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Morning Fix: House Democrats Play Offense on Health Care



Democratic Congressional Campaign Committee Chairman Chris Van Hollen (Md.) is spearheading an offensive against the GOP on health care

Hoping to regain momentum in the health care fight, the Democratic Congressional Campaign Committee is planning an August offensive against more than two dozen Republican House members that aims to paint them as roadblocks to reform.

"We are not going to allow supporters of the status quo to swift-boat health care reform in August," promised DCCC Chairman Chris Van Hollen (Md.).

The DCCC effort will comprise robocalls, e-mails and tele-town halls in 25 GOP-held seats; eight select members -- Reps. Michelle Bachmann (Minn.), Joseph Cao (La.), Charlie Dent (Pa.), Dan Lungren (Calif.), Thad McCotter (Mich.), Erik Paulsen (Minn.), Dave Reichert (Wash.) and Pat Tiberi (Ohio) -- will also get hit with radio ads.

A sample ad provided to the Fix lambastes Dent for taking money from the insurance industry while opposing reforms "to make health care more affordable."

It's important to note that radio ads, e-mails and automated phone calls are not terribly expensive and, while the DCCC would not make the amount they are spending on the campaign public, it's safe to say it's a modest expenditure.

More important than the money behind the campaign, however, is the motivation: to seize back control of an issue on which even Van Hollen acknowledges Republicans have gained traction.

"There is no doubt that some of the right-wing talk shows have exploited the situation and put an incredible amount of disinformation out there," said Van Hollen.

Recent national polling affirms the idea that the Democratic message machine has faltered somewhat. As we noted yesterday, 46 percent of respondents in an NBC/Wall Street Journal survey disapproved of the way President Barack Obama is handling health care although, in that same poll, the Democratic party still carries a 17-point edge over Republicans when respondents were asked who would do a better job dealing with health care.

While Van Hollen sought to paint a rosy picture of the recent disagreements within his party over health care legislation -- "the back and forth in Congress has strengthened the final bill," he said -- there were still signs of unrest in the caucus.

Arkansas Rep. Mike Ross, a leader on health care within the conservative Blue Dog Coalition, told the Post's Lois Romano earlier this week that "there's ten more hurdles for them before a bill goes to the President for a signature."

August will be a critical month in defining what the health care bills means to the average voter with both parties doing everything in their power to make their case. "We believe health care reform is a winning issue for us," asserted Van Hollen. That pledge will be put to the test between now and Labor Day.

Friday's Fix Picks: We'll admit it -- "Beerastroika" aka "The Audacity of Hops" aka "Yes, Three Cans" made our week.

1. Karl Rove's involvement in the U.S. Attorney firing scandal.
2. Tpaw rolls out 2012 messaging
3. Apparently there are lots of clunkers out there.
4. The mayor of Hoboken resigns.
5. Big Papi juiced.

Palin Drops Out of California Women's Event: In what is rapidly becoming a pattern, former Alaska Gov. Sarah Palin will not attend an event at the Ronald Reagan presidential library on August 8 as had been previously reported. "Neither the Governor's state staff nor SarahPAC has ever committed to attending this event or speaking at this event, and even requested that the Governor's name be removed from the invitation several weeks ago," wrote spokeswoman Meg Stapleton on Palin's Facebook page. "The Governor has other work and commitments to take care of at that time." The Associated Press -- among other outlets -- reported that Palin had planned to attend the 50th anniversary gala of a group of Simi Valley Republican women; it was, allegedly, to be her first major public appearance since she resigned her office last Sunday. Earlier this year, Palin was at the center of controversy over whether or not she had agreed to keynote a dinner in Washington to raise cash for congressional Republicans. After an extended back and forth, former House Speaker Newt Gingrich replaced Palin as the speaker for the evening although the former governor did attend the event.

* Hoeven Crushes Dorgan in GOP Poll: North Dakota Gov. John Hoeven (R) led Sen. Byron Dorgan (D) 53 percent to 36 percent, according to a poll conducted for the National Republican Senatorial Committee and obtained by the Fix. Both Dorgan and Hoeven have extremely strong profiles in the eyes of the state's voters. Hoeven had a stratospheric 86 percent favorable ratings while just five percent viewed him unfavorably; Dorgan had a 69/24 fav/unfav. Hoeven, who was overwhelmingly re-elected to a third term last November, has said he will make a decision on whether to challenge Dorgan by September. Earlier this week, Hoeven was asked about a Senate bid during an appearance on Bloomberg Radio and said only: "I haven't made any decision in that regard." Hoeven has been heavily recruited to run against Dorgan and Sen. Kent Conrad (D) in cycles past but has resisted. If he decides to run -- and this poll is designed to sweeten that proposition -- the North Dakota race would immediately become a toss up.

Northup to CPSC: President Barack Obama nominated former Republican Rep. Anne Northup (Ky.) as commissioner of the Consumer Product Safety Commission late Thursday. Northup held the Louisville-area 3rd district from 1996 until 2006 when she was defeated by Rep. John Yarmuth (D). Northup went on to lose a gubernatorial primary to then Gov. Ernie Fletcher (R) in 2007 and then unsuccessfully tried to win back her old congressional seat in 2008 -- losing to Yarmuth 59 percent to 41 percent. Northup was recommended for the post by Senate Minority Leader Mitch McConnell (Ky.), according to a report in the Lexington Herald-Leader.

Say What?: "I am hopeful that all of us are able to draw this positive lesson from this episode." -- President Barack Obama on Beerastroika.

By Chris Cillizza  |  July 31, 2009; 6:00 AM ET
Categories:  Morning Fix  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati   Google Buzz   Previous: Chatting the Day Away
Next: Mouthpiece Theater: Beerastroika

Comments

@BB: please. I'm talking about an American phenomenon, not about my own prejudices. I'm a software engineer, if I had any and I mean any problem working with Indians I would have to go into another line of work.

Posted by: chrisfox8 | August 2, 2009 11:01 PM | Report abuse

You are probably all gone, but if not, there is this.

We only import doctors on J1 visas [5 years work in an under-served location in exchange for eventual citizenship] because we don't want 'guest worker', temporary visa doctors.

If I have to explain why we don't want temporary doctors from other countries, I'd be glad to, but it should be obvious and of course, it has nothing to do with ethnicity.

There are lots of issues with the J1 program, but Homeland Security has mooted most of them. It is really, really hard to get a J1 visa now. Lots of people simply do not have enough paperwork to pass the security checks involved. One of our Pakistani doctor's medical school no longer exists and even though she is otherwise aok, it looks like she may never get a license to practice and without that license, you can't get citizenship.

Posted by: shrink2 | August 1, 2009 2:22 PM | Report abuse

My son's child psyciatrist is clearly of Indian descent, though I'd note he interned at the prestigious Kennedy Krieger Institute. You should judge a doctor by the content of his (or her) knowledge, not the color of his or her skin (or nationality for that matter). The best dental work I ever had done was in Costa Rica (an abcess developed while on vacation; the root canal was about as bad as taking care of a couple of cavities).

BB

Posted by: FairlingtonBlade | August 1, 2009 3:16 AM | Report abuse

"I also think, frankly, you overestimate Americans' willingness to go to Indian doctors"

there are a lot of Indian and Pakistani trained drs here who are well trained and acceptable here in our multicultural city.

