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Stop the Health Care Hysterics
Alex Brandon / AP Photo
No matter what critics say, health-care reform isn’t in trouble yet. Former Clinton budget official Matt Miller says after the bill gets through Congress, Obama’s role and rhetoric must change.
Business-minded Democrats and Republicans are apoplectic over the emerging House health plan because it funds expanded coverage with stiff new taxes on business, as well as surtaxes that could lift marginal rates on high-earning Americans toward the high 50s. For their part, liberal Democrats are apoplectic that the all-important Senate Finance Committee (fresh from a White House powwow Thursday with the President) is throwing the public option overboard, which they view as the litmus test for serious reform. If I hear anyone else explode over what they see as the fatal flaws of what’s happening on health care, I may go apoplectic myself. Which is why my advice to well-meaning zealots of every stripe is to chill. The truth is that everything that’s taking place right now is irrelevant.
Why do I say this? Whatever your leanings, if (like me) you’re hoping for some kind of major health reform this year, the crucial text at this juncture is from Schoolhouse Rock—where that famous old ditty, “I’m Just A Bill,” lays out how a bill becomes a law. We’re at the point in the process where this is literally all that matters. For health reform to happen this year, something has to pass the House, and something has to pass the Senate. It doesn’t matter exactly what those somethings are, or how offensive big chunks of those somethings may be to some of us. Never forget that when the Clintons convulsed the country over health care in 1993 and 1994, these simple Schoolhouse Rock steps never came close to happening. For all the drama back then, nothing came to a vote.
Even if his poll numbers are a bit tarnished, does anyone really want to bet against Obama seizing the presidential megaphone and making health care reform compelling?
Only after something passes the House and the Senate will the real work begin. The conference committee to hammer out a final, identical bill will be the mother of all summits. That’s where President Obama must weigh in heavily to shape and then sell the outcome. Contrary to all the carping, what he and the White House do before then on the specifics of the legislation doesn’t much matter. The White House’s only job until we get to conference is to shape the climate of opinion with one simple end in mind. Legislators need to get the message that their constituents want “change” on health care, and will punish them for supporting the status quo. The White House’s mission is to be sure that enough legislators feel they cannot safely oppose Obama’s definition of “change.” That’s it. (It’s also a tall enough order, what with organized conservative protesters having the early edge in disrupting town hall meetings as lawmakers head home for recess).
You can’t channel surf on cable these days without seeing pundits who insist that: 1) Obama has over-learned the lessons of Clintoncare; 2) ceded too much power to Congress; and 3) blown it by not detailing what he wants in a final bill at this point. These folks don’t know what they’re talking about. The nattering nabobs of an earlier era would have likewise slammed Abraham Lincoln when he said, apropos of his general outlook, that “my policy is to have no policy.” But Lincoln knew a thing or two about political leadership. Within general parameters (pro-slavery or anti-slavery, pro-health reform or anti-health reform), a president’s job is to preserve enough flexibility to get the results he seeks while carrying most of the people along with him. A studied ambiguity as events unfold is indispensable to this task, and Obama intuits this just right.
Once we get to conference, however, Obama’s role must change. That will be the moment. That’s when he and his team have to knock heads, crafting a deal that covers everyone, funds this in economically rational ways, and slows system-wide cost growth. As importantly, that’s when Obama must move from Rose Garden jawboning and press conference talking points to a riveting series of speeches on health care that will rival his race speech during the campaign. He needs to take the issue to an entirely new level of adult conversation, frame the case for “change” versus “the status quo” in ways that empathize with the fears and aspirations of all sides, and show why the path he’s forged is good for average Americans and a fit with the journey the country has been on since its founding. Only Obama can provide the macro political framing and cover and energy that at the end of the day (around Thanksgiving) gets a majority of legislators to transcend their own preferred versions of reform and agree to act.
Even if his poll numbers are a bit tarnished, does anyone really want to bet against Obama seizing the presidential megaphone and making this compelling?
