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Category: Health Care (page 1 of 4)

Do conservatives understand the Constitution they say they love?

Healthcare commerce
Several states banded together and
filed a lawsuit stating that healthcare reform was unconstitutional. They seem to be using a two-pronged argument: First, healthcare reform “infringes on state powers under the Constitution’s Bill of Rights.” Secondly, according to the Attorney General of Virginia, “Congress lacks the authority under its constitutional power to regulate interstate commerce and force people to buy insurance.” We’ve heard cries of, “where does it say in the Constitution that Congress has the power to force you to buy insurance?”
Well, let’s start from a position that I think we all can agree on — the Supreme Court is the final arbiter over what the Constitution says and doesn’t say. Whether we agree or disagree with the Supreme Court, they have the final say (Article 3, Section 2).
Let’s start off this legal journey to looking at Article I, Section 8 — “The Congress shall have the power… to regulate commerce with foreign Nations, and among the several States, and with Indian Tribes;” “Commerce” is defined in Merriam Webster’s Dictionary as “social intercourse: exchange of ideas, opinions or sentiment.” The secondary definition is the one that we are more familiar with — “…the exchange or buying and selling of commodities on a large scale involving transportation from place to place.”

We really weren’t a nation for long before this commerce clause was challenged. In 1816, Congress passed a law which opened the second Bank of the United States. Shortly after the bank opened, the state of Maryland passed a law which imposed taxes on that bank. James McCulloch was the cashier of the Baltimore branch. He refused to pay the tax. McCulloch versus Maryland was the resulting case. The Supreme Court, using the commerce clause, stated that Congress had the right and the power to incorporate a bank. Chief Justice John Marshall, who fought in the Revolutionary war, served in Virginia’s House of Delegates and was appointed to the court by President John Adams, argued that Congress possessed unenumerated powers not explicitly outlined in the Constitution. (Where was Antonin Scalia?) He went on to say, “Although, among the enumerated powers of Government, we do not find the word ‘bank’ or ‘incorporation,’ we find the great powers, to lay and collect taxes; to borrow money; to regulate commerce; to declare and conduct a war; and to raise and support armies and navies. The sword and the purse, all the external relations, and no inconsiderable portion of the industry of the nation are intrusted to its Government. It can never be pretended that these vast powers draw after them others of inferior importance merely because they are inferior. Such an idea can never be advanced. But it may with great reason be contended that a Government intrusted with such ample powers, on the due execution of which the happiness and prosperity of the Nation so vitally depends, must also be intrusted with ample means for their execution.” Therefore, in this early decision made almost 200 years ago, we see that Chief Justice John Marshall unequivocally rejects the notion that if the Constitution does not say X., Y. or Z. and Congress can’t do it. This in an of itself blows 99% of conservative arguments out of the water.

In 1824, steamboats were probably the fastest mode of transportation. Each state regulated its own waterway. A steamboat owner who operated in New Jersey and wanted to operate in New York challenged a New York law which gave exclusive rights to another company. Gibbons versus Ogden. Not only did the court find in favor of Congress that Chief Justice John Marshall also defined commerce. He stated, “The subject to be regulated is commerce, and our Constitution being, as was aptly said at the bar, one of enumeration, and not of definition, to ascertain the extent of the power, it becomes necessary to settle the meaning of the word. The counsel for the appellee would limit it to traffic, to buying and selling, or the interchange of commodities, and do not admit that it comprehends navigation. This would restrict a general term, applicable to many objects, to one of its significations. Commerce, undoubtedly, is traffic, but it is something more: it is intercourse. It describes the commercial intercourse between nations, and parts of nations, in all its branches, and is regulated by prescribing rules for carrying on that intercourse. The mind can scarcely conceive a system for regulating commerce between nations which shall exclude all laws concerning navigation, which shall be silent on the admission of the vessels of the one nation into the ports of the other, and be confined to prescribing rules for the conduct of individuals in the actual employment of buying and selling or of barter.”

