Bush VA: We'll Fix The "Shortcomings"


Attorney General Alberto Gonzales isn't the only Bush cabinet official worrying about his job.

Veterans Affairs Secretary Jim Nicholson, deemed "a Brownie situation" by Sen. Claire McCaskill, is also worrying as the Walter Reed scandal continues to unfold.

Trying to get ahead of the knives, Nicholson launched a (wee bit belated) review of 1,400 VA medical facilities, in an attempt to show he's on top of things.

The review was released yesterday, finding more than 1,000 incidents of subpar conditions -- including bug infestations, suicide risks and asbestos.

The spin from Nicholson's crew of hacks? Nothing to worry about!

From the W. Post:

VA officials said ... that the department's $519 million maintenance budget this year should address the "shortcomings."

For the moment, let's leave aside the question of whether there actually are sufficient funds available to fix problems.

Nicholson's own argument is, in essence, that while these problems have festered for two years on his watch, he's been sitting on the funds that could have addressed them.

Get this guy a job in Brownie's consulting firm.

Bill Scher blogs for Campaign for America's Future

Where The Health Care Debate Is Going


The following was written by Campaign for America's Future Co-Director Roger Hickey and Online Editor Bill Scher

The health care debate has leapt forward in the last few weeks. After the bold health care plan from John Edwards, and the new business-labor coalition Better Health Care Together-- spearheaded by Andy Stern (founder of Wal-Mart Watch) and the CEO of Wal-Mart, Lee Scott-- there is a growing consensus. America needs, and Americans want, heath care for everyone in America.

It is terribly significant that we are forging a broad consensus that everyone should be covered. Now the debate shifts to the question of how to get there.

Long-time advocates of universal health care are properly suspicious of plans that get the label right but the details wrong. If something called "universal health care" is a big flop, conservative forces will crow heartily, a scarred public may become too cynical to try major reform again, and too many Americans will remain uninsured and underinsured.

Massachusetts' new program and California's proposed plan did get it wrong. Under the "universal health care" label, they merely subsidize inefficient private insurers with taxpayer dollars. They may nominally cover everyone, but without cost savings for consumers, the middle-class and the poor will continue to be squeezed. So what's the point?

Does John Edwards' plan suffer from the same flaw? Some advocates for "single-payer" -- essentially expanding Medicare to cover everyone -- are raising questions because it doesn't immediately put private insurers, and all of that wasteful redundant overhead, out of business.

But Edwards' plan -- which draws from Jacob Hacker's "Health Care for America" proposal -- offers something that Governors Mitt Romney and Arnold Schwarzenegger did not. A new public plan for Americans under 65, complementing Medicare, that would compete with private plans.

Some remain understandably skeptical. For example, who cares if there's a public option, if private insurers can make a mint cherry-picking healthier young adults, burdening our government with the expensive cases? That might nominally cover everyone, but at excessive cost on everyone.

Here's where the details matter. If the rules set a fair playing field, and ensure a floor of quality coverage, then we'll get a win-win scenario.

One possibility: the public plan will attract the most Americans, win the competition against private insurers, and our system will naturally evolve into single-payer. (Edwards himself considers this a possibility.)

Or, because the floor prevents a race to the bottom, the public-private competition raises the bar on care and efficiency, improving quality and cutting costs, even in the private insurance plans.

Either scenario is a win substantively and politically. All Americans get good coverage. And we further prove that our government has a critical role in building a vibrant economy that works for all.

But if the rules for public-private competition are poorly thought out, an inefficient private system will simply suck subsidies from the public sector, sullying the promise of universal coverage.

Again, the details matter. The initial Edwards plan has room to add in crucial details. And Hacker is urging Edwards to enhance his proposal by ensuring the public plan would "offer the broader benefits necessary to attract younger workers and compete on a level playing field with private insurance plans."

And other presidential candidates have a choice: they can learn from Hacker and compete with Edwards to outline a serious public-private plan for covering everyone – or they can chose to give away our future to the private insurance industry, and suffer by comparison during this year of public comparison and issues debate. (Barack Obama has pledged to have a comprehensive health care plan on the table in the next couple of months, and Hillary Clinton and the other candidates will have to do the same.)

As the debate moves forward, let's do our best to keep our focus.

We have a consensus on achieving "universal health care." We know that the private market has failed in meeting that goal. We know that our government has a positive role to play. How we best direct our government to effectively serve our health care needs, that's the debate.

Jacob Hacker & Roger Hickey on Edwards Health Care Plan


Yesterday, presidential hopeful John Edwards announced a health care plan titled, Universal Health Care Through Shared Responsibility.

The New Republic reports today that a core feature of the plan is "the essential idea behind another health care reform plan that has been quietly generating a great deal of enthusiasm among reformers--a plan composed by Yale University political scientist ... Jacob Hacker."