I agree that the paperwork for dr. billing and delays for payment are a ridiculous waste of dr's time. Please note this morning my first post was to expand the roles of P.A.s and nurse practioners and why I asked the AMA to address that. My family has had mixed experiences with P.A.s and found some very compitent even better then the dr they worked for and some very scary incompitent. I don't see it as answering R complaints b/c they call Medicare and Tricare socialized medicine and I agree they object to any healthcare except for the affluent and would never approve Medicare today. But I see potential dr. shortage as a reasonable concern and few doubt that while a new healthcare system is transitioned we will need to plan for more drs. to be graduating from medical school. I simply see no way around that proposition.

Posted by: leichtman | July 31, 2009 8:50 PM | Report abuse

Please re-read my penultimate paragraph in the last post.

Honestly, I see answering Republican objections as a waste of time. Republicans are liars, the two are all but interchangeable, and if their objections are answered they will just come up with new objections, without a moment to consider whether they're true or not.

I would much rather see nurses performing more work that only doctors perform now, and I think you underestimate how VASTLY more productive doctors could be if they had to spend less of their working lives filling out insurance forms, which are entirely unstandardized.

I also think, frankly, you overestimate Americans' willingness to go to Indian doctors. Years of call centers haven't made Americans any less prejudiced against Indians. I fight bigotry in myself, and I'm motivated to defeat it, and even given that I find Indians a constant challenge. And most Americans lack my determination.

Have a good weekend.

Posted by: chrisfox8 | July 31, 2009 8:08 PM | Report abuse

one last post chris and I have to go.This has nothing to do with siding with management. I desperately desire good effective healthcare reform, for the country and for my family and see a potential void in physicans, something Rs constantly complain about and threaten to use to sabotage healthcare reform. Why allow them to do that?
Incidentally I strongly support unions in our Right To Work state and their push for Card check, so please don't view me as the enemy just someone who sees an issue with a potential shortcoming of heathcare reform that I have tried to address. Why has this conversation devolved into a management issue when all I asked is how will Congress deal with any potential physican shortage?

Posted by: leichtman | July 31, 2009 7:49 PM | Report abuse

I'm doing fine, thanks, fine enough to tell my last manager at Microsoft to take it and stick it, and resigned, took a nice vacation in Việt Nam and only took a month to land this job.

But this area is hurting bad. Texas probably doesn't have a lot of software jobs in the first place so talented people probably moved here and SF and other areas where the jobs are.

I get calls from headhunters who actually feel they need to apologize before revealing the rates their jobs will offer .. they know damned well they're insultingly low. Software testers are getting less than 7-11 clerks sometimes.

And around here Microsoft had its first layoffs ever, and they are aggressively working to push down rates; fortunately, other companies aren't following their lead. But most of us now regard Microsoft as hanging on by inertia alone, they don't know how to do good work anymore.

Anyway.

I find the suggestion of bringing in more foreign workers when Americans are out of work to be despicable. Maybe I'm being prejudiced and ever reactionary but I have never yet seen any reason to partition the H1-B program from efforts to push down wages. The two are entirely inseparable, joined at the hip and sharing a spine.

Apologies for my presumption of your party affiliation, but it's hardly an unreasonable one. I don't hear a lot of Democrats who side with management over labor.

Posted by: chrisfox8 | July 31, 2009 7:12 PM | Report abuse

actually chris the wages and demand for IT and energy engineers is still very high here in Texas, sounds like where you live things are different. I am being sincere in telling you there are shortages of engineers here in Texas and their wages are competitive. Sorry things seem so glum where you are, as we have done much better in the downturn.

Posted by: leichtman | July 31, 2009 7:04 PM | Report abuse

actually chris local software companies and energy related companies are always struggling to find engineers for their companies. Sorry you don't want to hear that but that comes straight from the mouth of a major local head hunter.

==

There are plenty of unemployed software engineers. I have several friends who are struggling to find work.

What companies and headhunters can't find are people willing to work for peanuts.

I'm a talented guy with a lot of diverse experience, and even though I have a job I've gotten two voicemail messages just today, looking for specific areas I've worked in before, like mobile connected devices and medical hardware. I'm lucky.

Other engineers with less experience than I, or experience less in demand, are hurting. Five years ago companies would hire talented people with an expectation they could come up to speed .. now they want people with precisely matching experience.

That's because there are so many unemployed that they feel they can be as picky as they want.

Your local headhunter would have no trouble finding people if the wages weren't insulting.

Posted by: chrisfox8 | July 31, 2009 6:55 PM | Report abuse

"I just brought up the topic and seem to have been attacked as a R traitor. Nonsense."

Sometimes it's best to consider the source.

Posted by: DDAWD | July 31, 2009 6:53 PM | Report abuse

what I actually said is that many medschools are state funded, and that while increasing medschool enrollment is a noble objective, and there are likely 10:1 qualified applicants to actual slots, that state governments are broke, new med schools would have to be built and more medschool professors hired which would take a decade. In the short term that seems impractical to fill any potential void and why I asked if Congress or the AMA is dealing with this and what other's ideas are. But I have yet to hear anyone agree that doctor shortage, In A Medical "Free Market System", may be problematic. I am sure other countries which have transitioned to national healthcare can help us with a road map, but it is doubtful we would listen. I just brought up the topic and seem to have been attacked as a R traitor. Nonsense.

Posted by: leichtman | July 31, 2009 6:50 PM | Report abuse

"First I am told that all physicans make $200-$300,000 and not to worry about their student loans (even though most residents earn well sout of $50,00/year)and we whould not encorage more physicians entering medschool or increase the slots"

I'm not sure if you are referring to me. If you are, can you point out where I said we shouldn't increase slots?

Posted by: DDAWD | July 31, 2009 6:40 PM | Report abuse

actually chris local software companies and energy related companies are always struggling to find engineers for their companies. Sorry you don't want to hear that but that comes straight from the mouth of a major local head hunter.

Posted by: leichtman | July 31, 2009 6:20 PM | Report abuse

"we turned away five out of every six Tata CS employees because they didn't know what they were doing." then they should be terminated and sent back.

As for foreign educated physicians my mom has several, she is happy with them and they are doing quite well financially.

This was only 1 of 5 suggestions I made this morning on how to deal wth Republican whining that there will be a doctor shortage, that Ds support rationing care which is nonsense, and thus we should reject the public option for healthcare which I thought was the topic. This was only one of my suggestions. First I am told that all physicans make $200-$300,000 and not to worry about their student loans (even though most residents earn well sout of $50,00/year)and we whould not encorage more physicians entering medschool or increase the slots and now you scream don't let foreign physicians into the country b/c they will drive US physician incomes down, Considering I have 2 family members who are phsyicans that is a joke. So what is your answer then sir. To simply bow down to Republican dogma and scare tactics regarding this issue, kill healthcare reform one more time or calmly come up with a reasoned alternative for any potential shortage so we can finally have universal healthcare this country desperately needs?
I just raised what I still think is a legitimate issue, And that some how makes me a Republican??

Posted by: leichtman | July 31, 2009 6:16 PM | Report abuse

When Bill Gates goes before Congress and says that Microsoft can't fill their open positions from Americans because we don't train enough engineers, he's lying.

Are you aware of that?

Posted by: chrisfox8 | July 31, 2009 6:08 PM | Report abuse

" I'm comfortable in presuming you are a Republican. Am I right?" are you nuts. Your immigrant bashing certainly sounds like that is your inclination, never has and never will be mine.


interesting assertion since I have traveled, done major fund raising and worked for more D US Senate candidates across the country then you will ever know.