To be fair, I should add that the courts tried to limit Congress’ power through the commerce clause in the late 1890s through the 1930s. In 1918 Congress tried to prohibit child labor. In the Hammer versus Dagenhart case, Justice William Day argued, in a 5 to 4 decision, that production was not commerce and therefore outside of the jurisdiction of Congress. So this limited Congress’s power through the commerce clause. Personally, I believe this is a nonsensical argument, since without commerce there’s no reason for production, and production as part of the process. It is part of commerce. The Supreme Court was splitting hairs here. Oliver Wendell Holmes’ dissent was brilliant. He states, “The act does not meddle with anything belonging to the States. They may regulate their internal affairs and their domestic commerce as they like. But when they seek to send their products across the state line, they are no longer within their rights. If there were no Constitution and no Congress, their power to cross the line would depend upon their neighbors. Under the Constitution, such commerce belongs not to the States, but to Congress to regulate.” This is a GREAT explanation of how the relationship between the States and the Federal Government should interact.

In the United States versus Darby Lumber Company, the Supreme Court overturned the Hammer decision. The Fair Labor Standards Act was passed as part of the New Deal. It regulated minimum wages and maximum weekly hours. It also dealt with child labor. This applied to all corporations that engage in interstate commerce. This unanimous decision came down in 1941. One of the most interesting things in the decision was that Supreme Court dealt with a common argument that conservatives have thrown out for years; states’ rights. The court ruled that, “the 10th amendment is not a limitation upon the authority of the National Government…”
In 1944, the Supreme Court ruled that Congress had the power to regulate insurance.
So, I think it’s pretty clear from the very beginnings of our republic that the Supreme Court’s interpretation of the commerce clause has been very expansive. For more on the commerce clause, I’ve written more here and here. Simon Lazarus of the American Constitutional Society for Law and Policy has written a nice 16-page brief on whether mandatory health insurance is constitutional.
Why don’t conservatives know this? I did a couple of hours of research and found information that is readily available on the Internet or in your local public library. My guess is many conservatives do know this information. Yet, they choose to ignore it while they stoke the anger and frustration of many Americans. The filing of a lawsuit and the multiple op-eds that have been generated seem to be part of a calculated political ploy. This is about politics. Maybe maybe that is what’s so sad about all of this.

Tackling The Right-Wing Health Care Spin: The Bill Dwight Show Podcast

Yesterday on The Bill Dwight Show, airing on WHMP-AM in Western MA I faced off with local GOP operative Isaac Mass about the pending health care. And I was able to put some persistent right-wing myths to rest about “government takeover,” the “Cornhusker Kickback” and the supposed “$1 trillion price tag.”
If you’ve been paying attention, you know private insurance will simply be better regulated, not abolished; the latest version of the health care bill strips out the unfair deals for certain states; and the bill will cut the deficit more than $1 trillion, not add to it.
You can listen to the segment by clicking here.

Health-care reform – reloaded

Do you remember Morris Day, the lead singer of one of the ultimate party groups, The Time? From the darkness, Morris Day would shout, “What Time Is It?” The music would start blaring and the party was on. It is time for health-care reform. It is time for us to have a universal program which covers everybody. We are currently spending 16% of our gross domestic product on health care. Personally, I think spending $2.3 trillion on health care is plenty of money. We should not have to spend any more to get everything that we want. We want access to quality primary care providers. We want these primary care providers to give us better outcomes — a better quality of life and a longer life. We want to be able to go to the drugstore to pick up our prescriptions without having to leave our first born as collateral. If we have an emergency – if we are in a car crash or fall off a roof; if we have a heart attack — we want to be able to be taken to a quality medical center where we can be treated with compassion, dignity and with the latest medical techniques. Why can’t we make this happen?

Last week, we had the rare opportunity to see Republicans and Democrats sit down and discuss a single issue. For over seven hours, we got to see our political leaders argue over healthcare. Yes, there was some political posturing on both sides but one thing should be clear to all Americans. The Democrats have a plan and a passion for health-care reform. Republicans had no plan, but they definitely have passion for stopping health-care reform. From Republican Minority Whip Eric Cantor to Senate Minority Leader Mitch McConnell, not one Republican put together a thoughtful argument that would control the escalating healthcare costs, cover the 45 million people who live in the United States without health insurance, nor a plan that can be taken from Maine to Florida to California.