Between now and then, everyone should take a deep breath. The talking heads have to fill up air time, but the rest of us should remember: until we get to conference, it’s all prelude.
Matt Miller is a management consultant, a senior fellow at the Center for American Progress, and the host of public radio’s popular political week-in-review, Left, Right & Center. His new book is The Tyranny of Dead Ideas.
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melissamsouza
Perfect--right on the money. The so-called egomaniacal "pundits", who have to advance their careers and earn their paychecks, are really much ado about nothing. They have to babble endlessly, finding faults and flaws everywhere, blaming this and that, attacking the President, and doing a terrible job of informing the public, and a wonderful job of misinforming everybody. The Progressive allies of the White House haven't been of much help either; I've said in this and other blogs that they are doing a lousy job of clarifying the issue for the public and framing it in an intelligible way, which should be in four parts: what the status quo is and why it is unsustainable, the amount of suffering it is causing millions of people, which steps are required to change it and, especially, how this change will NOT in any way be anything equivalent to socialized medicine, forced euthanasia, etc. In other words, debunk, completely, the lies put out there by the right-wing fringes. Instead these grassroots Progressives go off and attack Democrats for not supporting the public option. Well, the public at large seems to be splitting on the need for reform itself, let along this or that option. This is because they are confused, and the fringes are scaring everybody mad. I agree with you completely that the President is a masterful salesman, but if he doesn't have the public behind him by the time the bill goes to conference, it will be tough to get decent reform through. The Master Salesman needs assistance--his grassroots allies need to do a better job for him.
S-von-K
I agree! Obama will pass a sweeping Health Care Bill and it WILL have a public option. News is conflict. If there is no conflict, news will create it....
SvK
Ritarita
Obama needs an agent.
He needs to launch an all-out
PR campaign to combat the disinformation
Being spread by the insurance companies
Through Republican shills.
Fear and panic are powerful tools.
Plantagenet
Obama needs a mathematician
To help him count
He ALREADY has the votes
In the House and in the Senate.
The democrats were elected to Congress
To do healthcare reform...
Obama promised every American
the same healthcare Congress has
---Why won't the dems deliver it now?
AlanD2
Plantagenet: Because some Democrats are RINOs kicked out of the Republican party because they were too moderate. (Rush Limbaugh can't stand anything remotely resembling moderate.)
These "Blue Dog" conservative Democrats need a lot of coaxing to get on board. I suspect that the Town Hall riots organized by conservative groups and corporations will increase blue dog support for health care reform.
Chuckv
Both Miller and melissamsouza are right. I would like to point out a fallacy that underlies much faulty thinking--and not only by pundits. This is to assume that present trends will continue. Obama's poll numbers are falling so they will keep falling. If he fails at heath care reform, he will fail at everything else. Things change in unexpected ways. Many people thought the senior Bush was unbeatable after Desert Storm; but he was brought low by the economy. Sometimes it is just too early to make a prediction. Many people, including Horace Greeley, thought the Civil War lost after the battle of Bull Run. People change. Rumsfield, and McNamara before him, seemed like competent choices for Secretary of Defense on the basis of their track records.
Of course somethings are pretty certain, at least in the relatively short run. The President will remain extremely intelligent, articulate, reflective, and flexible. Not qualities you want to bet against.
I do have some sympathy for pundits. They would not keep their jobs long if all they said was: "I don't know. Beats the Hell out of me."
Granite
Thanks for the calming, soothing message. I can't take any more of the hysterics surrounding health care reform. (Palin and her "death panel" comment were the last straw).
I just want health care to be reformed so those for it can celebrate in the streets, and those against it can lock themselves in their bathrooms and cry.