I have also done some immigration work as a lawyer. I doubt you have ever seen the first thing about the process for Visas but keep shouting if that makes you feel better.

Again you do understand sir that Visas are temporary, right?

Posted by: leichtman | July 31, 2009 6:02 PM | Report abuse

And if we should open that door how long do you think it would take before employers used the precarious visa status of those imported physicians to push down wages to that of guys who bag groceries?

Funny you should mention Microsoft .. yeah they hire a lot of H1-Bs. It's not working out too well. Remember Windows Mobile? Well, you don't hear a lot about WM anymore compared to Blackberry and iPhone, so it should come as no surprise that WM is one division furthest along in the indianification of their work. When I was contracting there (doing singlehandedly in a year what six Indian developers had failed to do in the same time) we turned away five out of every six Tata CS employees because they didn't know what they were doing.

Posted by: chrisfox8 | July 31, 2009 6:02 PM | Report abuse

by the way H1 B workers receive a temporary Visa. They can be terminated, layed off or turned into part time workers as at will employees. So if Microsoft no longer feels they need that worker they can be sent home.
Curious: If there becomes a shortage of physicians why would that be a problem for you, if they pass the US Medical Boards? If you choose not to use that physician fine. In some instances their skill level and training may be equal to or superior to the US physician.

Posted by: leichtman | July 31, 2009 5:56 PM | Report abuse

obviously you know zip about immigration laws other than to shout there are too many immigrants. H1 B visas require ironclad proof that you are not displacing an American worker, period.

==

Why should I bother being civil to a guy who insults my intelligence?

I've seen advertisements for positions to be filled that explicitly called for an H1-B and made it clear that American citizens would not be accepted.

Lest I forget to mention in my zeal for a detailed reply, you don't know what the hell you're talking about.

There are nowhere near enough DoL agents to verify that every company that hires an H1-B has done its diligence in satisfying the labor certification. Your assertion is so close to being a complete lie that I'm comfortable in presuming you are a Republican. Am I right?

You think anyone ever demands an audit trail of advertisements and interviews?

Posted by: chrisfox8 | July 31, 2009 5:49 PM | Report abuse

obviously you know zip about immigration laws other than to shout there are too many immigrants. H1 B visas require ironclad proof that you are not displacing an American worker, period. There are slots/categories for highly skilled professionals ranging from software developers to Physicians. No one has said lets open more H1 B visas to software developers so stop your cursing or to cut your yard. My suggestion is to invite more well trained Indian and Pakistani(and other nationalities who's training meet AMA standards) licensed Physicians and P.A.who can pass American Medical Boards, to fill the void that will inevtiably happen when the newly insured will need doctors and we are trasitioning and will likely need over 5 years to train more new American doctors. Exactly what is your problem sir, other than to throw out hateful immigrant bashing comments? Your answer: do nothing and then belly ache and point fingers at Obama if there becomes a temporary shortage of physicians because you choose to do nthing to address the issue. Certainly there are other alternatives such as expanding the rolls of P.A. and Nurses Aids but that is something only the AMA could address.

Posted by: leichtman | July 31, 2009 5:44 PM | Report abuse

You want to import more foreign workers at a time when unemployment is breaking decades-old records. I think that's insane. That's one.

Second, you say that H1-Bs are too limited. Do you realize that there are over four million foreign workers in this country already? And that elimination of the H1-B program would end unemployment in many information-technology industries overnight?

Why should we bring in foreign workers when there are Americans ready to take those jobs?

You know the reason as well as I .. they can be gotten cheap, and they can be intimidated into accepting wages and working conditions that citizens won't put up with.

I've worked with H1-Bs a lot. A few of them are good at their work. Most of them aren't.

Posted by: chrisfox8 | July 31, 2009 5:12 PM | Report abuse

excuse me. what is your problem other than having a foul mouth?

Posted by: leichtman | July 31, 2009 4:58 PM | Report abuse

perhaps shrink2 the issue I raise can be resolved by expanding the H1 B visas which are so limited right now.

==

Are you out of your f*cking mind?!?

Posted by: chrisfox8 | July 31, 2009 4:49 PM | Report abuse

1) yes
2) I don't know. I do know that the AMA is opposed to nurse practitioners (taking work away from the people the AMA represents)
3) I do think the Federal govt. can use financial incentives to try and subsidize more slots for med school. This might be the sort of thing that can start taking care of itself as well. If demand rises, then you're going to have more doctors coming to the US from abroad (and more US students studying medicine abroad) That bypasses the bottleneck since as long as you have a medical degree, you can pass the board exams and start practicing. Many students who can't get into a US med school will study in the Caribbean and come back. I also know plenty of doctors who get their med degree from India or China and get licensed in the US.

Part of the reason that there are limited spots for med students is that it is expensive to train doctors. I don't know how Harvard fares, but a lot of the state schools are eating money for each med student. At UMass, the students don't pay tuition. Perhaps the government can finance spots at schools to allow more people in and then recoup some of that investment by requiring a certain amount of service. NIH does something kind of like that by offering to take up a new doctor's loans if the doctor agrees to do research for NIH for a certain period of time. Is this socialized medicine? Perhaps, but that doesn't bother me.

I hope that wasn't too stream-of-consciousy. Just some thoughts I had.

Posted by: DDAWD | July 31, 2009 4:41 PM | Report abuse

I'm just saying that we have a surplus of people willing to incur these debts.

which in event does not address the issue that I have to agree with a rightie about:
How do we serve 48 million patients with the same number of physicians. I presume Congress understands this and has a plan to address it with Visa reforms, AMA changes to allow more Physician Assistants, and hopefully more doctors coming up of medschool since you seem to agree that there are in fact many bright applicants with 3.9 GPAs where there are not enough slots in the medical schools.

3 questions: 1. Do you acknowledge this may be a potential problem?
2. do you believe that Congress and or the AMA have plans to address this and 3. what is your solution?

Posted by: leichtman | July 31, 2009 4:24 PM | Report abuse

http://www.washingtonpost.com/wp-dyn/content/article/2009/07/31/AR2009073101965.html?hpid=artslot

Kind of on topic, kind of off topic. Chris Dodd has been diagnosed with early stage prostate cancer. He should be fine. I think he'll need very little chemo if any.

Posted by: DDAWD | July 31, 2009 4:17 PM | Report abuse

"DDAWD wants to continue the argument that dcoctors and residents have no problem paying back their loans"

No I don't. If you say some do, then they do.

I'm just saying that we have a surplus of people willing to incur these debts.

Posted by: DDAWD | July 31, 2009 4:15 PM | Report abuse

perhaps shrink2 the issue I raise can be resolved by expanding the H1 B visas which are so limited right now.
DDAWD wants to continue the argument that dcoctors and residents have no problem paying back their loans, some do some don't, that is irrelevant.
What I think needs to be a ddressed is whether medical schools are preparing to expand their admission practiecs to cope with the new patient demands that certainly will occur. That will also create a whole host of other issues such as needing more med schools and medical professors at a time when all state governments are having financial problems.
Does anyone know if this issue(need for more doctors/Physician Assistants) is being considered since very little is being leaked from Congressional committees?

Posted by: leichtman | July 31, 2009 3:40 PM | Report abuse

laughing...you had it worse than I did.

