone's railcar or conveniently declaring someone so shallow they would destroy a town for profit, is really neither conversation nor debate.

It's just emotion.

And to be honest, having read page after page of such on many debate forums regarding this debate and many, many issues over the years, I find discussion driven by name-calling and personal insult... B... O... R... I... N... G.

Here is what I wish, I hope, I dream for my beloved Beaver River Station: those who are the most angry would calm the hell down and remember the person who disagrees with you isn't a villain or evil. As my Grandpa Earl said to Adirondack League Club's Mr. Gallagher when he opened the Bisby Gate for him one summer, "Anyone can be wrong. Even I was... once." And, this is harder: the other has a right to be "wrong," and have an opposite opinion... no matter how ill-conceived anyone may think their opinion is.

But what will most likely to happen, no matter who "wins?" Well, since either way requires action on the part of government... my guess? Though I pray I'm wrong, no matter which way it falls, no one will be happy with how it turns out. It will resemble the south part of that moose who walked north through the Station a few years ago everyone was talking about.

Finally! Having mentioned this to almost anyone in the Station I have spoken with regarding this issue, I finally found something I think we may all agree on!

-30-

Inspection is a column that has been written by Ken Carman for over 30 years. Inspection is dedicated to looking at odd angles, under all the rocks and into the unseen cracks and crevasses that constitute the issues and philosophical constructs of our day: places few think, or even dare, to venture.

Inspection- The Great Rhetorical Train Wreck Called America

You can almost hear the wheels screeching, the train horn blow in desperation, the tipping of the cars and the engine bucking at the sudden stop.

The great rhetorical train wreck called America.

You hear it in the "I am willing to say anything" nasal tone of Ann Coulter, the Left Wing pundits who claim Obama is George Bush in Black.. or that George Bush gets off on torture... the sniffles of Glen Beck moaning and over the top histrionics about "his" America and invisible plans to steal guns.

While my own political skew is obvious to most readers, I won't type that it's all the fault of the Right, the Left, the Fundies, the Secular, bloggers or even my own generation. I won't even claim that my personal pedestal is higher than all the aforementioned.

It's not.

We have a problem America. We can't talk to each other.

I know the past is filled with parents and sons fighting over Nam, yellow journalism at the start of the nation, split families killing each other over North-South issues, and when the first President Adams heard a pub patron call him old and querulous he had him locked away until Jefferson set him free. Why? Simply because Adams found him disagreeable.

All of this has happened before.

But it seems as of late the punditry; both armchair and more "official," has for little reason gathered the worst of these attributes and added both fertilizer and accelerant in a way that would make Timothy McVeigh jealous. It's a little different when compared with an understandable, passionate, violent, disagreement citizens might have during a Civil War. Or Nam where there was a likelihood you might be forced to kill; drafted into a position where there was a good chance you would be killed... or spat upon for doing what a nation asked of you.

If one's rhetoric those days was a little over the top, well so were the circumstances. Compared to now? Not so much.

These days it's both "over the top" with the mere intent just to be more "over the top" than the last guy; Glen Beck angst driven, baby-babble and, honestly... plain phony. Because many on either side really don't care who their targets really are. Disagreeing alone justifies saying anything; doing anything.

Think of North Korea and how they act as if everything is an offense and a threat. Currently they are getting ready for the impending invasion and yelling at us that, "We'd better not..." Yup. That's the North. We all know how "loony" and over the top" they are, right? Notice how for years they have laced every conversation with accusations and threats of their own. Yet... are we really far behind them rhetorically speaking as a nation when we argue with each other?

Recently I heard Thom Hartmann on his show discussing with Randall Terry the murder of Dr. George Tiller. Like a corpse dangling from his own rhetorical rope, Terry refused to admit that the over the top rhetoric of some of those in the anti-abortion/pro-life camp may drive people to murder others. After many decades of clinic bombings, murders of abortion providers, nurses, clinic workers... in your face clinic tactics and assassination lists, there can be little doubt that the way the debate has been framed by those who wish to make abortion illegal again has fueled passions.

As far as I'm concerned, Mr. Tiller, more than anything else, is a victim of the warped nature of the national discourse on most issues. He was run over by our metaphorical train.

And what must be said about a movement dedicated to saving life so frequently stained by the taking of it? Left, Right or "other," one cannot escape the blood stain left on any movement when many individuals over a long period of time are driven by rhetoric to such extremes.

But Pro-Lifers aren't alone in this out of control train wreck created by over the top rhetoric. We have become a society which argues by extreme; absurd, hyperbole... and that has become the standard for "rationale" discussion. Those who disagree with us are cast in absurd stage lights while we toss rotten tomatoes: personal insults and mischaracterizations, at them. Many of these comments are no more than mere smears that would make Boris Badenov seem more human: more real. They're certainly not true debate or discussion.

Of course another factor here is the tendency to portray whatever those who disagree with us believe in as always resulting in worst case scenarios, while whatever you believe in will always result in best case scenarios.

Worst and best case scenarios almost never come true. Intent is rarely as evil as we might claim.

We have a not so funny, funny, way of discussing issues these days. We paint anyone who dares to disagree with broad brushes then continue on as if our painting is "fact." We must ask ourselves when we discuss; when we debate, what exactly does strong sarcasm, name calling, and conveniently proclaiming you know the "true motives" of those who you disagree with achieve?

Will it make anything better?

Will those you disagree with just go away, no matter how clever your insults are? Or will they be more determined to oppose you?

Will it all escalate?

If you think the actions, opinions or words of those you disagree with might be very wrong headed, just how much good will handling such conversations in a very confrontational way achieve?

The answer here is almost always...

"It will make it all worse."

To bring up another specific example, I heard a master of exploiting this art a while ago on NPR. Michael Savage was being interviewed by Neal Conan on Talk of the Nation via the telephone after the unwelcome mat was tossed down for him in England. He blathered on and on about "free speech," "toleration" and "name calling..." I only use "blathered" because of what happened next. Neal Conan took some calls: as he often does when he has guests. The first caller questioned the choice of Savage as a guest, getting about eleven words out. (I believe it was, "I don't think Michael Savage was the wisest choice for a guest...") Savage immediately interrupted the caller with some version of "commie pinko liar jackass" and then pounced on Neal, claiming if he was going to let %$#@!*&^%$#@!s on to his program he would go elsewhere. To Neal's credit he politely: and I do mean politely, told Savage that if that's what he wanted to do... well go ahead. Savage slammed the phone down. I give Conan even more credit because he went on with the topic and mentioned what had been said by those who defend Mr. Savage without an ounce of sarcasm or nastiness.

Now that's a professional interviewer.

While I don't defend his tactics, I do defend Mr. Savage's right to say what he says, I just think he is the prime example of how we shouldn't be debating and discussing topics. I also think his style of "debate" is like an angry mugger with severe mental issues than a debater. Whether Mr. Savage actually has mental issues is a matter of how much of an act his act is.

May society learn to resist, or at least ignore, such: no matter what end of the spectrum it comes from.

Emotion isn't "discourse."

It's just emotion.

And how do we explain someone who claims Obama is nothing more than a Communist out to grab every gun, or Rush Limbaugh is nothing more than "a big fat idiot?" I have loathed Limbaugh since he first went national and quickly learned his idea of humor was promoting his own ego while using this very type of discourse, but I'm sure, as a human, he's more than just "a big fat idiot." And he is "human," despite smartass remarks even this author may have made occasionally.