Democrats, for all of our passion, where is our spine? Democrats are causing me to reach for my Pepto-Bismol especially, those who cannot stand up for healthcare reform.People who follow politics, as I do, have seen for over a year that it is going to be nearly impossible to get 60 votes in the Senate to stop debate on healthcare reform. Therefore, the Senate would need to go to reconciliation to pass health care reform. I talked about this on my radio show back in February of 2009. This summer, Senator Jay Rockefeller made an impassioned speech for the public option. He said it was morally right. It was only a couple weeks ago he said that he did not believe that we should use reconciliation to get health-care reform passed. What? Didn’t he say it was morally right? Senator Rockefeller was 100% correct when he said this was a moral issue. We need to get health-care reform passed.
Meet 11-year-old Marcelas Owens. Watch the video:
I would urge you not to fall for the same old cliches about our government. Government can do this right. We have to get this right. This is as important as landing on Normandy beaches on D-Day. If we want to have money for defense, homeland security, bridges and roads, education and green energy we have to control costs of health care now. Economists have estimated that health care will eat up 25% of our gross national product in 20 years if we don’t do something.
Finally, I’ve been listening to these talking heads on the Internet telling me that Democrats, liberals and progressives are not energized. Someone even suggested that we are depressed. Depressed? From what? I’m not sure who thought electing Barack Obama would be a panacea. I know that I’ve talked about the need for progressives to push harder with a Democratic Congress. We’ve seen Democrats in the past waiver and succumb to the whims of Republicans. We knew this would happen. Deep in our hearts, we knew this was going to be a huge undertaking. Just look at what we’re trying to accomplish – reversing 30 years of Republican rule and ideology (Clinton was the only bright spot). We are trying to reverse 30 years of giveaways to major corporations. We’re trying to put the American citizen ahead of big business. Even Democrats have bought into the ideology that the markets could fix everything. This is an idea that’s been pushed by the Republicans for decades. We have a lot of work to do. President Barack Obama has told us that this is not going to be easy. So, it is time for us to be fired up. Once we get health-care reform passed, we still have more work to do – create a green economy, create millions of green jobs, fix the Patriot Act and concentrate on lasting financial reform that will work for all Americans. We need to write and call our legislators. We need for them to support health-care reform. It is time to get busy.

Nothing from nothing leaves healthcare reform?

The great pianist and songwriter Billy Preston once sang, “nothing from nothing leaves nothing.” Although as 15 to 16 months, I’ve seen the promise of health care reform start with single-payer then morph into some sort of public option which, if it is robust should be able to contain health-care costs. This is kind of what they House passed. The Senate, on the other hand, is one confusing mess. Senator Max Baucus was given the keys to the city. I’m not sure what he came up with. As chairman of the finance committee, he was in charge of coming up with a health care bill that was attractive to at least a couple of Republicans. Olympia Snowe and others were courted with sweeteners which seem to eat away at the core of health care reform. Senator Kent Conrad decided that he would introduce his own health-care legislation which was some sort of co-op. Although he sold this idea on the Sunday talk shows and pushed it hard for 6-8 weeks, thankfully (hopefully), it is died a quick death.

The public option is been tossed around like a medicine ball. In Junior high school we were asked to throw a medicine ball in order to build up muscle strength and coordination. Every other throw, the ball was dropped, kicked and then picked up and thrown again. This is exactly what has happened with the public option. What was once a robust counterweight to private health insurance has turned into something that states can opt in or opt out depending upon the whims of their legislature. Oh, and it seems that opposing healthcare is a great way to get on TV and increase your image/status like Bart Stupak.

I have stated both on my radio show and on this blog that health-care reform must include something that is cost-effective, portable and increases access to healthcare. Currently, we are looking at a health-care bill that seems to do none of this. Many progressives have decided that they cannot support this bill. They want something else done. I understand the sentiment. I find this whole process extremely frustrating. Democrats seem to be completely unable to stick to their principles and stand up for the middle class. It seems like the only difference between Republicans and Democrats is that Democrats know what is right but can’t do it. Republicans have no idea what is right and won’t do it. BTW, President Barack Obama is leader come lately. Look I love this man but I’m telling the truth. Where was he in the middle of the heat of the summer when healthcare was taking the big hits? He needed to be out of front stating that we HAD to have a robust public option but alias, he wasn’t out there.
Here’s my problem. Washington seems to be controlled by big business. Lobbyists from K St. seem to surround the Capital like locusts. If we scrapped the health-care bill and start all over, how are we going to come up with a different outcome? We’re going to have the same politicians, the same White House and the same lobbyists. As a matter of fact, the lobbyists will be better armed to combat arguments they’ve already heard. They will probably be armed with more money. I’m afraid that starting over will leave us with a bill that’s even worse than what we’re looking at now — if that is possible.