Natural-Selection
They will sit in their bathrooms and cry when the cost burden is shuffled down from the so called rich to the middle class as well. The crying will be because they will lose their houses now do to their net income margins shrinking. We'll have another housing bust as soon as the middle class tax lie is uncovered.
clubed60090
You are willfully ignorant of what the current system will cost us if we don't change it. Just like climate change, all of your shouting and crying that it ain't true doesn't change the reality that the insurance lobby is doing their worst to keep their cash cow to themselves. We pay for that. We pay for everyone who uses ERs because they don't have doctors. We pay the insurance companies who have an exclusive, and un-governed control over who is entitled to health care and who is denied coverage to feed their own profit line and not the well-being of the patients. You may believe the BS pushed out there by Insurance company CEOs and former Republican staffers pretending to be 'regular people' but I don't, and anybody who is not so twisted in their own fear and delusion over a black man being President isn't taken in by the stupid lies of the hate-mongers on the political 'right'. The supreme irony in American politics is that the myopic, fear based, I'm better than you people who only want democracy for themselves and not everyone are known as 'the right' when they are actually the most destructive, wrong, selfish and undemocratic people in America.
This comment has been removed by The Daily Beast's editors.
AlanD2
Natural-Selection: All other industrialized countries have better health care systems than ours but spend less than half as much per capita as we do.
Are you assuming that Americans are too stupid to accomplish what every other industrialized country has done?
flyoverland
An exercise in wishful thinking by a man who has obviously been on vacation from the real world for the past two weeks.
AlanD2
flyoverland - An exercise in wishful thinking by a man who has obviously been on vacation from the real world since November 4th, 2008.
dana64
the past 2 weeks mean only one thing..............that the shouting BULLIES in town halls are desperate and mad.
Ronym5
We need a public option regulation alone won't do it.
Want proof take a look at FDR.
Social Security still around and the GOP can't touch it.
FDR's banking regulation destroyed back in the 90's and it lead to big to fail banks to this financial collapse.
dana64
Mr Miller...........thanks for your hopeful post......the criticism has become so MEAN and atrociously FALSE.
we will wait till thanksgiving
There should be 2 bills......
1- Health insurance REGULATIONs so they are TRANSFORMED into NON-PROFIT .
that will give those who have insurance enough goodies so they do not FEAR and accept that they GOT A VERY GOOD DEAL indeed.....!
perhaps then , they will feel sorry for those who do not have health nsurance.
2- The public option is really necessary....
3- BUT PEOPLE should also take more responsibilty for keeping healthy and we all should adjust to the REALITIES of SUPPLY and DEMAND
MsMarple
I've been saying the same thing for weeks to people upset about how things are going. Nothing's settled, and President Obama has said he will not sign anything without a public option plan in it. Those are the only two things you can say about the emerging legislation.
neverlate
As someone who will be asked to fund yet another unsustainable entitlement I hope you are wrong and this whole misadventure goes down in flames.
clubed60090
And just what do you think it will cost you and society if there are not programs like medicare, medicade, social security and oh, a public health option? Hmm, people who talk like you seem to forget that we're all in this together - and if you don't pay for it in one way, you will pay for it in another. Personally, I much prefer a decent, humane and intentional way to pay for our society over the chaos that allows millions to suffer, millions to pay anyway and a few fat cats in charge of the big corporations to build their fortunes on the backs of the rest of us. You are deluded and selfish to think that not doing anything is a better option.
JohnnyAces
Many of us wish we could have the same "problem" as you neverlate. If I am ever so lucky as to make it to the top tax bracket I promise you I will be more than happy to help those less fortunate get health care for their families. It would be the least I could do to pay back this great nation that made it possible for me to reach such heights. In fact I'm already willing to so at a middle class status. That said perhaps I am being unfair. Perhaps I don't understand your specific situation as far as your struggles and sufferage as a wealthy American. Please enlighten me.
dana64
if you do not accept this healthcare reform.................people will go in the streets in 2010 and throw all those who opposed this .
Do you think people are going to vote republican??
THE GREEN PARTY will have an opportunity to win big !
Margot62
As someone who is very familiar with socialized medicine, I hope the American people will take their country back and fight against this. It seems like a wonderful idea on paper, but the reality is that anything that government controls becomes a beauracratic nightmare.