See? I told you. I claim no purity.

Sonia Sotomayor... a racist? You would think that Newt Gingrich would be a little sensitive about such bomb throwing in the form of casting such aspersions, considering how he has been portrayed as a baby having a tantrum in the past, for example.

Why is it those who cast such aspersions never notice it simply ricochets back at them?

What is the result of running the national discourse as if it were mere framing of individuals and groups using potty bowl-based materials? Think of past shootings, bombings, even 9/11... and we're talking pure rhetoric driven mass murder here. You can draw a straight line between over the top, hate-filled, bleak; yet cartoonish, rhetoric pumping over our airwaves and the Knoxville UU church shooting, the assassinations of many Dr. George Tillers, 9/11 and Timothy McVeigh. When did we get into the realm of Joe Sixpacks walking into churches and blowing strangers away to get back at "liberals," or those who perform abortions?

When as a society did we decide that stoking the fires of mass murder via slander, lies and screaming fire in a formerly more placid theater, is OK?

When did we decide that to rhetorically mimic the Roman's delightful tendency to feed large portions of humanity to the wild beasts is still "entertainment?"

And just who are these "wild beasts?" To modify Pogo...

"We have claimed we have met the enemy, while we go out of our way to make him us."

-30-

_______

"Spank me, then let's do lunch"

by 1849 - September 12, 2009, 4:05AM

One of my favorite movies is Cat On A Hot Tin Roof. I love it mostly because Big Daddy articulates two words:, "High-pocrisy" and mendacity.

In my more subdued moments of delighting in the pathos and adulterous whinings of incalculable greasy right-wing politicians, I oft wonder at the threshold, the limit, if there is some sort of karmicboundary that will eventually snap and recoil and strike them all down on the spot, some sort of grand tsunami of wayward justice that will sweep them all to the great Thai brothel in the sky after one too many gay lovers, meth addictions, adulterous affairs, teen boy fetishes comes to light and the world says, you know what? Enough of you. Back to the primordial slop you go.

Canadian Health Care: Myths vs. Facts

by Dr. Goldstein - September 12, 2009, 2:59AM

Corporate lobbyists in Washington D.C. and the politicians in their pockets are bashing and misrepresenting our excellent Canadian health care system. As a Canadian who has worked in hospitals on both sides of the border I would like to set the record straight regarding our single-payer "Universal Health Care" system, and respond to some of these sickening attacks.

In a previous post I explained the basics of Canadian health care , and I pointed out that the highest rate is only $108 for a family of three or more. Those with limited income get their insurance virtually free, just like American members of Congress do. Yes, those same elected nimrods who bash Universal Health Care are receiving essentially the same thing.

Senators and Congressmen get to participate in the Federal Employees Health Benefits Program(FEHB). This is low cost (but good) insurance and taxpayers pay two thirds of the premiums. FEHB insurance does not deny claims because of pre-existing conditions, just like Canada's Health Care system.

Former President Bill Clinton has been a very vocal supporter of Canada's system. He knows America's system as well as any American, and he knows a lot about the Canadian system. Clinton notes that in the U.S. today, there are "incentives to keep people misinformed and full of fear."

The main tactic used by lobbyists is to take isolated incidents of poor health care delivery and misrepresent these rare incidents as if they were standard operating procedure in Canada. Sure, examples of medical malpractice and improper diagnosis can be found on both sides of the border, but malpractice is not the norm in Canada or the USA.

The Canadian System provides for universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay. In practical terms "universal coverage" means you get the services and care you need, but doctors bills and hospital bills are unheard of in Canada. I visit my family doctor every three months for medication refills, and to discuss any health concerns. These visits are free just like major surgeries and specialist appointments are free. "Ability to pay" is never a concern in Canada.

Any time (24/7/365) I have a health related concern I can dial 8-1-1 and speak with an experienced nurse or a pharmacist. The nurse will decide if I can treat the problem myself, or if I should see my family doctor or go to the emergency room.
The only time I used that service was when I had a swelling spider bite on my foot. I was driving home and the nurse told me it was potentially serious. "Go to the Emergency Room and have it looked at right away." As always the emergency room visit cost me nothing, and the prompt treatment probably saved me from getting a skin graft.

THE "WAITING LIST" STRAW MAN ARGUMENT

Yes, Canada does have waiting lists for some procedures, but...

...1. Nobody ever goes on a waiting list for emergency care. Heart surgeries, Cancer treatments, etc all take place immediately.

2. We have some waiting lists for some non-emergency procedures such as knee replacements, MRI scans, etc but wait times are not ridiculous and they are well prioritized. The big difference between Canada and the USA is Canadians will always get the procedure. ALWAYS. So what if they have to wait. It's not a perfect world.

3. In America I saw people die of Cancer with no treatment, because they were poor. I also knew several people who walked around on painful knees and hips because they could not afford the arthroscopy or joint replacement. I am certain they would have been delighted to get on a waiting list for a free joint replacement.

4. Rich Canadians can "jump the queue" and pay for non-emergency MRI's or surgeries if they wish. Personally, I would prefer to use a cane for a few months (just like Dr. House) and get my knee replaced for free.

Are Canadians really being "forced" to get treatment in the USA?

No. Sometimes the specialists and surgeons are backed up, or staffing shortages occur. In a small number of cases Canadian patients get sent south of our border when it is best for the patient. Complicated pregnancies requiring a certain hospital to do the delivery, and rare diseases where the best expert is in the USA are two examples, However - when this happens - it is all at the Canadian Governments expense. Travel(Ambulance or Air Ambulance) and treatment are all paid for 100% by the Government, not the patient.

How many Americans get to travel to Canada when the top specialist is in our country, and have it paid for by the American Government? Sending patients to the USA for teatment, when appropriate, is a good thing not a bad thing.

Overall President Clinton is on the right track, and he surely has President Obama in his corner. Both men know that America's system is immoral and embarrassing when compared to all established Western democracies.

Universal Health Care, regardless of ability to pay, is the only way to go. I look forward to the day when my American friends can enjoy the Universal Health Care I take for granted.

It's all in the name

by clandesdun - September 12, 2009, 1:53AM

So now that I've been posting some stuff around here I'm kinda looking' around and I see this link "How to use TPM" or something like that. So I click the link and start reading', yeah OK, know that, yup, check, ok. Then I come to this section on blogging and the example reads "Obama spelled backwards is Amabo!!" And it dawns on me as I'm wrangling the pronunciation of that name that it is exactly why the Rebubbacan'ts are scared of him, it's that boo sound on the end of Amabo. But it's not only that it's the Ama part too because that means America so now I've figured out that Obama spelled backwards means he's going to make America one scary assed place for all those Rebubbacan'ts. As natural as the hair abandoning my scalp and taking up residence on my back (we WON'T even talk about what taking place in my ears) the Rebubbacan'ts are fearful and distrustful of him. Add that exotic first name Barak which sounds like the call of some prehistoric bird and it gets even worse. So for the sake of bipartisanship the simplest solution is he has to change his name. He should go back to using Barry as his first name and you know we can't even touch that middle name so he has to change that last name to something simple and soothing like......SMITH! That's it! Barry Smith. Hell with a name like that chances are even the Rebubbacan't won't notice the color of his skin. We'll have bipartisanship, we'll get a bunch of cool laws passed, we'll start manufacturing again, there'll be jobs for everyone! We won't even mind the immigrants coming here to do the jobs we won't have time for because we'll be having so much fun. America will be the envy of the free world (even in our worst days we're still the envy of the unfree world) again. When we travel abroad foreigners will give us the thumbs up with BOTH hands and say "yeah, Americas great" in their cool foreign accents. It will be COOL to be Americans again and even John Boehner will admit it's really pronounced "Boner". America will Rock again!