We’re spending $2.4 trillion on health care every year (we spent that much in 2008). Isn’t that enough money? Why do we need to pay any more? Everyone agrees that insurance does not add any value to healthcare. Why is Washington cobbling the insurance companies? Their whole reason for their existence is not to improve health care or help doctors deliver better care or help increase access to doctors by patients. Instead, their whole deal is to simply make money. They make money by not paying claims.

$2.4 trillion is enough money to take care of all 300 million Americans. Combine Medicare and Medicaid and SCHiP and all of the state run programs into one program. Medicare for All! The government will set up a system to negotiate prices with pharmaceutical companies and medical device/product manufacturers. Premiums are paid out of our taxes in a graduated fashion. The more you make, the more you pay. Let’s extend patent protection for pharmaceutical companies by 2-5 years. Since the government is negotiating drug prices, pharmaceutical companies can recoup some of their losses through this mechanism. Doctors will be awarded for opening early and staying open late and on the weekends. This way, Americans can go to their physicians without having to take off from work. This increases access. Anyway, Medicare for All, at least for now, is a pipe dream. Right now, I’m good to try to work with my congressional representatives to try to get the best bill possible.
Billy Preston was right. Nothing from Nothing leaves nothing. The Senate is trying to sell us nothing and tell us it is something. They need to do better.

A couple of things on healthcare

Is there anybody who believes that America is about competition? If you believe that America and business love competition, please email me because I have some swamp land ocean-front property to sell you out in Idaho. Think about that period in American history after World War II. The big companies got bigger because of competition? No. Of course, there are a few exceptions but as a rule big companies split up the marketplace. Whether it was General Motors, Ford and Chrysler or, in steel, United States Steel, Republic and Bethlehem, these big companies split up the marketplace and made profits. There was no competition. None.
Now, it looks like we have more information on the pharmaceutical companies. They paid generic drug companies to keep their generics off the market. Is anyone really surprised? There is so much money in pharmaceuticals that drug companies are able to pay off these generic companies so that everybody makes money but, and this is important, the pharmaceutical companies make a ton more money and the consumers pay a ton more money. Everybody wins except the consumers.

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I talked about mammograms and the controversy surrounding them a couple of weeks ago. It seems that several of the folks who made the recommendations were brought in front of a congressional committee in which they yelled that it was all just some sort of misunderstanding. It was a problem in communication. Horse hockey. I hate when people kind of weasel out of things. Say what you mean and mean what you say. In the formal paper which was published in the Annals of Internal Medicine, this committee stated that it recommended “against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 should be an individual one and take into account the patient’s context, including the patient’s values regarding specific benefits and harms.”
The recommendations weren’t a mistake. They were not something that they just dreamed up out of the air. The panel should’ve stood firm and said that, in their interpretation of the literature, these were their recommendations. Then, they should’ve added a caveat, the same warning in the paper, that treatment should be individualized in these patients.
Again, as I said before, this is a minor task force which has no bearing on the American Cancer Society, really the main medical body to which physicians look for recommendations on cancer, including breast cancer. I believe in screening more women and not fewer. I believe that women need to be informed about their choices. They need to be told that the earlier you start screening the more likely it is that you’re going to have something found on mammography, which will lead to a biopsy, which most likely will be negative. Once women understand this and want to accept this risk then there should be no argument.

Okay, I’m just gonna have to go all Doctor on you now

No, it doesn’t mean that I’m going to charge you for reading this. 🙂
I’ve talked about healthcare reform over and over again (I don’t see how Joan does it every day without going insane). I’ve talked about healthcare from an emotional standpoint and from an American legislative standpoint. I’ve talked about all the benefits of healthcare reform. Well, I’d like to take a different tactic. I would like to review the medical literature. I’ve picked several studies which I will describe over the next several days. The one thing that all of these studies have in common is that they point out that health insurance is a predictor of outcome. On Wednesday or Thursday, I’m going to review an article from the Journal of the American Medical Association which clearly states that having a unified health program has survival benefits (we don’t have a coordinated, organized healthcare system in the United States).