I just had the Carondolet psych ward (and the Winter horror flights, in those Horizon cigar tubes with the 19yo pilot).

Heading over to PDX now, talk to you later, enjoy your day.

Posted by: shrink2 | July 31, 2009 3:40 PM | Report abuse

laughing...you had it worse than I did.

I just had the Carondolet psych ward (and the Winter horror flights, in those Horizon cigar tubes with the 19yo pilot).

We are heading over to PDX now, talk to you later, enjoy your day.

Posted by: shrink2 | July 31, 2009 3:38 PM | Report abuse

The Democrats should go on Offense. All out. This is a winning issue. They'd be fools to not carry through.

Posted by: nodebris | July 31, 2009 3:32 PM | Report abuse

@shrink2: but at least they aren't entirely dependent on the possibility of nuclear war to justify their existence.

I'll never forget .. while I was there the Chamber of Commerce raised 20K to investigate diversification that would keep the community going after the nuclear work dried up .. and they spent 15K of it LOBBYING FOR MORE NUCLEAR WORK.

I'll never forget some lonely old coot yelling at me in the hot tub at the gym that "not a single atomic bomb has ever been built at Hanford!" Reminds of JakeD and his repeated idiot lie about Palin and "from my house."

Posted by: chrisfox8 | July 31, 2009 3:28 PM | Report abuse

No way they are weaned; they are, if anything more dependent than ever on the cleanup billions.

Is there is any other reason why those towns exist? You know, now it is all about the cleanup of the leaky tanks, the clean up that never ends. And it is still the nation's dump for nuclear cores, I see them coming up the river from time to time with their Coast Guard escorts and cops on the bridges as the waste goes by.

Posted by: shrink2 | July 31, 2009 3:20 PM | Report abuse

Yes, I worked very hard, nights and weekends for three years (the Tri-cities, yuck!)

==

You have my profound sympathies.

I lived in that armpit of Washington for three and a half years after college, probably the worst time of my life. What a grotesque place it was back then, sucking hard on the federal tit, with daily letters to the editor saying a nuclear war wouldn't really be all that bad. There's something truly grotesque about a community that has a vested interest in the world being an unstable and dangerous place.

I wrote one letter to the editor expressing how I felt about this, and the Tri-City Herald saved it and printed it the day the announcement came that some of the work was shutting down. A friend of mine called me and said that people in his office were howling for my blood.

And in the long run weaning from nuclear dollars was the best thing ever happened to that Schießeloche.

Posted by: chrisfox8 | July 31, 2009 3:09 PM | Report abuse

You are absolutely correct Lman.

Millbrooks27 will be glad to know the doctor shortage in this country will not be fixed by importing the J1 visa people anymore, primarily from India and Pakistan. Homeland Security has made that process onerous if not impossible.

Even in places with "socialized medicine" there are severe shortages of doctors in various specialties. I am always getting guest-worker recruitment notices for Australia and New Zealand.

Posted by: shrink2 | July 31, 2009 2:57 PM | Report abuse

"Those numbers are nice but I know numerous pediatricians in private practice who are not earning that kind of money especially if you look at their net incomes, but if that makes you feel better fine."

I just posted the first numbers I found. There's no source and no indicator of distribution.

But I don't think we're debating on how much doctors make. I think the debate is still on whether med school costs are limiting the number of doctors we have. For all your friends who don't like how much they make (not saying this in a negative way), they still chose to go through the process. And if they chose not to go through the process, then other people would have.

One thing we could argue is whether we could be getting BETTER doctors if the price/salary structure was different. I just don't see any reason to believe that the costs of med school are limiting the number of doctors we churn out. If we were to substantially increase the number of seats, then yeah, cost would come into play, but not as it is.

Posted by: DDAWD | July 31, 2009 2:55 PM | Report abuse

"insurance industry's reimbursement rates"

and notoriously slow pay and mounds of paperwork from insurance carriers.

My initial point was that with 48 million prospective new patients hopefully someone has thought through that there will be a need for more doctors and physician assistants. Curious if that is anywhere in the works in any health proposal, so hopefully the poor will stop the totally inefficient practice of showing up in ER rooms rather than doctor's office. Many poor people do this b/c they are less likely to be turned away from an ER room rather than a doctor's office for sometimes nonemergency issues. Reducing that practice would potentially save county governments millions.

Posted by: leichtman | July 31, 2009 2:47 PM | Report abuse

Yes, I worked very hard, nights and weekends for three years (the Tri-cities, yuck!) to get out from under those loans. It was worth it though. American doctors complaining about money is so annoying.

We are one of the most privileged classes of people on Earth. I really believe that. Just one example, imagine never, ever having to worry about being unemployed.

That said, it is true and very strange that the doctors in all specialties who work with children get paid very much less than their adult patient peers. A pediatric orthopod at OHSU said on OPB the other day he was making about $150k less per year than his adult orthopedic surgeon counterparts, this as a result of the insurance industry's reimbursement rates.

Posted by: shrink2 | July 31, 2009 2:40 PM | Report abuse

"getting a total brain-wipe and reeducation"

Hey, is that a real possibility?
A Republican revival is going to depend on a lot more than the hopes and dreams of The Fix.

I know the Maoists tried it.

Then there were the lobotomists.
Western State up there near Steilacoom was a favorite spot for the evangelist of lobotomies, he loved to climb Mt. Ranier after destroying a few dozen peoples' minds on his annual visits, I am told.

Posted by: shrink2 | July 31, 2009 2:30 PM | Report abuse

DDWAD:
Those numbers are nice but I know numerous pediatricians in private practice who are not earning that kind of money especially if you look at their net incomes, but if that makes you feel better fine. There are many doctors not earning big pay struggling to pay off their med school loans. Especially those in residency earning as little as $35,000 for 2-5 years. Try earning that and paying off $100,000 student loans or even better talk with some pediatricians or residents working 60-70 hour weeks and they can tell you what they really earn and what it actually cost when they go to run a pediatric clinic. Seems like you have rather stereotyped doctors which is unlike your usual posts.

Posted by: leichtman | July 31, 2009 2:25 PM | Report abuse

Chrisfox if the dems pass a public option,the blue dogs will lose their reelections bids and Congress will go over to the republicans.

==

You guys have been crying this backlash wolf for thirty years. It's never happened. It's not going to happen. If you think Americans are going to return the party of Limbaugh and Cheney because the Democrats failed to side with private insurance and against the American people, you should consider getting a total brain-wipe and reeducation

Posted by: chrisfox8 | July 31, 2009 2:23 PM | Report abuse

"I think you (and many of the Blue Dogs themselves) greatly exaggerate how vulnerable they are."

Especially on the public option. This is one of the more popular hypothetical provisions of healthcare reform.

It probably behooves the blue dogs to get on the ball so that their constituents can benefit before the elections roll around. Just another year, folks!

Posted by: DDAWD | July 31, 2009 2:16 PM | Report abuse

http://wiki.answers.com/Q/What_is_the_average_salary_of_a_pediatrician

"Pediatrician salaries are based on years of experience, location, specialty, and the type of facility.

The current median expected salary for a typical pediatrician in the United States is $142,585. From working from 1 to 2 years the salary is $135,000. From working 3 or more years, it is $175,000. The maximum would be $271,000.

Specialized pediatricians usually receive a different salary; a cardiologist gets paid $607,000 yearly, critical care pediatricians earn $398,000 yearly, an Oncologist earns $251,000 yearly, and a Neurologist earns $362,000 yearly. "


If you want to believe an unsourced webpage...