Teabagger

by JoeThunder - September 12, 2009, 1:07AM

Found this guy warming up for the big event today!

Rules of Henhouse Security: 1. Fire Foxes...(Cooked Books Still Rooking Schnooks, Liz Warren) (update)

by jollyroger - September 12, 2009, 12:54AM

Yves Smith.brings us a devastating *roster of heavyweights uniformly riding Paul Revere’s horse, Like a horror flick sequel, Nightmare on Wall Street, Two (“This time they had no one to blame but themselves…”) is coming.

Already on record, Liz Warren, (whose rise to overseer I will lay down to Josh until proven wrong…)

“All successful efforts to address bank crises have involved the combination of moving aside failed management and getting control of the process of valuing bank balance sheets,”

It is, I suppose, possible to give Prez the benefit of the doubt anent his acquiescence in the wholesale looting of the fisc by the Goldman Gang (Butch Paulson and Tim “The Manhattan Kid” Geithner)—perhaps he had his reasons.

That said, only a doofus would fail to ensure that a double-dip of public rescue would not end up on top of the apple pie at the Financiers’ Annual Dinner and Swap Meet (Every year at the Bohemian Grove near my home…)

Since Prez is not a doofus, may we not ask when he will bring the hammer down?

It’s one thing to lock the foxes in the coop while you consider humane methods of termination (of their employment…). Hiring them to take inventory and simultaneously letting them roll up a moving van and start loading hens makes no sense.

*Including Nobel Laureates up the yinyang as well as Sheila Bair, the cutest Federal Bank regulator in history.

Update: Sheila Bair says:To prevent a replay of last year’s crisis, investors in financial institutions, especially bondholders, must believe that they will lose money if banks fail,.(emphasis added)

Ya think??!!

A Vote of No Confidence

by Oh Shoot - September 12, 2009, 12:41AM

How long will it be before we admit that the democratic party does not inspire confidence in this country? This party is responsible for much of the confusion surrounding health care reform and most of what goes with it.

The party is unable to speak with a single voice on the subject and just about everyday they waffle and backtrack and change course as if there is no consensus within the party. They act as though they do not meet to determine the course of action and this leads to a situation where different members say radically different things on the same subject everyday.

In many respects they are somewhat like the GOP with several talking heads and wannabe leaders. They leave loads of doubt and confusion in the public's mouth and hence it's hard to be confident in anything they say.

The DEMS are the reason why the GOP is gathering momentum. They sit back and let the GOP set the talking points and then they lazily seek to defend the,selves, if at all. I suspect that the DEMS will lose quite a few seats in the next election cycle but it will not be because the GOP won them but because the DEMs lost them.

The DEMs just do not inspire confidence in even its most loyal supporters. It's a pity.

Are Republicans Actively Trying To Get President Obama Killed?

by rmrd0000 - September 12, 2009, 12:34AM

Some parents decided to keep their children home rather than have the ids indoctrinated by President Obama. Jim Greer the head of the Florida GOP said that Obama was trying to advance a Socialist agenda. A GOP Representative from South Carolina yells out "lie" during a Obama speech on health care address to a joint session of Congress. Conservatives have been showing up at townhall meetings and Obama speeches with weapons and wearing t-shirts with It's time to water the tree of liberty!" (a wingnut way of stating Jefferson's famous quote, "The tree of liberty must be watered with the blood of tyrants.") . Michelle Bachmann talks of the need for armed rebellion from time to time and calls Obama a tyrant and Marxist. Governors Perry of Texas and Pawlenty of Minnesota talk of secession. Sarah Palin, Chuck Grassley and others talk of Death Panels in the health care bill. All of these actions have occurred with the support of GOP officials.

What is the overall goal of these maneuvers? Dan Savage says the following: "I really do think that the Michele Bachmanns of the world and the Glenn Becks of the world are actively and consciously, or subconsciously, trying to get - I'm just going to say it, trying to get the president killed. That's why they're setting this up as kill or be killed arguments. He's going to kill your grandma, pull the plug on grandma, death panels that little children have to go in front of."

http://www.breitbart.tv/olbermann-guest-dan-savage-beck-bachmann-actively-trying-to-get-the-president-killed/

MJ Rosenberg has a TPM post wherein he details a book on a presidential assassination titled "Dark Horse: The Surprise Election and Political Murder of President James A. Garfield." From the Rosenberg post:

Garfield wasn't even a candidate for a President in 1880 (he was a Congressman) and went to the convention to support one of the anti-Grant candidates.

But, after 35 ballots of deadlock, the Republican convention nominated Garfield who had won it over with a spellbinding speech. The Grant people went crazy, frustrated at the lost opportunities to rob the government blind for four more years and sat on their hands in November.

Grant himself refused to acknowledge that Garfield was the nominee and then President. Even after the inauguration, he personally snubbed Garfield at every opportunity and his supporters spread word of Grant's contempt for Garfield far and wide.

The corruptionist wing of the GOP (similar to the far right crazies of today) spewed incessant hatred at Garfield. To them, he was utterly illegitimate simply because he wasn't Grant and because he refused to appoint crooks whose names they suggested for government positions. Garfield spent the first four months of his Presidency trying to defeat the Grant faction (known as the Stalwarts, meaning they were stalwart backers of Grant).

There are marked differences in the situations between Garfield and Obama. The level of political violence was much higher in Garfield's time, but as neoboho noted in a TPM post in response to a blog from Elizabeth2, "The Last Word On Race (IMO)", Obama gets 30 death threats a day - up 400% from GW Bush's average.

http://www.telegraph.co.uk/news/worldnews/northamerica/usa/barackobama/5967942/Barack-Obama-faces-30-death-threats-a-day-stretching-US-Secret-Service.html

Should we take comments like the "lie" shouted out by Representative Joe Wilson, as a mere moment of passion, or a part of a larger plan in which the GOP tries to delegitimize Obama's Presidency? Are the Republicans feeding red meat to the GOP base, fomenting secession and the bearing of arms at public meetings?

If that is the goal, aren't Republicans also placing Obama's life at risk?

Bipartisanship - Peace is Every Step

by acamus - September 12, 2009, 12:32AM

Alot has been put forth about Dem and Repubs working together, whether it is possible. Much have been said about how we talk to one another when we disagree. How do we move forward? I don't have the answers. But this video, Peace is Every Step, speaks to depth and breadth of what we fave, It is not as simple as getting people to understand some facts. (note: it is a long video)

testing

http://www.youtube.com/watch?v=bXQhspVJKxY&NR=1

Peace to all.