As a trauma surgeon, I don’t like to talk “shop” with people who are not in the medical profession. As soon as you start mentioning cytokines and mitochondria DNA, most people’s eyes glaze over. But, with watered-down legislation creeping through the Senate at a glacial pace, I thought it was important for me to go over some of this literature. The literature makes approximately the same point that Keith Olbermann made approximate monthly go when he talked about having health insurance being life-and-death.

In trauma, we, trauma folks, would like to think that we treat patients all the same. Many states have trauma systems, in which an injured patient, is shunted away from small hospitals that probably cannot help that patient and toward trauma centers who have the expertise and the manpower to help. This move has been shown to save lives. Most, if not all trauma centers have protocols which are then individualized for a particular patient. We have found through numerous studies that these protocols help save lives. Therefore, you would figure that the outcome of a patient who was seriously injured in a car crash would be directly related to his or her injuries which is true for the most part. A recent study has thrown a wrench in this.
A study, which was published in The Archives of Surgery in 2008, investigated over 400,000 patients which had been entered into the National Trauma Databank. One thing that we have known for years is that socioeconomic status does influence your outcome. As expected, mortality rates for Black and Hispanic patients were higher than those of White patients. Patients with insurance had a mortality rate of approximate half of those without insurance. Now, for the shocker — both Blacks and Hispanics with insurance who were injured had a mortality rate less than Whites without insurance.

This was a very surprising result. Numerous studies in trauma patients over the years have shown differences in outcomes amongst the races. As more and more studies have been done, it is clear that race is a surrogate for multiple other factors including eating habits, living conditions, and other things that can affect outcome. It is also clear that insurance acts as a surrogate for those same kind of factors. People with insurance have jobs. People with jobs drink less than people without jobs. People with jobs tend to live in better conditions than people without jobs. What was surprising is how strong insurance is as an indicator of lifestyle.

So, if every American has health care coverage will they all have better outcomes from trauma? Well, this question is somewhat hard to answer. On one hand, just having insurance does not get you to live in a better house, in a better neighborhood with better indoor plumbing and a refrigerator that works all the time. On the other hand, one of the huge problems that we have in the trauma community is that we have to send many people home from the hospital, after their hospital stay is over, when they should go to a rehabilitation center for more therapy but they can’t qualify because they don’t have insurance. These patients will instantly do better. Getting adequate health care coverage to all Americans is a step towards better equality.
I would like all members of Congress to read this article. This is important. This is what we’re fighting for. We’re fighting for a more equitable society. I’m not trying to take away any healthcare from anybody but instead, I want to add healthcare to those who don’t have it.
Tomorrow, I’m going to review an article called health insurance and mortality in United States adults. This article expands on the concept that insurance is a marker for outcome.