If you want to see what socialized medicine looks like, go visit a VA hospital. There's government-run health care in action.
clubed60090
Hey McFly - the bill is not socialized medicine. The bill does NOT take away the right to private insurance. You and your ilk carry signs like 'congress give us your health care' and demand your social security payments and your medicade and have the gall to complain about government run health care and rail against what you call 'socialism'. You are so lost in your own myopic fears you can't see or won't admit your own hypocracy.
mcmchugh99
If it were socialized medicine, they would have a plan for the Public Health Service to take over the hospitals and put the doctors on the government payroll. There is no such plan, only a provision to provide more aid to public hospitals and clinics--which are the institutions that already treat the poor for free. there already is a plan to expand Medicaid to cover that, but no one is saying much about it since it is not very controversial.
This whole thing probably could have been sold much better as a plan to expand Medicare, Medicaid and public hospitals to cover the uninsured--whatever the real numbers are. These hospitals already cover illegal immigrants as well, since the law and the Hippocratic Oath require that anyone who needs medical care must receive it.
Ritarita
Margot-
You're not helping
By being so poorly informed.
AlanD2
Margot62: The government already controls over 60% of our nation's health care - Medicare, Medicaid, and VA health care. The people in these programs are much happier with them than they were with private health insurance.
I am a retired veteran that uses VA health care. The VA hospitals are fine, the care I get is great, and the people who work there are wonderful. The doctors (and other staff) are salaried, so they are in no rush to hurry you up and get on to the next patient.
These government-run programs have less than 1% overhead, so taxpayers are not on the hook for profits, CEO bonuses, advertising, and lawyers to fight claims by members. If you are using private insurance, anywhere from 30% to 50% of your (or your company's) health care premiums go to these things - and not to take care of you when you are sick.
Think about this, and stop listening to Fox News.
GPatton
Hope they do a better job on Obamacare than they've done on financial reform and the um, porkulus bill. George Patton
byersl
You do know that GP suffered from narcissism, right?
AlanD2
GPatton: You do know, of course, that a lot of the problem with the stimulus bill was that it was too small. Its effects are already being felt with less than 10% of the money spent so far. Things will really pick up over the next two years as big projects finally get funded.
Had Republicans and blue dog Democrats not fought against it so hard, this country would be in better shape now.
As to financial reform, it is being fought against by the same Congressional members, who are owned by financial corporations. And the financial CEOs make millions of dollars in bonuses this year? Republicans, of course.
Ritarita
It will get through.
Because the GOP
Is about to burst into flames.
We proved during the election
That we have a measure of common sense
As a Nation-
Even if Idiot Nation is grabbing
All the headlines.
Carole65
"Dissent is the highest form of patriotism", said historian, Howard Zinn in his opposition to the war in Iraq in 2003. The Dem's burst into flames (not).
The Idiot Nation marches on
prettyscary1
WHY WHY WHY would anyone want the government to run health care??? its INSANE
whirligig
WHY WHY WHY would anyone think that this is what obama has proposed?
clubed60090
Thanks to Medicare and Medicade - oh, government run health care, my mother is alive today because they funded the heart surgery she needed and the nursing home care afterwards until she could return home. Thanks to the VA, my brother, who was wounded in Viet Nam, is alive today. Thanks to private health care, I know 2 people who are on the verge of bankrupcy, and I know one person who cannot get the shots he needs to manage a condition he has as a result of an injury while he was working at an undercover policeman. Hmm, which of these is INSANE?
AlanD2
prettyscary1: Would you rather have insurance companies running health care, as they do now? Testifying under oath at a congressional hearing in June, executives of three of the nation's largest health insurers, when asked if they would give up rescission (the canceling of a health care contract) , all replied "No." More from this hearing:
"An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period."
WHY WHY WHY would anyone want insurance companies to run health care??? its INSANE
dana64
we just want a PUBLIC OPTION..............you can have whatever your wallet allows you to buy!