11：22 a.m.

by lin - September 11, 2009, 11:14PM

怎么搞的？

Confessions of A Truther

by Zipperupus - September 11, 2009, 11:03PM

y name is Eric, and I am a truther. I have been a truther for eight years. The moment tye second plane made impact. I asked myself (what happened)? A harmless question. I think everyone asked it to themselves at some point that day. My initial guess was that it was domestic terrorists-- ex-soldiers like McVeigh. I turned out to be wrong. You see, I am a truther that believes the attacks were the work of Al Qaeda. Oddly, there is interesting backstory to Al Qaeda. In the travel diary of Marco Polo, the narrator recounts the legend of the Old Man of the Mountain. The mountain was called Alamut, and the Old Man was a descendent of Saladin. Now, the Old Man trained assassins, who were orphan boys brought to Alamut and brainwashed. They were given hashish (assassin being derived from hashishim). In their drugged state they were seduced by several women and given a night of pleasure barely imaginable. The next day, when the srugs wore off, the boys were convinced that they had gone to heaven... And Allag had revealed to them that if they fight and die for Him they would be rewarded with 72 cirgins. So Al Qaeda has a mythic heritage rooted in the Crusades. I have no problem believing the official story. We trained and armed a bunch of folklore-infested exfremists who planned, funded, and executed the attack. Cool. Clinton leaves office specifically warning about the threat of Al Qaeda. Dick Clark cites Al Qaeda and cyberterrorism as the two gravest threats to national security. A PEB specifically states that Bin Laden is determined to attack. The possibility of planes being used as missiles is actively theorized upon in war games. Yet it happened in a manner where our national defense's pants were completely down. Don't believe me. Look it up in the commission report. Now, I am only making points. I am not creating an alternative theory. That is the difference among truthers. I want the truth. I have no interest in creating truth wholecloth. I write fiction, but I live real. The fact that I am tied together with hologram kooks is insulting. It is red-baiting, pure and simple. The fact is that warnings were ignored and profits were made. The PATRIOT act passed with one dissenting Senate voice... And we went to war. Twice. With daisy cutters, shock and awe, and not a single fucking thing to show for it. Did the government let it happen? No. I think that's absurd. But what is more troublng is the threat was ignored but the attack was exploited. It is that through laziness and ideology a cabal of neoconservative theoreticians were allowed to lay down a welcome mat for world war three by actively courting risk. And that clear avenues of investigation have been cleared in favor of narrowing the guilt to Al Qaeda. Ignore the Saudi connection. Ignore the Egyptian connection. Overall to ignore the collusion between our oil interests abroad funding the terror threat and insurgency that plagues us today. That is what makes me a truther. Our oil and gas appetite has blinded us to the bedfellows we have made. But it is far better to believe a few fanatics hate us for our freedoms than to recognized the compromising situation we are placed in. So yes, the truth of 9/11 has been sanitized, in my humble opinion. I may be heading to Aghanistan in a year or so. The military theory is that my job can help bribe farmers into growing wheat instead of poppies. So after the agriculture lobbyists come the bankers. Once the drug money is stifled, the insurgency will weaken and make way for the Caspian pipeline. Oil wealth grows while governments around the worls grow ijcreasingly oppressive. Then the next attack will occur and (surprise!) no one will be looking. Because our eyes are stuck on the prize.

Debtbeat Nation

by San Fernando Curt - September 11, 2009, 10:59PM

Given the degraded nature of our sense of right and wrong - and the relentlessness of showy, shallow, shabby "catwalk morality" we parade before the world - the credit card companies have missed a bet by not prattling that they've "gone green". The economic downturn has diminished their come-ons in my mailbox, from at least a half-dozen a week to about two a month, now. Think of all the trees left alive - pumping out oxygen, unpulped... unrecruited to sucker the hapless to join Debtor Nation.

by ~flowerchild~ - September 11, 2009, 8:51PM

Contrary to what may be thought, I do not spend all my time hanging around with old geezers. I know a few young geezers too, and am on fairly good terms with said young 'uns.

I asked for and received permission to copy and paste a rant sent to me by a young person I had asked an opinion from about President Obama's speech on health care reform. I was surprised their response was quite different from my own. Where I was vaguely pleased with the answers to concerns the Prez covered and the stern warning he gave those who wish to derail reform, my young friend saw it through....different ears.

Anyway, here is my young friend's rant (with a few punctuation changes)....

And on Obama's speech. He needs more balls. And I will not be forced to pay for medical. That's retarded. How the hell am I going to be able to afford that? And millions of others, too? We can barely make it now, so what do I have to give up to get health insurance?   Electricity? Heat for the house? I consider those things preventive care, for if you decrease my standard of living, I'll have to deal with the diseases that I'll get by having to live in squalor. Fucking Brilliant.

This is not a step forward but a step back. I think that they forgot what they are supposed to be doing what with all the bullshit that's going on. Which way do I go? Let's go back to the dark ages.

I'm starting to get fed up with this crap. I thought Obama was to bring some different Ideas and stick by them.

Big Insurance is now going to get even richer and control things 'cause they need their profits so instead of fucking people over in the usual way, now they are guaranteed customers by the gov't.

And Tax Credits. Seriously, that's what poor people really think about, isn't it? I mean, say I go get insurance and pay like $400 a month. I'm fucked to begin with 'cause I need that money to live in a place just better than a fucking hole, but now I have to use that money for my health insurance. OMG this is a stupid idea.

So, I'm thinking that I'll get tax credits, which means I can live well for about a month after my tax refund, 'cause I'm going to need to use the credit refund on bills and late fees I couldn't pay because I needed to get a gov't mandated health insurance plan from some shithole insurance company. That's brilliant.

Anyway, I say that the plan is fucking worthless.

And pooling them to compete.   Really, you think that is going to work? Fuck no, it's not. What do they think they are doing?.

This is an unfortunate turn and it's leaving many behind. The old adage continues, "the poor get poorer and the rich get richer".   Send the poor off to fight their wars. Either I'm done with this country or I'm going to change it. IT'S BULLSHIT. I am tired of getting fucked over everywhere I go.

Rant End.

Just thought this perspective might be of some interest.
Happy weekend, everybody.

Drill, Baby, Drill

by John - September 11, 2009, 8:42PM

Will try a topic not related to Health Care...and spurred on by a post from tmmcarthy0 (thanks) on a different topic.

The anniversary of 9-11 has me thinking (again) about how our national addiction to oil has affected our country, and many parts of the world. The terrorists who attacked us on that day were NOT from Iraq, but from Saudi Arabia, United Arab Emirates, Egypt and Lebanon. But, to Iraq we went to wage war. Likely for many reasons (which I don't want to argue about here) but one was definitely OIL. And the reason we didn't go after Saudi Arabia is also OIL. King Abdullah's regime has some of the most oppressive human rights in the world. Their record toward women is abominable; their support for wahabbism is destabilizing; their oil is oh, so lovely. Saddam was an awful person and dictator also, but his oil didn't flow well into world markets.

Our national requirement for more oil -- the majority of which is imported -- requires us to pursue foreign policy with special consideration to oil access. Importantly, when you look at those countries whose economy depends on the extraction of oil, you see a who's who of despots, dictators and human rights abusers. Leaders in Saudi Arabia, Venezuela, Iran, Russia, Nigeria, Libya, Angola, Kazakhstan all obtain a large percentage of their wealth from oil exports. And our demand (representing 25% of world demand) drives up the price which sends more of our wealth into the pockets of those leaders.

Imported oil is a serious national security issue...and hampers our ability to pursue other national interests both domestically and globally. So I would love to see the administration do the following:

To reduce demand...increase the gas tax. Gasoline is responsible for half our oil consumption. Scrap the complicated and opaque cap-and-trade. Go simple and direct: Start the gas tax with an additional $0.08 per gallon and increase it by $0.08 per month (almost $1 / year) until the tax reaches $4-$5 per gallon. People will be buying hybrids and scrapping those SUV's so fast it will make your head spin.