There are two things I know very little about: medicine, cars, and the Law. (I am also not great at math.) So, like many people, I am sort of at the mercy of my doctor when I have medical decisions to make. She could tell me ANYTHING and I would just have to believe her.
‘Well, Traci, you have hematomiosis with recurring acne. Also your lug nuts are loose.” She seems like a nice enough person, very bright and un-evil, so I believe her, because I have to trust in someone. Similarly, my mechanic can tell me I need 4 liters of blinker fluid and that a new headlight costs $400– how am I to know?
As I wrote this yesterday, I got an email telling me that a person who has contact with my daughter is being treated for H1N1. So again, I have to make decisions on whether or not to immunize myself and especially my kid and I am again at the mercy of the medical profession.
Like most of you in the listening area, I did research before she was born, and made the informed decision – THAT WAS RIGHT FOR ME AND MY FAMILY AND IS IN NO WAY A JUDGMENT ON HOW YOU RUN YOUR LIFE FOR GOD’S SAKE DON’T BE Such A big baby- to stick mostly with the routine scheduled vaccinations. I almost didn’t do the chicken pox vaccine because I thought, really? I had the chicken pox it was no big deal I stayed home from kindergarten for a while and watched General Hospital with my mom every day. But then I was taking a stroller walk with other parents of tiny babies, and one of them happened to be a doctor, and he sort of turned white and got this 1000 yard stare and began to talk about his ER days, and dear lord woman, when chicken pox goes wrong it goes REALLY REALLY WRONG and I started to cry and tried to stroller my baby to the nearest walk in clinic and handcuff myself to the reception desk until they shot The Girl up with dead chickens or whatever it is they have to do. It was pretty traumatic.
And so here we are again, and we, as an informed, news watching public, are being pulled in a million different directions. If we vaccinate, Will she get the flu from the vaccine? Will she grow up to rob banks because she got the vaccine? Will she suffer horribly if she doesn’t get the vaccine? Will there even be enough vaccine to go around?
I am sympathetic to the alternative medicine way of thinking; I used to work for an acupuncturist, who prescribed me teaspoons full of some horrible tasting concoction; We use ginger for bellyaches, and Calms Forte for sleepless nights. I am not in the pocket of Big Pharma – I am unfortunately not in the pocket of anyone. I get the fear: having to count on someone else, essentially a stranger, to have the expertise to make decisions that affect your kids makes you feel powerless. Nobody loves your kid more that you do; how can they possibly make the best decision for them? Truth be told, and as attached as I am to other people’s children, if it means saving Audrey’s life, all those other kids can just fend for themselves, and I know other parents feel the same way. Having said that, I am firmly in favor of vaccinations, and I am a bit dismayed by the rise of non-vaccinations in the US.
(cue the angry mob coming to burn my house down)
I think it is disingenuous to call parents who choose not to vaccinate victims of pseudo-science or hippie morons who believe unicorns cure cancer. Like I said, it is scary to have to trust in experts, and the stakes are so high. Scientists are not always the best spokespeople for their cause, either; ask any nerdy person you know about the thing they are nerdy about, and your eyes will glaze over almost immediately. But, to quote a famous scientist, I recently read something Carl Sagan said about pseudo-science satisfying a human need and offering more comfort than cold, hard science:
“A great many of these belief systems address real human needs that are not being met by our society,” Sagan wrote this about the embrace of reincarnation, channeling, and extraterrestrials. “There are unsatisfied medical needs, spiritual needs, and needs for communion with the rest of the human community.” Simply put, science may be the truth, but our brains are hard wired to want more than that. So, I get it, I truly do. I am not inclined to just believe anything the government or big corporations tell me. I read 1984. But I do believe in science.
In a recent Wired magazine article, which I link to at my blog, it says:
“nonprofit health care provider Kaiser Permanente reported that unvaccinated children were 23 times more likely to get pertussis” which is whooping cough, and potentially deadly to infants. “Kaiser’s Institute for Health Research, revealed that the number of reported pertussis cases jumped from 1,000 in 1976 to 26,000 in 2004. A disease that vaccines made rare, in other words, is making a comeback.”
Choosing to not vaccinate your children is simply choosing a different risk- you are betting your kid won’t get the flu, or whooping cough, or polio. You are basing a lot of this bet on the fact that most kids do get vaccinated, so you are piggybacking on their continued good health. Statistically,however, the better bet is with getting the vaccinations. Especially in an area where a lot of parents are not vaccinating, there have been outbreaks of disease; most recently there was a measles outbreak in San Diego and one of mumps in Brooklyn. It would be heartbreaking to have your kid, or anyone else’s kid, get sick or even die because of the choice you make. Remember that babies don’t get a lot of these vaccines til later, so these outbreaks affect other people’s children as well as your own. So the stakes are high. No vaccination is risk-free, but we are also taking a greater risk by not vaccinating.
There is a huge debate over whether vaccines are terrible and bad and more specifically cause autism, it can be summed up by the following: science says it doesn’t, Jenny McCarthy, actor/playboy model/mother of an autistic child, says it does.
The controversy stems mainly from a preservative called thimerosal, which contains ethylmercury. Pregnant women are told not to eat fish because of the mercury content, so naturally freak out a bit when they hear about this preservative, and, somehow- the origins of this theory are unclear to me- it became linked with autism. Possibly because symptoms of autism show up around 18 to 24 months of age, around the time when kids typically get certain vaccines. Thimerisol has largely been removed from vaccines since 2001, yet the incidences of autism continue to rise, probably because of better diagnostics and clearly not because of mercury. There is also talk of the aluminum salts in vaccines used to increase antibody response, which also sounds really bad, right? However, one dose of antacid has about 1,000 times as much aluminum as a vaccine does. But, it’s too late. Many people have “vaccines = bad” already stuck in their heads. It doesn’t help that nobody knows exactly what causes autism, and autism has been in the news a lot in the past decade. We want to protect our kids, and we will do so in any way we can, right?
My cousin is autistic, and my aunt always laughs and says, “He’s not my problem child. His sister, on the other hand…” I in no way want to minimize the effort, the worry, the heartache of having a child with autism. However, i speak for my entire family when I say that we would very much rather have my cousin in our lives, rather than risk his life by exposing him to infectious and potentially deadly disease. Autism has never killed anyone. And, again, for the record, there are no reputable, peer reviewed studies that make the link between vaccines and autism. I have links to the CDC and FDA websites on my blog if you would like their take on it, as well as other sources.
I expect a lot of mail about this, a lot of name calling and rending of garments. Don’t disappoint me, people.
Links to articles on this subject can be found here.