Also, median salary is meaningless without some kind of measure of distribution.

Posted by: DDAWD | July 31, 2009 2:13 PM | Report abuse

" I am not prepared to celibrate a GOP victory yet, but I like our chances."

based upon what other than a hope and a prayer, your partie's stellar performance in November, losing conservative states like Fla, North Carolina and Indiana?" Hispanics I can assure won't be in the GOP corner next November. You probably have pretty good odds in Texas but in Ca. their governor is at best even with Gray Davis miserable removal numbers of 28%. I wouldn't count on the GOP winning anything there. Good luck with your southern strategy as New Hampshire looks likely D among others. Guess your party is holding out hope that W's bad economy holds on til next Nov. Sorry, most all economic indicators point otherwise, no thanks to W and the GOP.

Posted by: leichtman | July 31, 2009 1:35 PM | Report abuse

"the blue dogs will lose their reelections bids "

I think you (and many of the Blue Dogs themselves) greatly exaggerate how vulnerable they are.

Posted by: nodebris | July 31, 2009 1:34 PM | Report abuse

A psychiatrist I know left his public sector medical director job ($205k) to become a concurrent care manager for a well known West coast insurance company. Once in awhile we hear from him when he asks us to justify what we are doing with a patient whose Medicare benefit his company "manages". He adds no value, he is not improving quality by harassing the people who still see patients. His salary is now $385k.

What does industry have to fear of the public option? They are already in the business of looting Medicare.

Posted by: shrink2 | July 31, 2009 1:28 PM | Report abuse

Chrisfox if the dems pass a public option,the blue dogs will lose their reelections bids and Congress will go over to the republicans. The dems best chances of keeping the House is passing modest reform both parties agree on and a strong upswing in the economy. I am not prepared to celibrate a GOP victory yet, but I like our chances.

Posted by: vbhoomes | July 31, 2009 1:22 PM | Report abuse

"Given all the Republicans that make this claim and given the fact that I know a lot of Europeans and Canadians, you would think that ONE of them would agree with this sentiment."

I, too, would like to meet one of these Canadians or Europeans who have nothing but bad things to say about their countries' health care systems, DDAWD. I keep hearing these stories from people opposed to a public health care option that Canadians and Europeans secretly hate having that kind of system, but I've never heard the Canadians or Europeans say it themselves.

Posted by: GJonahJameson | July 31, 2009 1:15 PM | Report abuse

an AMA study shows that only 2% of healthcare costs are attributable to mal practice premiums. That cannard is getting rather old.

==

Well they don't mention it to make an actual debate point, they mention it by way of creating a distraction. Along with abortion, euthanasia, and illegal aliens.

If we get real health care reform with a public option then the GOP will be in the wilderness for decades for this alone, the party that sided with a corrupt private insurance industry and against the American people.

Crybabies and sore losers.

Posted by: chrisfox8 | July 31, 2009 1:10 PM | Report abuse

"And I'm not all that sure about this, but isn't it a reasonable expectation for a practicing doctor to make $100k at the minimum?"

try pediatrics, salaries aren't that great.

You are absolutely right about the competition to get into med school and why I think it ridiculous that students with 3.9 GPAs are being turned away, especially if we have 48 million new patients expecting care. It seems like a reasonable concern to me. Can't do that anymore or expect med student graduates to tolerate $2,000/month student loan payments.All docs are not getting paid like neuros or anesthisologists.

Posted by: leichtman | July 31, 2009 12:59 PM | Report abuse

Millions of dollars from your insurance premiums going to advertisements, lobbyists, huge office buildings and so on. All waste, no value added. Yet, we are told our free market system (which does not actually exist, those lobbyists ensure that) is so efficient that there is no way to improve access and quality without paying too much. Wrong. Playing on the fear that our crony capitalist government is too corrupt to make health care anything but worse is not acceptable, but that is the Republican position.

Experiments in health care systems that work has been going on for decades, in places like Germany and New Zealand. We do not need to invent the wheel.

We are crazy (a technical term, I know) to think so little of ourselves we can't change the course of a system of care that is dooming our economy and eroding the quality of life of an ever larger number of our people. You could argue it is our patriotic duty to change the health care business model.


Posted by: shrink2 | July 31, 2009 12:56 PM | Report abuse

my Republican Vet brother in law loves Tricare and regularly tells me how cheap his prescriptions and copays are and how good the quality of care he is getting for his cancer. Of course he loves it but is against others having the option of government healthcare, go figure. I can tell you some pretty scary stories about private healthcare from clients, so I urge you not to presume that private healthcare is the end all. It really depends on what part of the country your provider is serving b/c it varies from state to state, which is in itself an abomination.

Posted by: leichtman | July 31, 2009 12:52 PM | Report abuse

"I must once again disgree with your response DDAWG.
I have 2 family members who recently graduated medical school and they would beg to differ with you, especially those who don't go into lucratic medical fields and are staring at $100,000 plus in student loans at 15% interest rates."

But I bet if they decided not to go to med school because of the costs, their school would have no trouble filling those spots.

And I'm not all that sure about this, but isn't it a reasonable expectation for a practicing doctor to make $100k at the minimum?

I'm not saying that the costs are unsubstantial. I'm saying that you've got plenty of people willing to pay them.

Posted by: DDAWD | July 31, 2009 12:52 PM | Report abuse

Leictman: From a personal experience(I recognise others may have different experiences) I have two plans, I can use my wife's Blue Shield/Blue Cross or I can use the Govt ran Veterans Administration. Having used both, Blue Cross/Blue Shield has much higher quality than the VA. Maybe Congress should be required to use the VA. system if they think government healthcare is so great.

Posted by: vbhoomes | July 31, 2009 12:42 PM | Report abuse

an AMA study shows that only 2% of healthcare costs are attributable to mal practice premiums. That cannard is getting rather old.

Posted by: leichtman | July 31, 2009 12:40 PM | Report abuse

Just a thought. Corporations in the U.S. do not put a bar of soap on a shelf without first conducting consumer tests. Why not the same with Health Care. How about a lottery to pick out 10 (?) states, and let them try the public health option for a 2 year test. Another 10 (?) states picked by lottery could try the Blue Dog Option, and another 10 (?) states could try the Republican Option (if they have one). The 2 year testing could provide cover for our fearless Congress people, and also give a realistic view of costs. It won't help the uninsured for the short term, but talking this to death isn't helping anyway.

Posted by: melpremium | July 31, 2009 12:35 PM | Report abuse

@DDAWD and others - Good point. The AMA controls supply right now. Combine the enormous cost of medical school with liability insurance and it's no surprise that finding a GP or an obstetrician is like playing Where's Waldo in some areas.

(A) An effort at increasing slots. We pay for the public universities and it's time for some, errm, back pay. (B) Agreed subsidy of costs and liability insurance for doctors willing to serve in needed capacities. Don't make it a payoff as there are famous cases of wealthy doctors blowing off their student loans.

A variation on this system is in essence how we get pilots. Aren't many ex-Vets? The DOD pays for the training costs and gets a number of years of service. I don't think you need to go as far as a civilian medical corps, though that might not be a bad idea.

BB

Posted by: FairlingtonBlade | July 31, 2009 12:33 PM | Report abuse

"I think you could triple the cost of med school and not affect the number of doctors. Lowering med school costs won't help since the bottleneck is the number of slots. You're going to have to expand that first."