To increase supply...drill for more oil in the US, now, everywhere. Drill in ANWR; drill off the coasts; drill in the gulf; convert oil shales; provide support if needed to make the oil shales economical. This won't help forever, but it will help in the short-term (<20 years). And, it will be done with less impact to the global environment than having other countries drill in less-developed and less-responsible parts of the world.

Take the proceeds from the tax on gas to invest tens of billions of dollars into the development of alternative energy sources...now. Solar, Wind, Geothermal, Natural Gas, Electric Batteries, Fuel Cells...all of it. Fund it inside the Defense Department -- it is a national security imperative.

Sell all of this to the American people in terms of national security, global human rights and respect for the environment. Both Democrats and Republicans can support it for their own reasons...but it will be a way to reduce imported oil quickly and ultimately eliminate our dependence on oil altogether.

Republican declention

by HomerSexual - September 11, 2009, 8:41PM

Okay, we have:

Michael "I Lie" Duvall

Joe "You Lie" Wilson

Michael "We Lie" Steele

Barney Frank: Joe Wilson's "you lie" remark wasn't a big deal

by truthseeker77 - September 11, 2009, 8:36PM

Frank said last night on the Rachel Maddow show that Wilson was frustrated, and the tirade shows that Obama's speech was effective and the GOP couldn't handle it; but that this was not a big deal, citing heckling in the British parliament.

MADDOW: A Republican Member of Congress named Joe Wilson of South Carolina screamed, "You lie" at the president tonight, interrupting his speech. Is this an "ignore the tantrum" moment or is that a big deal?

FRANK: I don't think it's a big deal. Look, I think free speech--you know, heckling is a tradition, obviously, in the British parliament. They even have mikes that come down to hear the heckles.

I think what we should take it as--it is unusual--it's a sign of how effective the president was. These guys just couldn't handle it. I looked at John Boehner and he looked about as glum and as dour as--as possibly he could be.

So what Joe Wilson did was just scream out in frustration because the president was nailing it.

What do you guys and ladies think about the fact that we think it was a big deal and progressive stalwart Barney Frank doesn't?

Is The Public Option Important?

by Fred Moolten - September 11, 2009, 5:24PM

The question as to whether a public option is important deserves rigorous scrutiny, but must be distinguished from a second question - is the public option essential?

The differences are not inconsequential. If robust reform is achievable with or without a public option, enormous effort and enthusiasm will now be justified to ensure the passage of reform legislation as a transformative change for the better in American healthcare. If, on the other hand, reform without a public option would be almost worthless, as some have suggested, little enthusiasm would be justified, and little would likely ensue.

There are "in-between" scenarios involving non-profit cooperatives, a "triggered" public option, or a public option as a pilot program in selected regions. Indeed, one of these may eventually emerge as a component of reform bills, but for the sake of clarity, I wish to consider only the stark alternatives - a public option or reform without it.

Here, I will make the argument that if other reform objectives are met, a public option as an additional component would be important, but far from essential. I hope others will offer their perspectives indicating why they agree or disagree. I also hope, however, that those opinions will be documented by evidence, so that we might all end up better informed. In the end, the public option is a policy rather than a religion, and its value must be decided on the basis of evidence rather than faith.

Let me start with the obvious - a public option would reduce the costs of health insurance premiums. To an important degree, however, the value of a public option depends on the extent and magnitude of that reduction. At this point, I would like to lay out, in two parts, what I consider relevant evidence. The first part concerns the level of impact that might be anticipated from a public option per se, and the second the impact of other reforms independent of the public option.

EVIDENCE BEARING ON THE POTENTIAL IMPACT OF A PUBLIC OPTION:

1. The cost of existing public insurance (e.g. Medicare) has been rising at rates similar to private insurance (about 8-9% per year).

2. Of the U.S. total healthcare expenses (almost twice that of most other industrialized democracies), private insurance profits account for less than 2%, and insurance company administrative costs about 6%. If all profits were eliminated, and administrative costs reduced to levels in other countries such as Canada, total healthcare costs would fall by only 3-4 percent. (Note that the above estimates are obtained by multiplying estimated reductions in private insurer costs by about 36% , which is their contribution to the total healthcare bill).

3. Almost all the excess healthcare costs (including excess administrative costs) reside within healthcare itself, due to duplicate or unnecessary facilities, tests, procedures, and specialty referrals based on a fee for service paradigm that encourages excess. Compared with these, insurance excesses are rather minor.

None of the above evidence refutes the conclusion that savings achievable with a public option are meaningful, but provides less reason to conclude that their impact will address more than a small fraction of the healthcare challenge. Among challenges not addressed are the abuses inherent in the insurance system independent of overall costs, and the huge excesses in healthcare outside of the insurance system. Let's look at how these might be addressed. Much of what follows is encompassed within proposed legislation, and much is already operative already in other nations with successful healthcare programs - some with dominant public insurance components and others that rely primarily on strong regulation of private insurers.

OTHER PROPOSED REFORMS WITH SIGNICANT POTENTIAL IMPACT

1. All individuals must be accepted by insurers, with no exclusions for illness or pre-existing conditions.

2. There can be no discriminatory rates for illness or pre-existing conditions, and only small differences for age.

3. No insurer can withdraw coverage from an individual who pays the premiums.

4. There can be no annual or lifetime caps on coverage.

5. All insurance plans must offer at least a minimum essential benefits package.

6. There will be limits on copays, and no copays for routine checkups (preventive care).

7. All individuals will be insured (with waivers in exceptional circumstances or with tax penalties for refusing insurance).

8. Low income individuals will receive government subsidies to render insurance premiums affordable.

Each of the above addresses inequities, but not cost containment. The following is a critical component of proposed reforms that directly addresses costs.

9. Minimum limits can be set on insurer medical loss ratios. These are the percentage of premium dollars that must be spent on medical care rather than profits or administrative costs. Many states already have established minimums (e.g., 70-80%). HR3200, for example, doesn't specify a figure, but allows this to be set in the future by the insurance commissioner or other authority, whereas the Senate HELP Committee bill sets the minimum at 85%. If this is set high enough, it would preclude excessive profiteering or insurer administrative inefficiency even in the absence of a public option. Note that this minimum can be set for each type of insurance (e.g. employer-based group insurance as opposed to individual coverage), so that insurers could be prevented from using a high ratio in one group to offset a low one in another group.

Assuming all these other reforms, many of which already operate in other nations, are implemented in adequate fashion, would the absence of a public option constitute a seriously damaging omission, or merely a moderate disadvantage in a program that is otherwise an enormous step forward?

To summarize the foregoing in another manner - if all individuals have adequate insurance (subsidized for affordability when necessary), and if insurers are required by law to spend the large majority of premium dollars on medical services rather than administration or profits, would not premium costs without a public option be only marginally higher than costs achievable with that option? Would not the percentage figures set for minimum medical loss ratios offer comparable opportunities to constrain costs, and deserve far more attention than the debate has focused on them?

My answer to the question I raise in the last paragraph is a tentative "maybe but not necessarily". Here is why.

