PAYING THE PIPER

Anyone who who has had the misfortune of taking the bus in Los Angeles is probably aware that most of our drivers are, regrettably, rude and thoughtless. The reason is simple: drivers are instructed that their primary mission is not moving passengers in a courteous fashion, but moving busses in a timely fashion. The result is a tight schedule for the busses and a dismissive attitude for the passengers.

Attorney General Eric Holder’s investigation of torture during the Bush/Cheney administration is focused on the wrong people. Holder would do better to look away from the low-level operatives who did what they were told to do, and turn instead to those who told them to do it. Former V.P. Dick Cheney’s response to a FOX News question as to whether or not he will deign to cooperate with this investigation - "It will depend on the circumstances and what I think their activities are really involved in" - shows his profound disrespect for the law. Clearly he believes the law should simply be dismissed in favor of the judgment of those in power. His own administration is the best argument against that!

In the mean time, his arrogance is almost beyond belief and just within the borders of contempt. If Mr. Cheney really believes that his actions were appropriate, let him stand up in court and say so, accepting our praise if he is proven right, and the consequences if he is proven wrong. My guess is that this aging patriot will revert to his Viet Nam War strategy, sending others out to do battle while he hides behind deferments till the shooting stops.

TEDDY

Senator Edward Kennedy died of brain cancer late Tuesday evening at his Hyannis Port home. He was living proof of two old adages: the first is that money isn't everything. Despite the fortune amassed by his father, Joseph Kennedy, the Kennedys couldn't buy longevity for three of their four sons at any price. They had to simply struggle through multiple deaths and family tragedies like everyone else. Their money may have made it a more comfortable journey, but no less painful.

The second adage is Yogi Berra's great truism: it ain't over till it's over. It certainly looked like it was over at Chappaquiddick. Most political analysts were betting the ranch that Kennedy’s political future had drowned in the Poucha Pond inlet with Mary Jo Kopechne. But Kennedy rose from the depths and through humility and perseverance not only survived but went on to become the most enduring and important player in liberal American politics and a legend in the Senate. You never know.

Not to be forgotten or understated is the fact that as the last surviving male Kennedy of his generation, he became “Uncle Teddy.” He looked after the children of his fallen brothers and was the soul of what was arguably the most important American family of the 20^th century.

BE COOL

The struggle for healthcare reform is a tough one. Victory is almost in sight and I'm not anxious to have anyone give up, but I have to confess, I’m getting a little tired of broadcast bullies ... on both sides.

Rush Limbaugh, Glen Beck, and Bill O’Reilly have, expectedly, proclaimed any attempt at healthcare reform to be socialism, pure and simple, joining together in a full-throated chorus of The Russians are Coming. However, they are not alone.

Lawrence O’Donnell, one of msnbc’s best and brightest stars, interviewed Rep. John Culberson (R. Texas) today on Hardball, though it was less of an interview than an ambush. As I have seen him do on other occasions, he specifically orchestrated the segment in such a way as to make the interviewee look like a fool. In this case, referring to comments from one of the town hall meetings about returning the country to the original intentions of the founders, O’Donnell asked Culberson if, given the opportunity, he would vote to repeal Social Security, which is, by definition, a kind of socialistic program. Needless to say, that question has no good answers: if the congressman says yes, he will be voted out of office by angry constituents; if he says no, he can’t claim opposition to healthcare reform because it’s socialistic. The question is a set-up.

Worse than that, O’Donnell badgered the congressman, refusing to allow him to explain his position, demanding that he answer the impossible question, and denying him any modicum of respect due to a national legislator. Chris Mathews, for whom O’Donnell was sitting in, often does the same.

I happen to like Lawrence O’Donnell. He has a deep well of experience, both in journalism and government service and is obviously smart. But that’s no excuse for incivility and rudeness. And just in passing, where has all this aggressive journalism been hiding for the last eight years? Where were these tough guys when George W. Bush was lying us into a war and emptying the treasury into the front yards of the nation’s wealthiest people? The national press corps was shamefully silent when it counted most.

Healthcare reform is a desperately important issue, which, if passed, could help propel this nation toward a more positive future. Both advocates and opponents would do well to take their cue from the president, who, despite the weighty implications of the outcome – for the nation and for his presidency - has somehow found a way to maintain his cool. Come on – that’s cool?

SINGLE PAYER

I like to listen to Thom Hartman on the radio at 1150 AM. Among his major talking points is his affinity for the single payer insurance system. Being a pretty savvy guy, politically, I was way too embarrassed to admit that I had no idea what that was. Here's a definition I found on the internet. Seems reasonable to me. You decide.

What is Single Payer?