I must once again disgree with your response DDAWG.
I have 2 family members who recently graduated medical school and they would beg to differ with you, especially those who don't go into lucratic medical fields and are staring at $100,000 plus in student loans at 15% interest rates.

Certainly medical schools must also be in the equation and need to expand their enrollment and stop refusing students with 3.9 GPAs. I strongly believe we will need to increase the numbers of doctors we have(which will take at least 5 years) and the AMA needs to consider ways of expanding the rolls of Physician Assistants and Nurse Practioners to treat routine illnesses. I hope that Congress is considering this in their debate b/c it is a legitimite concern.

Posted by: leichtman | July 31, 2009 12:25 PM | Report abuse

What you DO see, however, are state schools giving big discounts to in-state medical students as a way to encourage them to stay in the area. U-Mass med is free and open only to in state. LSU med is probably cheaper than LSU undergrad and a fraction of what a private med school costs. LSU also makes it free for med students who commit themselves to work in Louisiana rural areas for a period of time after graduation.

Posted by: DDAWD | July 31, 2009 12:23 PM | Report abuse

@vbhoomes - I completely agree with you. [I know. Must be a first.] This has to be done carefully and I can even see incrementally. Take all the agreed savings in the general market (hospitals chipped in some, insurers some, control drug costs), add in a modest employer mandate (say, 5% of payroll), some requirement for catastrophic health care coverage for adults, and that takes care of most of the uninsured problem. Yes, I'm tossing figures off the top of my head, but I assume something along these lines is in the works in the various committees.

A truly radical reform effort has to be applied to Medicare and Medicaid. That is independent of the coverage issue, but linked in terms of overall costs. Cutting reimbursement rates is making it difficult for providers to survive and patients to find access. It's kind of like having the government provide vouchers for education, but only funding them enough to pay for the lousiest schools in the area.

I suspect that going from a fee for service to maintenance agreement has enormous potential for cost savings. Add in liability shields as well to satisfy the doctors and various Heffalumps. Trial lawyers have to take their lumps too. I'm sure you've seen the estimates that Medicare & Medicaid will eventually consume the entire Federal budget. This system is broken and it's about time Congress stops kicking the (expletive deleted) can down the road.

Thanks for responding.

BB

Posted by: FairlingtonBlade | July 31, 2009 12:23 PM | Report abuse


Change is hard, especially when it is being pushed by a black president in the 21st century. Change is hard when people have become comfortable with the status quo. Change is hard when people refuse to challenge themselves to overcome complacency. Change is hard when our congressional leaders put their own selfish interests ahead of their constituents. They are afraid to challenge the mega pharmaceutical, insurance, and HMOs corporations, for fear of loosing precious campaign contributions that will keep them in their jobs. Most of these politicians, both democrat and republican, are wealthier than their average constituent, and want to remain so, by helping these corporation maintain their stranglehold and monopolize the healthcare debate. The average American, given the unvarnished truth, want the healthcare system fixed, to their advantage. Not to the advantage of the major pharmaceutical and insurance companies. The PEOPLE OF AMERICA, must rise up and let their voices be heard over the den of the lobbyists, who want to maintain their largess for their corporate benefactors.

Posted by: demtse | July 31, 2009 12:20 PM | Report abuse

this quote from ROSS is NOT in the linked Romano story.
--Arkansas Rep. Mike Ross, a leader on health care within the conservative Blue Dog Coalition, told the Post's Lois Romano earlier this week that "there's ten more hurdles for them before a bill goes to the President for a signature."---

what is up with that. I looked to find out who Ross was calling "THEM." His own party leadership? the president?

Posted by: pmwarren | July 31, 2009 12:19 PM | Report abuse

"I would suggest defraying some of the outrageous costs of medical school loans and subsidies to medical school programs to stimulate the graduation rate of new doctors."

The cost of medical school doesn't have anything to do with how many doctors we have. I'm not saying that no cost matters, but at the costs that we have, it doesn't matter. If cost was a limiting factor, then getting into medical school would be easy. It's not. Students are willing to take out any loans that are needed knowing that they will enter a profession that will allow them to pay it off easily. I think you could triple the cost of med school and not affect the number of doctors. Lowering med school costs won't help since the bottleneck is the number of slots. You're going to have to expand that first.

Posted by: DDAWD | July 31, 2009 12:15 PM | Report abuse

"and would more sickly and uneducated patients be discriminated against? That is fear we have now, that Congress will end up making things far worse than they are now. Given Congresses History, that is not an unreasonable fear."

and if you don't think that HMOs don't do that now you are misguided. If you don't think your employer NOW hs a say in your healthcare you know nothing. Obviously you have heard nothing of those who have health insurance and have to file for bankruptcy b/c their medical bills exceed their lifetime limits; seniors who pick and choose which medicines they can afford to take; cancer patients who NOW can't get the chemo they need but can't afford, I know several in my neigborhood, and these are the INSURED patients. What kind of chemo do you think the uninsured are getting? This is the answer we heard in 1994 to kill healthcare by the righties, FEAR FEAR FEAR. Just make up stuff spoon fed to them by the Family Research Counsel paid for by the same whack jobs who created Harry and Louise.
Enough is Enough !

Posted by: leichtman | July 31, 2009 12:06 PM | Report abuse

Chris,

Since the anti-reform forces have pulled out all the stops (and also plan a media 'carpet bombing' in August), I expect that the DCCC is certainly right in doing so.

There has always been this fear-inspiring taken tack against health care reform (viz., the original Harry & Louise ads), going back to FDR. SOMEONE has to counter these mistruths effectively.

Posted by: sverigegrabb | July 31, 2009 11:54 AM | Report abuse

I agree with you FairlingtonBlade that it is not a game when you alter one sixth of the economy, if you don't get it right, we could kill quality healthcare along with our economy. We should take a look at changing fee for service but we have to be careful of unitended consequences. Would not doctors be tempted to just treat patients with a better chance of recovery of that is how they are paid? and would more sickly and uneducated patients be discriminated against? That is fear we have now, that Congress will end up making things far worse than they are now. Given Congresses History, that is not an unreasonable fear. I perfer we use test States before we try changing the way we pay doctors.

Posted by: vbhoomes | July 31, 2009 11:54 AM | Report abuse

DDAWD:

It is certainly valid to say that we will need more doctors to serve the 48 million uninsureed who currently end up in ER rooms rather than a doctor's office where care is cheaper. I would suggest defraying some of the outrageous costs of medical school loans and subsidies to medical school programs to stimulate the graduation rate of new doctors. It is a legitimate concern but in the end will help state and county governments with curtailing crowded ER rooms but in no way should it be an excuse to not cover the 48 million uninsurred. Incidentally I met a CEO of very large real estate conglomerate in Calgary(actually in Canmore) last summer who loves their healthcare system even with its flaws, and says they are working to revise its reach and he strongly believes that healthcare problems in the US are crushing American corporations competitiveness. Canadians think America's refusal to deal with its healthcare problem is insane.

Posted by: leichtman | July 31, 2009 11:48 AM | Report abuse

Health care is such an important topic that it shouldn't be a playball between the political parties. And the rules should begiven with common sense and intuition on social responsibility.
Dorine

Posted by: donegrini | July 31, 2009 11:43 AM | Report abuse

Challenge to Deathers to end Government run healthcare:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=385x345627

and why not also end the other government run healthcare program called Tricare while you are at it?