To reverse the unsustainable trajectory of high and rising costs within healthcare itself requires major restructuring to incentivize elimination of unnecessary services, and to reward quality rather than quantity of the services delivered. Proposed legislation begins to address this issue with demonstration projects testing alternative healthcare delivery mechanisms, incentives to increase primary care, and funding for comparative effectiveness research to develop guidelines helping physicians decide what works and what doesn't (or may even be harmful). Among the alternative delivery mechanisms are accountable care organizations (ACOs) that receive payments in exchange for providing necessary care as an integrated package rather than uncoordinated services from providers acting without reference to each other. This mechanism rewards good outcomes but penalizes unnecessary expenditures, and can thus reduce costs.

Let us consider a community with a few large, well-established hospitals and provider networks, and an upstart ACO with few patient subscribers to date. Let us assume that it can afford to charge as little as $7000 annually for patients whom the established providers would charge $10,000 due to duplication and inefficiency. We will also assume private insurers must spend 80% of premiums on medical services, and can keep 20% for profit and overhead. If they spend $10,000 in paying the established providers, they can therefore keep $2,500, whereas if they pay the ACO $7,000, they keep only $1,750. As long as the ACO is too small to attract many patients away from the established institutions, it benefits the insurers to cover patients these institutions serve rather than ACO patients, simply passing the extra costs on to subscribers. In the long run, a growing ACO would provide formidable competition to the establishment and a major attraction to insurers, but private insurers tend to respond to short term demands from investors. In contrast, a public option, particularly with startup subsidization by the government, could in theory invest in a contract with the ACO with the goal of helping it grow to a point where it replaces more expensive providers for many patients.

To what extent would this scenario play out with a real world public option? I doubt that anyone can predict the answer with accuracy, nor is it fair to claim that only a public option would enable ACOs to grow and eventually serve as major cost reduction mechanisms. It is these uncertainties that make it difficult to judge the eventual importance of a public option independent of its short term ability to achieve minor cost reductions beyond those achievable by a robust reform program lacking a public option. The additional benefits might ultimately prove substantial, but they might equally prove trivial if healthcare costs can be constrained via comparative effectiveness research and the natural growth of ACOs or other alternative provider mechanisms. To me, the uncertainty is a signal that I should refrain from excessively dogmatic claims. Even so, I would argue that proposed reforms outside of a public option will represent major advances toward the eventual goal of high quality affordable healthcare for all, and do not deserve to be belittled. It would be truly unfair the characterize them as "worthless". My personal enthusiasm for them will remain high, even as I hope they may be supplemented by a public option in its strongest form. The likelihood that a public option would be less critical for robust reform than other reform options in no way detracts from the firm conclusion it would be important.

In asking for the views of others, I would again urge them also to refrain from dogmatic assertions of belief, and instead document all claims with the most persuasive evidence they can muster.

The Selfish Reason for a Public Option

by Mr. Conspiracy - September 11, 2009, 5:16PM

I've seen several progressive bloggers lately, most recently Digby, state that the most important thing is to get universal coverage.

On a purely personal, utterly selfish level, this is not the most important thing to me. Or to 99% of the community. Health care costs are eating me alive, and I'm not even sick. I'm one chronic illness away from insolvency. I need healthcare I can afford, not healthcare that costs 1/3 of my net salary. I want a public option because it will be cheaper, because I haven't had a raise in almost five years, and I desperately need a raise to come from somewhere.

Truth is, you can't sell healthcare reform on an altruistic basis. When blogger like Digby (and I can't believe she actually wrote this) say that the public option isn't as important as making sure everyone is covered, that may be true at the macro level, but it damn well isn't true in the pages of my checkbook.

Why can't we sell healthcare reform based on the ways it helps the vast majority of people - people with insurance that is too expensive and out-of-pocket costs that could easily bankrupt them, given one major illness?

Biden said we'll have a bill by Thanksgiving, so there's still time to do this right. Why can't we dust off the Kennedy-Dingell bill that offers a buy-in to Medicare for everyone? It was written by Kennedy - that's worthy 50 senate votes all by itself, and the House would pass it without even reading it. A Medicare for All bill offers numerous advantages practical and political. In fact, it's virtually unbeatable. Those who oppose it need only be asked, why do you hate Medicare?

So if Obama must have a healthcare bill to sign, why not offer one that is virtually assured of passing both houses? Why go through this political kabuki? The solution to this should be simple. It is simple.

Proof of Citizenship

by pbw - September 11, 2009, 4:53PM

The not-so-hidden problem with "proving citizenship" to get health care is that, once again, it prevents people (primarily poorer, older, people of color) from exercising their right - as it does with voting as the Republicans well know- and thus not getting health care. Not only do Dems cave once again, but they screw the poor, older, citizens of color again...as by now most of the health "reform" does

tpm cafe versus red state

by jason everett miller - September 11, 2009, 4:20PM

After the break, a series of quotes from both Red State and TPM Cafe will be provided in an effort to determine which side of the political spectrum is truly the craziest.

I won't label which quotes came from which site, but some long-time readers may be as amused as I am that it is becoming increasingly hard to tell the difference between the left and right fringes.

Enjoy!

by NYkrinDC - September 11, 2009, 2:37PM

September 11, eight years ago, a sunny Tuesday morning whose routine was shattered by a series of coordinated suicide attacks on our country that would go on to claim the lives of 2,974 innocent civilians and change New York City's skyline forever. Eight years have past since that fateful day and today we find ourselves still engaged in world-spanning struggle that has further claimed the lives more American combat troops, and diplomatic personnel. Much has changed. This September 11 anniversary is different from the rest, in that it is the first in which George W. Bush is no longer President of the United States. In January of this year, Barack Obama was sworn into the office and has since had to tackle not only the wars resultant from the attacks, but also a global economic meltdown not seen in decades. Under this new President, the US has recommitted to Afghanistan, where the 9/11 attacks were conceived. Things however are not going well.

Since 2001, when we toppled the Taliban and installed the government of Hamid Karzai, our mismanagement and lack of focus on the country allowed the Taliban to return, stronger than ever, and set up cells throughout the country. Iraq, a war sold to us on the idea that in a post-9/11 world we could no longer allow a dictator like Saddam Hussein to remain in power manufacturing weapons of mass destruction that could make their way to terrorists, has stabilized somewhat. Most of the reasons given for the conflict, however, turned out not to have been right. In short, mistakes have been made even as we've had a few successes in the capture or death of men directly connected to the 9/11 attacks, among these Ramzi bin al Shibh and Khalid Sheik Muhammed. Osama bin Laden, and Ayman Al-Zawahiri, however, remain at large and despite 8 years of looking for them, we are no closer to finding them.

Since the 9/11 attacks, 4343 American soldiers have died in Iraq, along with UK 179; Italy, 33; Ukraine, 18; Poland, 21; Bulgaria, 13; Spain, 11; Denmark, 7; El Salvador, 5; Slovakia, 4; Latvia and Georgia, 3 each; Estonia, Netherlands, Thailand and Romania, 2 each; and Australia, Hungary, Kazakhstan and South Korea, 1 each.

In Afghanistan, 726 American soldiers have lost their lives, most coming in the last few years as the Taliban insurgency has gained strength. Additionally, the US military also lists a total of 69 more American military deaths in Guantanamo Bay Naval Base, Cuba; Djibouti; Eritrea; Ethiopia; Jordan; Kenya; Kyrgyzstan; Philippines; Seychelles; Sudan; Tajikistan; Turkey; and Yemen. The most recent article I could find mentioning US ally deaths, puts the tally at Great Britain 110, Canada 85, Germany 25, and the Netherlands 16.