Senator Reid has added the public option to the Senate version of the health care bill

Yay, there is much rejoicing. Unfortunately I’m not really sure what I’m rejoicing about. We’ve had all this nebulous terminology that is been bouncing around the airwaves. I don’t know what a public option is? I guess, more precisely, I don’t know what they mean by public option.
Let’s back up a little bit. Let’s look at one of the goals that I set out for healthcare reform (portability, cost-effective, efficient). In order to deliver cost-effective health care, we need to do something to control costs. One way to control costs eliminate health insurance altogether. This will save Americans billions of dollars which currently go to a 30% overhead that we see with private insurance. This would be the most progressive option. Democrats took this off the table before the discussion began. Therefore, as a fallback measure, the government would provide a plan that would compete with private plans for people who are not already covered. In my mind, this would include employees of small businesses who cannot currently afford health insurance. This is kind of a sticky point. Republicans don’t want small business to flock to the public option. Personally, I think that this would be great for small business. It would help lower their operating costs and allow them to spend more money investing in their employees and their business. The other thing, that many people on Capitol Hill are not talking about, is whether the public option will be able to negotiate pharmaceutical prices and prices for medical devices. Again, this is a sticking point for Republicans and blue dog Democrats. As far as I can tell, none of this is been clarified for Senator Harry Reid’s announcement.
A public option that is not allowed to negotiate drug prices in the prices for medical devices, will be a sinkhole for our taxpayer dollars. We might as well just give these companies money.

From DK:
Robert Gibbs provided the following statement on behalf of the White House in response to Reid’s announcement:

“The President congratulates Senator Reid and Chairmen Baucus and Dodd for their hard work on health insurance reform. Thanks to their efforts, we’re closer than we’ve ever been to solving this decades-old problem. And while much work remains, the President is pleased that at the progress that Congress has made. He’s also pleased that the Senate has decided to include a public option for health coverage, in this case with an allowance for states to opt out. As he said to Congress and the nation in September, he supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition.”

Meanwhile, Greg Sargent highlights this statement from Reid’s presser.

“As we’ve gone through this process, I’ve concluded, with the support of the White House and Senators Baucus and Dodd, that the best way forward is to include a public option with an opt-out provision for states.”

