It’s becoming pretty clear how Republicans plan to defend their budget. They’re going to lie about it.

via How Will Republicans Defend Medicare Cuts In The Ryan Budget? Lie About Them. Marco Rubio Shows How. | The New Republic.

I’d like to be shocked and appalled by behavior like that, but it’s been the standard go-to play in the GOP for way too long to be surprised.

I thought this might be a promising approach that lends itself to bipartisan support:

I meant to write about this the other day, but Peter Orszag’s proposal for medical-malpractice reform is pretty clever. As I read it, in fact, it’s not primarily a malpractice-reform proposal at all. It’s a proposal for spreading evidence-based medicine through a vehicle that conservatives and doctors find congenial…

… Instead of protecting doctors from lawsuits by capping damages or limiting the ability of plaintiffs to sue, you could protect them by charging the American Medical Association or the Institute of Medicine with creating standard lists of best practices and then providing immunity to doctors who can show they followed them. That’s easier said than done, but if you could manage it, it would give doctors a reason to follow the best practices and, in theory, drive down overall health-care costs. That would be much more effective than just attacking malpractice suits, which aren’t a large contributor to spending and are often quite warranted.

As Ezra mentions the GOP hated the very sound of  “evidence based medicine” during the health reform debate. I guess it smacked of too much pointy headed book learnin’ gettin’ in the way of good ol’ fashioned faith healin’. Praise Jeebus! Anyway, giving real incentives to physicians and surgeons to follow scientifically derived standards of practice, rather than the “seat of the pants” method that’s stood since Hippocrates sounds like an improvement that has the potential to improve care and lower costs.

It’s a very nice review of actual data and econ journals on the effects of tort reform.

To summarize: very, very little. It appears to be a politically motivated red-herring designed to punish a left leaning constituency. Nothing more, nothing less.

Texas makes a lovely example, the net of capping damages at $250,000 was essentially undetectable.

What has been really striking has been the eliminationist rhetoric of the G.O.P., coming not from some radical fringe but from the party’s leaders. John Boehner, the House minority leader, declared that the passage of health reform was “Armageddon.” The Republican National Committee put out a fund-raising appeal that included a picture of Nancy Pelosi, the speaker of the House, surrounded by flames, while the committee’s chairman declared that it was time to put Ms. Pelosi on “the firing line.” And Sarah Palin put out a map literally putting Democratic lawmakers in the cross hairs of a rifle sight.

All of this goes far beyond politics as usual. Democrats had a lot of harsh things to say about former President George W. Bush — but you’ll search in vain for anything comparably menacing, anything that even hinted at an appeal to violence, from members of Congress, let alone senior party officials.

No, to find anything like what we’re seeing now you have to go back to the last time a Democrat was president. Like President Obama, Bill Clinton faced a G.O.P. that denied his legitimacy — Dick Armey, the second-ranking House Republican (and now a Tea Party leader) referred to him as “your president.” Threats were common: President Clinton, declared Senator Jesse Helms of North Carolina, “better watch out if he comes down here. He’d better have a bodyguard.” (Helms later expressed regrets over the remark — but only after a media firestorm.) And once they controlled Congress, Republicans tried to govern as if they held the White House, too, eventually shutting down the federal government in an attempt to bully Mr. Clinton into submission.

Mr. Obama seems to have sincerely believed that he would face a different reception. And he made a real try at bipartisanship, nearly losing his chance at health reform by frittering away months in a vain attempt to get a few Republicans on board. At this point, however, it’s clear that any Democratic president will face total opposition from a Republican Party that is completely dominated by right-wing extremists.

via Op-Ed Columnist – Going to Extreme – NYTimes.com.

Bush can pass tax cuts guaranteed to lead us down the road to fiscal suicide, while enriching the wealthiest and he’s a hero to the GOP. Obama passes HCR which actually reduces the deficit while helping millions and the death threats fly. The true (evil) genius of the right is in convincing workaday Americas to vote against their economic interests over and over. My favorite recent example is this Militia Leader who was calling for breaking the windows of Democratic offices:

Vanderboegh, who lives in the Birmingham suburb of Pinson, described himself as a “Christian libertarian” and said he has long been a gun rights advocate. He said he joined a clandestine militia group called the “Sons of Liberty” and later became a public leader of the First Alabama Cavalry, Constitutional Militia..

…Vanderboegh said he once worked as a warehouse manager but now lives on government disability checks. He said he receives $1,300 a month because of his congestive heart failure, diabetes and hypertension. He has private health insurance through his wife, who works for a company that sells forklift products.

I guess he doesn’t see the irony. What the hell is a “Christian Libertarian” anyway? Is that they don’t believe in government intervention unless it’s an attempt to ram their oddly slanted form Christianity down your throat?

To reduce it t a simple slogan “antibiotics are not cough medicine”. Most advanced nations overuse antibiotics to the point of bacteria developing resistance that kills tens of thousands. Norway has developed a common sense approach that works by changing the prescribing habits of doctors, banning advertising of prescriptions and carefully tracking any resistant infections that pop up. We would do well to learn from their example.

They must have checked the pockets of that other pair of pants they were wearing last week and found $2 billion (that belongs to us) it didn’t even remember having. Wow it’s like a miracle! Not to cast aspersions on divine intervention, but maybe it has something to do with a politcal climate and leadership that’s willing to take these guys down to the mat? Funny they weren’t willing to do anything like this when Dubya was in office…

Krugman is concerned that state level spending cuts will counteract federal level stimulus.

But even as Washington tries to rescue the economy, the nation will be reeling from the actions of 50 Herbert Hoovers — state governors who are slashing spending in a time of recession, often at the expense both of their most vulnerable constituents and of the nation’s economic future.