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Two Retired Generals Denounce Former Vice President Cheney

by David Danzig - September 11, 2009, 2:19PM

It's not every day that retired generals denounce a Vice President. But two distinguished military leaders felt compelled to speak out against Mr. Cheney's support of torture, in an op-ed in today's Miami Herald.

General Charles C. Krulak and General Joseph P. Hoar have this to say:

In the fear that followed 9/11, Americans were told that defeating Al Qaeda
would require us to "take off the gloves." As a former Commandant of the U.S.
Marine Corps and a retired Commander-in-Chief of U.S. Central Command, we knew that was a recipe for disaster. But we never imagined that we would feel
duty-bound to publicly denounce a Vice President of the United States, a man who
has served our country for many years. In light of the irresponsible statements
recently made by former Vice President Dick Cheney, however, we feel we must
repudiate his dangerous ideas - and his scare tactics.

Cross-posted from Human Rights First Blog.

Families of Antebellum Virginia

by 1849 - September 11, 2009, 2:19PM

It was a spectacular autumn day in the Piedmont of Virginia. The trees were all dressed in their finest reds, oranges and yellows. The day was warm and I was stunned by the beauty of hilly Virginia countryside. I was there in part to follow up on some abstracts that I found with the assistance of various resources on and offline. There was one record, my great great great grandfather's 1886 obituary in Ohio that pointed me in the direction of Charlottesville; and I wanted to know more. I am terrible at long distance research. I went and needed to go Central Virginia to orientate myself with the topography, the sounds, the smells and the crimson soil. I needed to do this so that I could and can better image/understand the people with whom I strongly believe I have kinship. I needed to understand the descriptions the records etched in my mind.

One of the first stops on my trip was the Albemarle Historical Society in Charlottesville. The historical society occupies the McIntyre Library and sits on 2nd and E. Jefferson Streets next to or around the corner from the Jefferson Madison Regional Library. The Jefferson Madison Regional Library resides at 201 E. Main Street. Both of these libraries are just down the street from the main square in Charlottesville. That part of Charlottesville displays some of it's historical past with wonderful restored brick buildings. One of those nicely refinished buildings is the Albemarle County courthouse; a library unto itself. I am sure that this building was restored because the brick housing along with the brick pavement is immaculate. Anyone doing family history or any other type research about the area is lucky because this area lends itself to being actually what it might have been like during a certain period in American history. In other words, someone gets a since of history in this place. Researchers are also lucky to have so many records with so much history within such a small area. To prove this point, there are even more records and history at the University of Virginia. It is just up the road a bit and they have some of the oldest records--thrid only, I believe to the State Archives in Richmond and William and Mary College-- about Virginia's history and and ultimately themes in the history of the United States and North America. I took full advantage of the surroundings. Though it may have been just a bit too much, I made it up to the little mountain upon which Monticello sits to see that small dome that faces the great green expanse of the west lawn. Visiting the cellar of Monticello is a history lesson waiting for any American ready to have their beliefs about the country and nation challenged.

It is really easy to get caught in bigger story of American history in that place. It was difficult to stay focused because the history is everywhere.

Still, the main reason I was in Charlottesville was to find any traces of my family in that place and the remaining traces are in vertical files and history text among several libraries in Virginia. Again I used the McIntyre Library or Albemarle Historical Society records, the Albemarle Courthouse records and made a trip the University of Virginia to get a better sense about this place and its people through records. There was so much to digest in a short span of time from a period that has long past. I was spread thin between the State Archives in Richmond, the University of Virginia and copious records at the Historical Society and Charlottesville's Courthouse .

I did do a little bit of homework before making that fateful trip from California to Virginia. One of the steps I took prior to arriving in Charlottesville was to write the Albemarle County History Society to request a 1995 copy of The Magazine of Albemarle County History; and they complied. This helped tremendously. I requested this particular edition because Mr. Ervin Jordan, Jr. penned one of most incredible articles I had ever (at that point) read about black people in antebellum America. The article, A Just and True Account. Two 1833 Parish Censuses of Free Blacks takes inventory of the lives of people with whom I strongly believe my great great great grandfather shares kinship . The Parishes of Fredericksville and St. Anne's are the focus of Mr. Jordan's( Charlottesville was included because it is in Albemarble county too) article as the State of Virginia required its counties to take censuses of any and all black people and or free people of color. What Virginia was trying to do was "persuade" Afro-Virginians to remove to Liberia. And one of the reasons Virginia wanted to decrease its black and freed people of color populations resides in the fact that the state was trying avoid rebellions like the ones inspired by Nat Turner and Gabriel Prosser, both in opposition of slavery.

According to Mr. Jordan only a few blacks (if any) and or free people of color in Albemarle County took the persuasion to leave the area seriously. My ancestor(s) was/were one of few who left Virginia. I found an abstract of my great great great parents 1835 marriage record in Ohio. A few years prior to my trip to Virginia, I found the abstract at the Mormon library in Salt Lake City. This lead me to look for any other records in that Ohio county and I found my great great great grandfather's obituary that told me to continue and look east. I believe my great great great grandfather was in his early to mid-twenties when he left the Commonwealth. I don't know if he left with family, friends or just others in the vicinity. The 1850 Ohio Census shows a high concentration of free people of color in Ohio who said or it was reported that they said, Virginia was from whence they came. Still many black and or free people of color refused to live their families and home(s). I understand. They, after-all, some of them, fought in the American Revolution and some of them earned the land they owned in Virginia through service. Why would they give it up? They like native Americans help forge what we know as the United States. Another reason I believe many black and free people of color refused to leave or even decided to leave--yes leave-- has to do with the size of their families; a good number of the families in Mr. Jordan article are huge. My surname listed in that famous 1833 Census, is one of most prolific in the area according to authors like Carter G. Woodson. I believe many remained in the vicinity despite the enormous pressure from the state because they formed tight knit families and sometimes these families ties crossed state, county, ethnic and legal lines; for example I have a lead on my great great great grandfather's grandmother in Louisa County which is Albemarle's neighbor to the east. Once again and at the same time, some black Virginians--as the 1840 and 1850 Ohio Censuses indicate--decided to try to establish homes west of the Ohio River. These cross-state ties were important to the people in those documents and it is important to me because a line--a very straight line-- can be drawn directly to place in which I was doing research.

While I was doing this tedious leg work, I could not help but notice some of the attributes about some of the families in the area. Mr. Jordon's article opened a whole new line of inquiry. He piqued my interest because I was never taught in official American history courses to question the official narrative. After reading The Magazine of Albemarle County History and comparing that with some records at the State Archives in Richmond, I noticed that many families were multi-ethnic families. When I say multi-ethnic, I include native Americans under that banner. I must say that the whole Jefferson-Sally Hemings affair was like tip of this historical iceberg. After reading Annette Gorden-Reed's, The Hemingses of Monticello, I learned how complicated families were in antebellum Virginia. Gordon-Reed delves into the genealogy and family history of Sally Hemings' mother Betty. She had extra-legal relationship with John Wayles that produced seven children.. And as if this couldn't not get any more complicated Sally Hemings, according Gordon-Reed was one of Martha Wayle's,( Thomas Jefferson's wife), seven half siblings.