GOVERNMENT IS NOT A DIRTY WORD !!
you tried for 30 years ...........ENOUGH
byersl
Is there nowhere to escape the rabid right? Thank you for a thoughtful comment on what is happening--those of us in DC know this of course, but in the meantime I hope no one is hurt by the people that are blowing up the town hall meetings. I'm all for protest, but the meetings are meant to be discussion--you want to yell and rant, go outside. They are sorry losers and can't stand what we on the left know: there will be health care and insurance reform. We are the majority, we won the election, we will support our President, while the right stamps their feet like petulant children.
donjay41
My last best friend just up and died of a heart attack. He probably had a treatable condition, but could not get health insurance from any public health care service because he had a cancerous tumor removed over 25 years ago and therefore had a pre-existing condition. Everybody should have acccess to affordable health care; even stupid Republicans should be able to see that. John Stwerat Mill once said, "Allthough not all Republicans are stupid, most stupid people are Republicans.
AlanD2
donjay41: Do you mean he could not get private insurance? As far as I know, anyone eligible for Medicare gets it, regardless of any pre-existing conditions.
mcmchugh99
We progressives have compromised quite a bit by not going all-out for the single payer system--although it looks like it may be allowed on the state level. I have always favored giving the states the right to adopt the system they prefer, whether cooperatives, single payer or the public option/insurance exchanges. Let the South opt out of it totally if they don't want it.
We progressives don't get much credit for being to willing to compromise on the thing we most wanted, just for the sake of passing a bill.
We are certainly not the ones running around trying to close down the town hall meetings, and I hope the Right has gotten the message that we are not going to sit still for that. We will call out the labor unions to protect these meetings, and they people will not be gentle with anyone trying to shut them down. Labor wants health care reform, and they do not like the Republicans.
I do not mind anyone disagreeing with the president, since I disagree with him myself from time to time, but I do not approve of anyone trying to shut down the whole debate and refusing to let our side have its say.
I should add that we progressives are not the ones screaming about how the president wants to exterminate the elderly and disabled children. Let's not forget who the bad guys really are here--the ones who would do anything to eliminate the public option and require that everyone just buy private insurance.
dana64
BRAVO PROGRESSIVE..............you make sense
exploora
This disrespect for the opposition I think should be seen as a warning sign.
The same thing with the Madoff case, there were around 8 red flags, and all ignored, or appeared to be ignored by SEC.
The issue with over prescribing/ forcing anti phsychotic drugs on to seniours, especially those who are diabetic and have or perceived to have dementia, and sudden death, is sort of being ignored too,
When my mother died, I never heard from her doctor. I had so many questions. It was the nurse who told me my mother died in her sleep, and on the death certificate it said died from diabetes and Alzheimer.
No mention of anti-psychotic drugs, that mother was complaining about to me at the beginning that something they were giving to her was making her feel funny, and when I asked the nurse, she told me what my mother was taking, but I couldn't get hold of the nursing home doctor to ask how safe it was or why they were giving them to her.
So don't think this fear is not based on some truth.
AlanD2
exploora: Why didn't you look up the medicine on the web? There is lots of information available out there, although you do have to figure out which sites are reliable.
I would also ask why you didn't put more effort into contacting the doctor. You could surely phone, e-mail, or even visit his or her office.
cbeenthere
exploora
Nursing home care is another issue. But the good news is the proposal for discussions with doctors in regard to end of life issues. You and your mother did not have this discussion which made it so much more painful for you. I am sorry, but please let's be grateful that it may not continue for others, and mindful of the reaction of some to this very healthy proposal which has been damned and distorted by those who oppose reform.
exploora
Diabetic seniors who take antipsychotic drugs at higher risk of high blood sugar level
Provided by: The Canadian Press
Written by: THE CANADIAN PRESS
Jul. 27, 2009
TORONTO - New research shows that seniors with diabetes who are given antipsychotic drugs to control the symptoms of dementia have an increased risk of ending up in hospital with potentially dangerous high blood sugar.
A study found older diabetics newly treated with an antipsychotic medication were 50 per cent more likely to be hospitalized for high blood sugar compared to those who were not taking one of the drugs.