These state-level cutbacks range from small acts of cruelty to giant acts of panic — from cuts in South Carolina’s juvenile justice program, which will force young offenders out of group homes and into prison, to the decision by a committee that manages California state spending to halt all construction outlays for six months.

Governors are panicked and don’t have the ability to engage in deficit spending while capital markets are dried up. They can’t print money like the feds can.

What can be done? Ted Strickland, the governor of Ohio, is pushing for federal aid to the states on three fronts: help for the neediest, in the form of funding for food stamps and Medicaid; federal funding of state- and local-level infrastructure projects; and federal aid to education. That sounds right — and if the numbers Mr. Strickland proposes are huge, so is the crisis.

In the short time it would be wise for the incoming Obama administration to send targeted funds to the states and at the very, very least prevent cutbacks to the very programs that are most needed right now. A better idea would be to help fund and expansion of local infrastructure projects and mend the gapping holes in the social safety net. Health care reform plays a key role here. Medicaid is under funded. Medicare has some long term funding issues that will only be resolved once we begin adressing systemic health care reform.

Perhaps this should be viewed as a good thing for the prospects of true systemic health reform, given of course you personally don’t die of cancer or become disabled by MS because you can’t afford the drugs to treat the illness. When the middle class begins to feel the bite of this kind of profit before people policies forced upon them, perhaps they’ll be a real, broad-based coalition for reform. Insurers and drug companies may have just gotten a little too greedy and I don’t think Montel Williams’ TV commercials will save them.

Jonathan Cohn has the same idea

Ezra wonks out on tier 4 drugs

McCain’s health plan fails her test – Los Angeles Times
Elizabeth Edwards, the wife of former Democratic presidential contender John Edwards, said she and John McCain have one thing in common: “Neither one of us would be covered by his health policy.”

Edwards lodged her criticism of the presumptive Republican presidential nominee’s proposal Saturday at the annual meeting of the Assn. of Health Care Journalists.

Under McCain’s plan, insurance companies “wouldn’t have to cover preexisting conditions like melanoma and breast cancer,” she said.

Compared to other industrial nations the good old US of A ranks 19, out of 19, in preventable deaths. Way to show all those nasty socialist countries that we don’t need their stinking commie health care delivery systems!!!

Krugman takes Obama to task for echoing GOP talking points in defending his health care  plan against attacks by the Clinton and Edwards campaigns. Obama only mandates children have coverage in his plan, not adults.  He sees this as a strength, inveighing against forcing people to buy coverage and punishing those who don’t.

I don’t any serious reform plan should be without a coverage mandate. Without near universality the situation for insurers becomes untenable has those who most need coverage rush to join, while those who are healthy may not. The other option is for the government to simply pay directly for coverage, but I don’t think the special interests that benefit from the current broken system will allow that to happen.

Sliming Graeme Frost – New York Times
All in all, the Graeme Frost case is a perfect illustration of the modern right-wing political machine at work, and in particular its routine reliance on character assassination in place of honest debate. If service members oppose a Republican war, they’re “phony soldiers”; if Michael J. Fox opposes Bush policy on stem cells, he’s faking his Parkinson’s symptoms; if an injured 12-year-old child makes the case for a government health insurance program, he’s a fraud.

Meanwhile, leading conservative politicians, far from trying to distance themselves from these smears, rush to embrace them. And some people in the news media are still willing to be used as patsies.

Politics aside, the Graeme Frost case demonstrates the true depth of the health care crisis: every other advanced country has universal health insurance, but in America, insurance is now out of reach for many hard-working families, even if they have incomes some might call middle-class.

Bush vetoes bill on children’s health care – Yahoo! News
President George W. Bush on Wednesday vetoed a measure to expand a popular children’s health care program, launching the first in a series of major battles with Democrats over domestic spending.
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The legislation would have provided an extra $35 billion over five years for the health program, which is administered by the states. Taxes on tobacco products would have been raised to pay for the increase.

The health bill enjoyed bipartisan support. The veto is likely to anger a number in Bush’s own Republican Party who fear the issue will cost them votes in the congressional and presidential elections.

UPDATE:

McClatchy has more

The Bush administration’s clear choice is insurers:

As I said, it’s hard to see how anyone can, in good conscience, think that preserving subsidies to insurance companies is more important than providing health care for children. But that is, of course, exactly the position taken by the Bush administration, which is adamantly opposed both to any attempt to expand the children’s health insurance program — in fact, the administration wants to cut its reach — and to any attempt to reduce Medicare Advantage payments.

The official reasons given for this position are evasive and dishonest.

Explaining the administration’s opposition to expanding the children’s program, Michael Leavitt, the secretary of health and human services, said the program “should not be the vehicle by which we insure every adult and every child in America.” But that isn’t what the Democrats are proposing.

Evasive and dishonest? Par for the course with BushCo

Additional Notes on 1/22 Column, “Gold-Plated Indifference.” – Krugman – NYT Web Journal

Now here’s the thing: in the name of consumer-directed health care theory, Bush is proposing changes that would essentially encourage people to move into the individual market — which wastes a lot of money, and doesn’t and can’t work for those most in need — while undermining the employer-based system, which isn’t wonderful but is still essential. In particular, healthy high-income people would be encouraged to drop out of employment-based plans, leaving behind a sicker risk pool, driving up rates, and pushing employer-based care in the direction of an adverse selection death spiral. The plan we’re supposed to learn about tomorrow doesn’t sound big enough to have catastrophic effects, but it’s a step in the wrong direction.