With all the records and Mr. Jordan's article, I seized upon the story of the West family. It is one most fascinating families in Central Virginia. Again, the West family was a multi-ethnic, multi-generational and multi-racial family that took on a life of its own in my research. The West family- at least the members of the family that were considered persons of color-- appear in Mr. Jordan's 1995 article because the State of Virginia in the 1830s specifically required counties to count the non-white population in every town and hamlet in order to push emigration; what is interesting about the West family is that Jane West's ( a woman of color) parents were in and created an extra-legal household. Jane's mother Nancy West and from all indications her father David Isaacs, were two people who dared to have a relationship across the entrenched color line. Although Mr, Jordan's article doesn't and couldn't note this detail, I learned about it later after reading Joshua Rothman's Notorious in the Neighborhood. It is also important to note that Nancy West's father Thomas West, a white man, had children or even may have set up a household with a black woman he used to own named Priscilla. Remember all of this is happening in antebellum Virginia.

Mr. Rothman, who again wrote Notorious in the Neighborhood believes Thomas West along with the two brothers David and Isiah Isaacs (who happened to be Jewish immigrants from Germany) were trading partners in Charlottesville. It is very reasonable that the Isaacs brothers were familiar with West family and certainly Mr. West's daughter Nancy. David Isaacs and Nancy's father know each other through business dealings. Isaacs is important to this story because again he created a household with Nancy West which wasn't apparent just looking at Mr. Jordan's work. Isaacs and Nancy West were ( for all intents and purposes) common law spouses without all the benefits and privileges that comes with that status. Nevertheless Isaacs and Ms.West set up house or houses in the area and it was one of the one of the most unusual and extra-legal households to appear in both the area and some records which Joshua Rothman illustrates in his book Notorious in the Neighborhood.

Notorious in the Neighborhood fills in the gray areas and details of the 1833 Census discovered at the University of Virginia by Mr. Jordan. Mr. Jordan specifically talks about Jane West, the daughter of David Issacs and Nancy West in his article. Until I read Mr. Rothman's book, my imagination took off to far away places when it came to trying to figure out how Jane West came to own property in Charlottesville at the time. Mr. Rothman again gave the answers to the questions dancing in my mind. According to Notorious Thomas West died and David. Isaacs was a signee or witness to Thomas West's last will and testament. In his will, I believe the story goes that Mr. West leaves real property--land in downtown Charlottesville--to his daughter Nancy. I believe Mr. Isaacs made it known before Thomas West's death, that he fancied Ms. West and surely Mr. West had some say in his daughter's domestic affairs. The Nancy West---David Isaccs arrangement takes on a quasi-marriage insofar as the laws disallowed households and marriages between people like themselves to exist in the open. These laws were remnants of colonial America and grew stronger and probably applied to a great number of people in a great number of cases.

Even though the weren't legally married, Nancy West and David Isaacs set up an extra-legal household. Notorious in the Neighborhood points out that Nancy West took up residency on land "she purchased with the money from her inheritance on lot number 46 near Charlottesville's southern boundary." Her partner Mr. Isaacs, according to Notorious had a house one block north and two blocks west on lot 36 ." The 1820 Census shows that " David Isaacs was the head of household with ten free people of color living with him in downtown Chalottesville. So they eventually combined households as she purchased property closer to his and dismissed what others might have thought. She also had enough property to run a business as a baker and rent space to others. It was quite an arrangement. They managed to have some sort of co-habitation arrangement which allowed him to be counted as head of household . " The map in the book does a great job of depicting how close they lived to each other. Notorious says they had seven children--Jane being the one that appears in Mr. Jordan's article--and they managed to make a family under the circumstances. Those circumstances resided more in the minds of individuals who would tried to enforce the strict color line. The color line was an unwritten law that required blacks and whites who might become couples and start families cease from co-habitation. They were playing the game they had to play to live as a couple under this ridiculous scheme. This story became even more interesting as West and Isaacs settled into their extra-legal arrangement and life in Charlottesville.

Mr. Rothman writes that there were economic jealousies that prompted someone to put Mr.Isaacs and Ms.West's domestic business in the unpaved streets of Charlottesville. The Charlottesville authorities convened a grand jury where, West and Isaacs were presented with the charge of "umbraging the decency of society and violating the laws of the land by cohabiting together in a state of illicit commerce as man and wife." According to Notorious in the Neighborhood a grand jury requested West and Isaacs prove they were not committing crimes against society. This was of course a heavy burden since Isaacs and West were a "mixed-raced" couple with seven children. How do you hide this in plan view?

West and Isaacs hired an attorney who stunned the court in Charlottesvile with the truth that in fact they had set up a household but "he questioned whether the state could prosecute on a fornication charge at common law." I am sure they could hardly deny, seven human beings running around the vicinity as free people of color, who looked like one or both their parents. The Charlottesvile court referred the case to the General Court in Richmond. According to Notorious, the court in Richmond ruled "that the State of Virginia could not prosecute Isaacs nor West and the court in Charlottesville followed the higher courts lead." This meant that the couple could return to their life as unusual in Charlottesville; as long as they lived their lives as couples as out of the public view.

Up ahead and the on the road in this relationship, their private lives entered the public domain again. This time, after they had been an unusual and well established couple, living in Charlottesville, Mr. Isaacs' nephew Hays Isaacs found himself in trouble. Some where between what was about to transpire and the life and subsequent death of David's brother Isiah, the former became the executor of his brother's will. This meant that David Isaacs was responsible for any financial trouble Hays Isaacs might get into. According to Notorious trouble for Hays Isaacs came before his inheritance did. He was in debt before he received his father Isiah's estate. This was a problem for David Isaacs because he was responsible for his nephews finances. It wasn't not only a problem for Isaacs but for his common but illegal wife Nancy.

The creditors came calling. They made demands of David Isaacs. More financial demands than Isaacs and West probably had as individuals and almost more than they had as an extra-legal couple. They had to be creative to fight off the creditors pursuit of Hays Isaacs, the son of David's dead brother Isiah. I believe West and Isaacs had to sell some of their assets--the ones they owned together-- to satisfy a small bit of the large appetite of the creditors. Someone noticed their coordination and sure enough the legal authorities came into the picture again. This time the law--or the people pretending to uphold it--questioned how Isaacs and West could jointly own what they owned without being married or at least co-habitation. The case was sent to the Grand Court in Richmond but they refused to press charges because the circumstances of the charges failed to prove that any law which seemed to be left up to the whim of person bringing the charge, was broken. In other works there was no actual evidence that West and Isaacs had sexual relations in public. That left the whole case on shaky ground at best. Once again the Grand Court of Richmond found no reason to punish the couple without fail-safe proof of breaking the accepted societal norms. The couple had to pay strict attention to how they conducted themselves in the company of others.

The West--Isaacs relationship was an interesting tour of American history and detour as I continue to follow the trail of my ancestors in Central Virginia. I think learned more about American history than I ever learned in two and a half decades in American schools. I can't wait to get back to Charlottesville and dive deeper into the records. I really enjoyed looking at those late 1700 to early 1800 documents in those huge portfolios at the Courthouse in Albemarle County. I haven't had the chance to properly scrub the records Louisa's County Courthouse.

Paul Heinegg's Free African Americans of the South with a forward by Ira Berlin

Coming Soon	Nov. 30-Dec. 4
January 12-16

Week of September 6, 2009 - September 12, 2009

The Origins of the Decorum Rules

Dress and Comportment

Exhibits

Unparliamentary Speech

References to the Senate or Executive Branch