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs. In the current US system, there are literally tens of thousands of different health care organizations—HMOs, billing agencies, etc. By having so many different payers of health care fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.) In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

Access and Benefits

All Americans would receive comprehensive medical benefits under single payer. Coverage would include all medically necessary services, including rehabilitative, long-term, and home care; mental health care, prescription drugs, and medical supplies; and preventive and public health measures.

Care would be based on need, not on ability to pay.

Payment

Hospital billing would be virtually eliminated. Instead, hospitals would receive an annual lump-sum payment from the government to cover operating expenses—a “global budget.” A separate budget would cover such expenses as hospital expansion, the purchase of technology, marketing, etc.

Doctors would have three options for payment: fee-for-service, salaried positions in hospitals, and salaried positions within group practices or HMOs. Fees would be negotiated between a representative of the fee-for-service practitioners (such as the state medical society) and a state payment board. In most cases, government would serve as administrator, not employer.

Financing

The program would be federally financed and administered by a single public insurer at the state or regional level. Premiums, copayments, and deductibles would be eliminated. Employers would pay a 7.0 percent payroll tax and employees would pay 2.0 percent, essentially converting premium payments to a health care payroll tax. 90 to 95 percent of people would pay less overall for health care. Financing includes a $2 per pack cigarette tax.

Administrative Savings

The General Accounting Office projects an administrative savings of 10 percent through the elimination of private insurance bills and administrative waste, or $150 billion in 2002. This savings would pay for providing medical care to those currently underserved.

Cost Containment

The Congressional Budget Office projects that single payer would reduce overall health costs by $225 billion by 2004 despite the expansion of comprehensive care to all Americans. No other plan projects this kind of savings.

Different Perspectives on the Benefits of Single-Payer

Patients

Each person, regardless of ability to pay would receive high-quality, comprehensive medical care, and the free choice of doctors and hospitals. Individuals would receive no bills, and copayment and deductibles would be eliminated. Most people would pay less overall for health care than they pay now.

Doctors

Doctors’ incomes would change little, though the disparity in income between specialties would shrink. The need for a “wallet biopsy” before treatment would be eliminated; time currently wasted on administrative duties could be channeled into providing care; and clinical decisions would no longer be dictated by insurance company policy.

Medical endorsements include PNHP (9,000), the American Public Health Association (30,000), American Association of Community Psychiatrists, Massachusetts Academy of Family Practice, American Medical Women’s Association (13,500), Alameda-Contra Costa Medical Society, American Medical Student’s Association, D.C. Medical Society, National Medical Association (6,500), American College of Physicians (Illinois Chapter), Long Island Dermatological Society, Islamic Medical Association, American Nurses Association, the Nurses’ Network for a National Health Program, and the D.C. chapter of the American Medical Association.

Hospitals

The massive numbers of administrative personnel needed to handle itemized billing to 1,500 private insurance companies would no longer be needed. A negotiated “global budget” would cover operating expenses. Budgets for capital would be allocated separately based on health care priorities. Hospitals would no longer close because of unpaid bills.

Insurance Industry

The need for private insurance would be eliminated. One single payer bill currently in the House (H.R. 1200) would provide one percent of funding for retraining displaced insurance workers during its first few years of implementation.

Business

In general, businesses would see Single Payer limit their health costs and remove the burden of administering health insurance for their employees.

Congress

Single payer would be the simplest and most efficient health care plan that Congress could implement.

Ding-a-Ling

The bells are ringing for American journalists Laura Ling and Euna Lee. Convicted of hostile acts and sentenced to 12 years hard labor in North Korea, their sudden release was facilitated by former President Bill Clinton. Though his trip to Pyongyang was said to be “private,” a lot of back room diplomacy went into the deal and a lot of positive political capital came out. Aside from the obvious – two American women don’t have to spend 12 years digging ditches and eating Korean food - the Obama administration gets big points for acting like grown-ups, concerning itself more with potential human tragedy and less with potential political fallout; Clinton gets to buff up his somewhat tarnished legacy and wipe some of the shmutz off his reputation; and the American people get a happy ending, for the first time in a long time.

Predictably, just beyond the celebratory sound of church bells, the gloomy chant of Republican monks fills the airwaves. “It’s a disgrace! It’s humiliating! We’re rewarding North Korea for bad behavior!” Chronic commentator Pat Buchanan characterized the rescue as Kim Jong-il “whistling up” a former US president and forcing him to apologize. Whether or not Clinton actually apologized – the North Koreans say he did, Clinton says he didn’t – Buchanan and his friends see international diplomacy as a day at the O.K. Corral: if you don’t walk in shooting you just ain’t American enough. Which is so George W. Bush league.

I am equally sure that these two women were in North Korea illegally and that their trial and sentencing were pure political theater. That said, I am thrilled that they are out and that we finally have a someone in the White House who understands the meaning of the word “mench.”