Tort Reform, Misdirection, and The Lesser of Two Evils

Before their 2008 meltdown, the hit on the Republican Party was simple: great at campaigning, bad at governing. Republicans were able to whip up populist fervor in ways that Democrats hadn’t in a generation, and had so successfully honed their message that in election years their strategy no longer revolved around winning independent voters, but activating a base that could win an election by itself. In spite of that, Republican candidates that reached office seemed to almost inevitably descend into scandal, like Governors Ernie Fletcher and Bob Taft in Kentucky and Ohio, or ineptitude, like Sarah Palin.
The question is, then, how did these same candidates win an election in the first place? Some ran in bright red states; some were confronted with Democrats who were slightly less talented campaigners than the yard signs that become so plentiful during even-numbered Octobers; almost universally, they sold issues that have no effect on the lives of most voters.
To be clear, the voting majority doesn’t always know an issue won’t affect their lives. Rather, they become so emotionally activated by it that they seize upon the issue, only to realize later that they’ve been duped. If you need proof, ask the 92% of Iowans who told the Des Moines Register this week that their lives had not changed since gay marriage became legal in their state.
Gay marriage, of course, is a civil rights issue, and while it has a profound effect upon the lives of some, it does inspire more of us to action because of the stakes. More than just ineffective ideas, however, we’ve seen a generation-long peddling of irrelevancies and frauds from the GOP: during the 2008 campaign, John McCain railed against earmarks. He did this without telling you, of course, that earmark spending is as readily transparent and fully disclosed as any spending in the federal government, spent in a more direct and efficient manner, and, despite all of the howling over it, comprises an infinitesimal amount of government spending. When cable news erupted over the $410 Billion Omnibus Spending Bill this spring and the multitude of earmarks included, their ire was captured by 2% of the total cost.
This trend continues even into the healthcare reform debate, as the President has thrown the GOP a bone, acknowledging their wish to explore tort reform on a national level. One would imagine that after the last eight years our federal government would have ceased looking to Texas for ideas, but I digress; tort reform just doesn’t matter. In 2003, Texas saw a campaign to pass Proposition 12 instituting tort reform, which was sold to the voter largely as a method of luring doctors to rural communities. Texas does indeed have more doctors today than it did in 2003. They’re also overwhelmingly choosing to live in the wealthiest areas; the number of neurosurgeons, obstetricians, and orthopedic surgeons (all identified as critical needs in the Proposition 12 campaign) grew by 45% in Collin County, which is the wealthiest in the state. Against this backdrop, Texas still has the highest rate of uninsured individuals in the country.
As our national debate on health care rages for what 24-hour news cycles make feel like an eternity, it’s important to maintain focus on the key issues at hand: lowering costs and expanding coverage to the uninsured. Hypothetically, lower damages would allow the provider to lower their rates; in practice, Texas has seen insurance premiums rise by 92% since 2000. After the gay marriage and earmark debates we know better than to trade away the last recourse for 98,000 families who lost a loved one to negligence for no appreciable gains. Right?

Congressman Joe Wilson is an example of something… I just don’t know what

Tonight, President Barack Obama, in front of a joint session of Congress, spoke with conviction on healthcare. He beat down the lies and pledged his support to Medicare and seniors. He told his progressive colleagues that the public option is a means to an ends. It is the ends that we want.
Watch the video:
Before I go on, I must address Congressman Joe Wilson. What a dork. In public, there is some behavior that is simply unacceptable. If you’re a meeting with colleagues and you suddenly drop your trousers, that is unacceptable. If you’re in one of those nice hotel meeting rooms with some perspective clients and you suddenly spit on the floor, that is unacceptable. Shouting in a joint session of Congress, “You lie!” Is unacceptable. There no two ways around it. After his jaw-dropping comment, after the president’s speech was complete, the South Carolina representative released a statement which stated in part, “While I disagree with the president’s statement, my comments were inappropriate and regrettable.” Accidentally knocking over a glass of cold water which spills in your wife’s lap is regrettable. Shouting at the president as an elected official of United States Congress is totally unacceptable for Republicans or Democrats. Since it seems that no Republicans ever resign (almost never) from anything these days, I’ve donated money to Rob Miller who is challenging him in 2010.
Now, as we sat back and analyze the president’s words, we must remember that Republicans never rest. This fight is not over. Republicans, the health-insurance industry and the pharmaceutical companies are reloading. We have to be ready for their counterpunch because it is coming. Even if we pass effective healthcare reform, this fight isn’t over. There are still Republicans who are trying to kill Medicare and Social Security. We cannot become complacent because the president has just laid out his case and given a great speech. We must continue to organize. We must continue to write and call our Congressman. (No matter whether your Congressman is for or against healthcare reform he or she has to know where you stand.) This is the legislative fight of our generation. Healthcare will help level the playing field and give a huge boost to small business. We must win this fight.

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