Posted by: leichtman | July 31, 2009 11:35 AM | Report abuse

"If he hadn't stupidly expressed his opinion on the Cambridge cops' actions, we'd be further along that path. He made some excellent points during the press conference, but pissed it all away with one ill-considered comment."

Yeah, I guess it's easy to blame the press for this, but the biggest voices in the press are invested in seeing any healthcare reform fail. The rest just go along with the big voices. But Obama should know better.

But there's still a month of debate and he should be able to catch up. I'm still amazed with how he turned the stimulus debate around almost like he waved a magic wand and *poof* popular support!

Posted by: DDAWD | July 31, 2009 11:13 AM | Report abuse

@vbhoomes - Open to you as well. Incidentally, we spend as much on public health care as most other countries do on *ALL* health care. So, I'm happy to leave private insurance alone (I'm with UHC) and bring the uninsured onto a public plan.

The key to health care reform will be to kill fee for service. It can and must be done with Medicare & Medicaid. You should know that we're going to be bankrupted regardless. Yet, Republicans seem to act like this is 1994 all over again. Kill health care reform and take back the Congress. This isn't a political game, but that's exactly how it's being treated.

BB

Posted by: FairlingtonBlade | July 31, 2009 11:08 AM | Report abuse

'FIX' READERS, TEAM OBAMA AND CONGRESSIONAL INTEL COMMITTEE MEMBERS:


MORE EVIDENCE THAT U.S. GOVERNMENT SURVEILLANCE PROGRAMS ARE BEING USED AS A PRETEXT TO HARASS, CENSOR AND IMPOSE PRIOR RESTRAINT UPON MAJOR MEDIA WEB SITES AND UNJUSTLY 'TARGETED' USERS


For the latest apparent constitutional affronts -- and the tricks that rogue operatives apparently use to maliciously disrupt telecommunications -- scroll to end of "comments" section at this American Civil Liberties Union blog link:

http://blog.aclu.org/2009/01/26/internet-filters-voluntary-ok-not-government-mandate

Posted by: scrivener50 | July 31, 2009 11:07 AM | Report abuse

@dbw - I'll give it a go, though you rarely respond to challenges, thoughtful or otherwise. We spend a significantly higher fraction of GDP than every other industrialized nation and we also have high per capita incomes. What exactly are we doing wrong? Why is it 17% here and 12% in that third-world pit Switzerland? Or why is it that we spend so much here and yet don't have better outcomes than, say, Costa Rica? We're buying a Cadillac and getting a Chevy.

I doubt you can answer the questions (and the claim that it's the lawyers' fault has been debunked). I will give it a go. Fee for service has to die. The medical system is rewarded for giving more care not producing better outcomes. Doctors own medical test companies. It's been shown that ownership increases the number of tests.

Here's my simple idea. Take the average amount for insurance. Call it around $15k/year/person. That goes to the primary care provider. We'll make it a co-operative so that you average over many consumers. Don't want 1 heart transplant to bankrupt the practice. Doctors get a generous salary as well as annual bonuses if the coop is meeting its targets for cost and patient health.

No one is getting between you and your doctor. If you need, I repeat need a test, you can get it. If you want that fancy brand name medicine advertised during ER, then it has to be justified or you pay out of pocket. The profit motive is in giving good care as good preventative medicine is a lot cheaper than the alternative. Unless, of course, you think your doctor would deny you needed health care so he/she can pocket some extra money. Because that's exactly what's happening right now.

BB

Posted by: FairlingtonBlade | July 31, 2009 11:04 AM | Report abuse

"Good post DBW1: As it stands now I can get in to see my doctor with a same day appointment. If you add 50 million people to the system without adding more doctors, you would be lucky if you could see your doctor within 6 weeks. Quality of Healthcare will take a big hit if a public healthcare is added."

Given all the Republicans that make this claim and given the fact that I know a lot of Europeans and Canadians, you would think that ONE of them would agree with this sentiment.

And yeah, whenever I meet someone from Canada or Europe, that's like the first thing that blurts out of my mouth. After that, I'll get to know her name.

Posted by: DDAWD | July 31, 2009 11:03 AM | Report abuse

More specifically, the debate is whether competition between for profit health care companies adds to quality or access. We know it adds to cost, or do you think the tens of thousands of people in the health care Anlage who never deliver any care to anyone work for free?

Posted by: shrink2 | July 31, 2009 11:01 AM | Report abuse

Better post, bsimon1.

Posted by: nodebris | July 31, 2009 10:56 AM | Report abuse

Good post DBW1: As it stands now I can get in to see my doctor with a same day appointment. If you add 50 million people to the system without adding more doctors, you would be lucky if you could see your doctor within 6 weeks. Quality of Healthcare will take a big hit if a public healthcare is added.

Posted by: vbhoomes | July 31, 2009 10:48 AM | Report abuse

dbw1 writes
"I don't fault liberals for also wanting low-cost for health care, the only question is which of the other two qualities are you willing to give up?"

I find your construction to be faulty. You left out another thing we can trade.

I would like to trade high profits for low cost. Our current system is high-cost, high-profit. I'd rather see low-cost, low-profit.

Posted by: bsimon1 | July 31, 2009 10:47 AM | Report abuse

Republicans are winning the battle on healthcare because their messege has substance: no government ran public option is acceptable. The moderate democrats that want to reform healthcare but not create a public option has it right. Healthcare certainly needs reform, but the public option is horrible. Gov't. can't manage anything. Obama says that's a fear of a people, but it's a legite one. It's a true fear and it's been proven, government ran healthcare sucks. People from other nations come here that have socialized medication. Why? America has the best quality of healthcare in the world & the best doctors. Why? Because we pay R&D, we pay doctors good wages to encourage the best & brightest to enter the field. Price containment comes at a cost: quality. Quality of healthcare & healthcare professionals. What we need is a way to allow a community rate and allow people to band together to get group rates like businesses. That is the system we need.

Hoeven leads Dorgan by that margin, wow! If Hoeven runs, that's yet another victory for Cornyn & yet another headache for Shumer. Run Hoeven run!

Posted by: reason5 | July 31, 2009 10:45 AM | Report abuse

ddawd writes
"Obama can quickly turn these kinds of situations around. He's gotten started, but hasn't really ramped up the pressure."

If he hadn't stupidly expressed his opinion on the Cambridge cops' actions, we'd be further along that path. He made some excellent points during the press conference, but pissed it all away with one ill-considered comment.

Posted by: bsimon1 | July 31, 2009 10:44 AM | Report abuse

Palin quits another event. As common as The sun rising in the morning.

Posted by: MerrillFrank | July 31, 2009 10:37 AM | Report abuse

1) High Quality
2) Easy Access
3) Low Cost

Those are the three qualities everyone wishes for our health care system, no matter their political stripe.

Unfortunately, it's an economic and social reality that it is impossible to achieve more than two at the same time. The (mostly) private health care system has tended to deliver quality and access, but has failed to deliver (and won't deliver) a low-cost system.

I don't fault liberals for also wanting low-cost for health care, the only question is which of the other two qualities are you willing to give up?

It's not a question for debate, it's a fact. One of the other qualities will be sacrificed as liberals push to drive a low-cost system. So which are you willing to give up: Quality, or Access?