That plan is Health Care for America, which Campaign for America's Future has been promoting debate around.

Today, Jacob Hacker and CAF Co-Director Roger Hickey released statements praising the basic outline of the proposal. Hickey noted this will significantly move the debate, while Hacker laid out areas for Edwards and other candidates to strengthen.

Here's Roger Hickey:

The health care plan put forward by Sen. John Edwards this week moves the debate in a very constructive direction. We hope other candidates will address as comprehensively as Edwards has the changes necessary to make sure that everyone in America gets good health care coverage -- and what it will take to ensure that new system controls costs as well as Medicare and the VA system now does.

The public wants to hear bold solutions to what they perceive as a health care crisis, and most Americans want to hear health care plans that not only step up to the scale of the problem; they also want to hear solutions that are simple and understandable to be discussed it town halls and barber shops. On both counts, the Edwards health care plan is a big step forward.

And Jacob Hacker:

Those who believe in health security for all Americans should celebrate John Edwards's new plan. It includes two key building blocks for affordable universal coverage: a requirement that employers either cover their workers or make a reasonable contribution to the cost of coverage, and the creation of a new publicly overseen insurance pool through which workers without secure workplace coverage can have a choice of guaranteed public or private insurance, including an insurance plan modeled after the popular Medicare program.

To be sure, Edwards's proposal could be less complex and even more effective. I would prefer, for instance, a single national insurance pool for those without workplace coverage, and I believe the public Medicare-style option should be allowed to offer the broader benefits necessary to attract younger workers and compete on a level playing field with private insurance plans. If this were done, as Edwards himself has said, the system may evolve over time toward a Medicare-like approach -- the only approach that has been proven to control costs over time without shifting more costs and risks onto patients.

The Edwards proposal should be commended for creating a flexible framework for building on good employment-based coverage and the best elements of public insurance, rather than locking us into an individualized private model, as so many recent proposals have done. The challenge for those who believe in this basic approach is to press for an even better proposal -- one that more forthrightly expands Medicare-like coverage to those without workplace insurance so as to guarantee broad pooling of risks and better control over costs and quality.

Hopefully that's helpful background as we all size up what the candidates have to offer.

Bill Scher blogs for Campaign for America's Future

Bush Budget: Last Gasp of Conservative Failure


When President released his budget today, it once again showed the limits of the conservative message.

Like many conservative leaders, Bush knows he can't rally the public by pledging to deny funds for goals deemed important by the voters, like health care, energy independence and education.

That's why in every State of the Union, Bush talks a liberal game when it comes to domestic priorities.

But then comes the obligation to propose a budget, and he has no choice but to supplant the phony compassionate rhetoric with cruel conservative numbers.

In our State of the Union -- By The Numbers, we noted past empty pledges to make health care, clean energy and education more affordable and accessible.

And once again, we have a Bush budget that fails to adequately fund any of Bush's own stated priorities.

If you want to see the paltry numbers, check out TomPaine.com, the Center for Budget and Policy Priorities, and Business Week's Economics Unbound.

Thankfully, we don't have to get overly concerned about the specifics this time.

The voters threw out the last Congress because they were sick and tired of budgets just like this one. And with the new Congress, this budget proposal is dead on arrival.

But the Bush budget is another reminder of the failure of conservatism, and the inability for conservative leaders to lead with straight talk.

Now it's time for Congress to show what a progressive budget looks like.

Bill Scher blogs for Campaign for America's Future

How Can We Make Ethics Reform Matter?


The first order of business in the House last week was to pass new House ethics rules, including new reporting requirements for congressional trips and earmarks.

But these new reporting requirements will only be good tools to shine a spotlight on corruption if we know how to use them well.

So what are they? Here's a few quick wonky details.

Regarding travel, when Members of Congress are about to take trips paid for by another party, they must get a certification from the sponsor that no lobbyist is involved. The Ethics Committee must review the certification and approve the trip in advance. Within 15 days after the trip, the certification and other materials related to the trip must be given to the Clerk, who then releases it to the public. (Exactly how the Clerk makes the materials available is not yet clear.)

Regarding earmarks, instead of special interest provisions being secretly slipped into bills, lists of projects in Members' districts (and tax breaks tailor-made for 10 people or less) will be clearly placed in the Congressional Record. Congresspeople must disclose their own earmark requests.

Disclosure is great, if people are aware of what's been disclosed. Otherwise, these reports collect dust and corrupt congresspeople continue to believe they can get away with anything.

How can we in the netroots best use these new rules to call attention to inappropriate junkets and special interest handouts? A dedicated blog? A regular ranking of the worst offenders?

What are your ideas?

Bill Scher blogs for Campaign for America's Future.

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