Posted by: dbw1 | July 31, 2009 10:24 AM | Report abuse

Audacity of Hops wins my vote.

Republicans are definitely winning the battle on health care at the moment, but as we saw with the stimulus package, Obama can quickly turn these kinds of situations around. He's gotten started, but hasn't really ramped up the pressure. Hopefully he will soon.

Posted by: DDAWD | July 31, 2009 10:16 AM | Report abuse

After the compromise, even more very tall buildings and stadiums will bear the names of insurance companies. Still, their executives will be jealous of the handouts over at AIG. Hell, the AIG guys did not even have to stuff the wallets (freezers too?)of any legislators.

The Great Bipartisan Wall Street Give Away, now there is a reform effort every Chinese peasant [who has no social service safety net whatsoever and has his kids in a school that will crush them in a temblor] should be proud to finance.

Indeed, the "Communists" seem to have made an amazing choice. I don't see an historical precedent. You simply buy your rival's future at the expense of your own population. I guess they figure wars cost the people too, not to mention the bloodshed.


Posted by: shrink2 | July 31, 2009 10:14 AM | Report abuse

@drindl - Good news for the Dems. Happy now? :-)

BB

Posted by: FairlingtonBlade | July 31, 2009 10:10 AM | Report abuse

"The DCCC effort will comprise robocalls, e-mails and tele-town halls in 25 GOP-held seats; eight select members -- Rep. Michelle [sic] Bachmann (Minn.)... -- will also get hit with radio ads."

DFL Rep Tarryl Clark has joined the race for Rep Bachmann's seat (only one 'l' in Michele, by the way). Clark won her current seat easily and was picked by some as a plausible candidate for the Governor's seat next year. She'll likely win the party endorsement & primary easily (vs Elwyn Tinklenberg & Maureen Reed). Given Rep Bachmann's national reputation & the Dems renewed focus on unseating her, Clark should be well-funded & will likely be the toughest competition Rep Bachmann has yet faced.

Posted by: bsimon1 | July 31, 2009 10:04 AM | Report abuse

Eh. The DCCC is wasting its time and money going after Pat Tiberi; he's got his House seat for as long as he wants it, barring some sort of massive scandal.

Posted by: GJonahJameson | July 31, 2009 10:03 AM | Report abuse

Chris:

Polling in ND is a seriously flawed proposition, and accentuates GOP strengths. If you're ready to move ND into toss up if Hoeven gets in (a proposition that I wouldn't even rate as highly as a coin toss), then you don't know a heck of a lot about the state (duh!). A highly effective campaign could easily be utilized by Dorgan to play to his strengths and the liking the Governor angle, and I for one, don't see Hoeven winning.

Cruised to reelection, the Dems keep putting up stiffs against him, probably due to the Democratic bench being very very weak. John Hoeven's primary advantage in the state is that he is viewed as being almost nonpartisan, an advantage in a Senate race that would go away simply by making the race.

Posted by: leuchtman | July 31, 2009 9:44 AM | Report abuse

"Palin Drops Out of California Women's Event:"

Watch her show up.

Posted by: edlharris | July 31, 2009 9:17 AM | Report abuse

Wow a National Republican Senatorial Campaign Committee has Republican Governor John Hoeven crushing Democratic Senator Byron Dorgan. What a huge surprise! By the way this is the same Byron Dorgan who has never faced a close reelection campaign and currently holds sky-high approval ratings.

Posted by: fable104 | July 31, 2009 9:12 AM | Report abuse

"...regain momentum..."

Um, Chris, do we live on the same planet?

It would appear to the casual observer that a Democratic President, with a 60 seat Democratic majority in the Senate, benefitting from a massive majority in the Congress - who all support some kind of health reform - would, um, have all the 'momentum' it needed to do whatever the heck it wants.

For you to suggest otherwise is simply rubbish.

Posted by: Heerman532 | July 31, 2009 9:08 AM | Report abuse

Yeah, right on Mark-in-Austin, thats the problem, politicians still offering free lunches and the public is still accepting them. We are in a Fiscal crises, we cannot afford what we have now, so what will Washington do?, add more people to entitlement programs. Apparently basic Math is not a strong point for most americans. Its a ticking time bomb, the deficits we are running up we kill us long before Al Queda.

Posted by: vbhoomes | July 31, 2009 9:06 AM | Report abuse

True Love saved her in the Fire Swamp, and she treated it like garbage. And that's what she is...Politiks.

One, the flame spurt - no problem. There's a popping sound preceding each; we can avoid that. ...Hells bells.

Posted by: Dermitt | July 31, 2009 9:04 AM | Report abuse

Republicans are in big trouble if they don;'t come up with a plan of their own. Folks won;t be hoodwinked by the press forever...

http://www.political-buzz.com/

Posted by: parkerfl1 | July 31, 2009 8:49 AM | Report abuse

vbhoomes, I think it is good that they are not rushing into comprehensive health care. Multiple committees taking the time to fashion far reaching legislation that may affect the rest of our lives in many ways should be the order of the day.

I worry, like Krauthammer, that only insurance and not health care aggregate costs will be addressed in the end. The inflationary spiral of 4x the CPI rate of inflation is the fiscal killer. The disincentive to insure the sick is the social problem. I think Congress may only address the latter.

But I believe the Congress will pass a bill and that it will have consequences and that it will also mark the escalation of the actual debate, not the end of it.

Too many Americans do not realize that they are in a widely federal and local government subsidized health care system now, one that props up huge profits for private health insurance companies by leaving the young and healthy and well off in the private system while taking the highest risk and poorest patients out of the private market pool.

More will understand the system after the debates, if they pay attention. Of course, polling predicts they will demand something for nothing and Congress will oblige.

Posted by: mark_in_austin | July 31, 2009 8:39 AM | Report abuse

TO: "ahashburn" @ 8:07 a.m.

RE: Lame psy ops "take your meds" meme

Sir: This is not statecraft. Your alleged humint has been forwarded to IG/Office of DNI for review and notation.

Please refrain from embarrassing the unit.


Posted by: scrivener50 | July 31, 2009 8:20 AM | Report abuse

Dorgan is done if the Gov jumps in the race. Red states dems will be wipe out next year along with a few blue state dems.

The public health care debate is over, the D's lost. Time for them to admit it and take whatever bones the R's and moderate dems throw their way.

Posted by: vbhoomes | July 31, 2009 8:15 AM | Report abuse

scrivener50 - are you off your meds again?

Posted by: ahashburn | July 31, 2009 8:07 AM | Report abuse

WHAT GOOD IS HEALTH CARE REFORM...
WHEN OPERATIVES OF SECRETIVE MULTI-AGENCY PROGRAM
COMPROMISE MEDICAL CARE OF 'TARGETED' AMERICANS?

• Obama agenda, rule of law subverted by fed-funded, nationwide vigilante "Gestapo" that has co-opted and compromised local law enforcement.

* Microwave/laser radiation "directed energy weapons" deployed to silently TORTURE and degrade the health of American citizens.

• "Intelligence-based policing" a pretext for a security/military/intel social purge executed at the GRASSROOTS with the cooperation of local law enforcement.

http://nowpublic.com/world/gestapo-usa-govt-funded-vigilante-network-terrorizes-america

OR (if link is corrupted / disabled):

http://NowPublic.com/scrivener RE: "GESTAPO USA"

Posted by: scrivener50 | July 31, 2009 7:47 AM | Report abuse

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