Principal investigator Dr. Lorraine Lipscombe of Women's College Hospital says the greatest risk appears to be right after a patient takes the first prescription for the drug to control behavioural symptoms.
The Toronto diabetes specialist says that if antipsychotic drugs are prescribed, families and health-care providers should pay close attention to signs of rising blood sugar.
Those signs include increased thirst and urination, lack of appetite, as well as confusion and diminished consciousness.
Some antipsychotic drugs already carry safety warnings because research has linked them to an increased risk of stroke and death.
The study by Women's College Hospital and the Institute for Clinical Evaluative Sciences is published in this week's issue of the Archives of Internal Medicine.]
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5:13 pm, Aug 8, 2009
exploora
There are abuses related to medical care and seniours. Especially for seniours who are/or percieved to have dimentia, who are being placed on anti spychotic drugs, to control them. This was a big issue in Ontario.
re: [includes voluntary discussions of living wills, power of attorney, or the decision to reject "extraordinary measures of life support."]
One nurse told me what my mother was on, but her doctor never gave me information. She died in her sleep, and another doctor said that was the best thing which could have happened.
So that is a legitimate fear people have, and possibly is being exploited.
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Message Board :: View message - Overpresribing anti psychotic drugs in ...
Overpresribing anti psychotic drugs in Ontario nursing homes ... Ontario nursing homes are too quick to give vulnerable seniors antipsychotic drugs to keep ...
www.alzheimer.ca/forum/viewtopic.php?p=13042 - 35k - Cached
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Antipsychotic drugs being dispensed more often: Study
Other seniors in Canada may pay for prescription drugs out of their own pockets, ... One study from Ontario for example, showed that about 55 per cent of senior ...
working.com/health/Antipsychotic drugs being dispensed more often/... - 70k - Cached
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CBC News In Depth: Seniors and Drugs
... 2005 about the dangers of prescribing anti-psychotic drugs to seniors with mild ... A U.S. ad featuring an Ontario woman who spoke out against the Canadian health ...
www.cbc.ca/news/background/seniorsdrugs/off-limits.html - 40k - Cached
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Dangerous drugs continue to be prescribed to seniors: CBC report
... are continuing to prescribe drugs dangerous to seniors in spite of government warnings, ... They shot up in six provinces, including in Ontario and Quebec. ...
www.cbc.ca/health/story/2007/12/17/dangerous-drugs.html - 40k
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London Free Press - Canada & World - Use of anti-psychotic drugs in ...
Use of anti-psychotic drugs in seniors rising. HEALTH. By THE CANADIAN PRESS ... P.O. Box 2280, 369 York Street, London Ontario Canada N6A 4G1 ...
lfpress.ca/newsstand/News/CanadaWorld/2008/08/26/6572261-sun.html - 40k
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Hamilton Spectator - Variables.page:description
Seniors overprescribed anti-psychotic drugs, study suggests. Helen Branswell. The Canadian Press ... the study looks at Ontario data only, senior author Dr. ...
www.echoworker.com/articles2/seniors2.htm - 10k
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Anti-psychotic drug use in seniors on rise: study
Anti-psychotic drugs are increasingly being prescribed to senior citizens to treat symptoms of dementia, ... that more seniors are taking drugs with serious ...
ottawacitizen.com/Anti psychotic drug seniors rise study/1776008/... - 93k - Cached
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Seniors Health, Diet, Nutrition & Fitness - Medbroadcast
... on the latest issues of seniors' health, nutrition, fitness, and illness. We ... about "widespread" use of anti-psychotic drugs in nursing homes but Ontario ...
medbroadcast.com/channel_health_news_details.asp?...&relation_id=0 - 125k - Cached
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Anti-psychotic drugs linked to deaths
Seniors. Family & Child. Men. Women. Travel. Middle East ... 000 Ontario patients living in the community and 20,000 in nursing homes, from 1997 to 2004. ...
www.canada.com/story.html?id=7a11406c-f6db-43b1-a9d2-9fd7e836323b - 94k - Cached
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Lethbridge Herald - Diabetic seniors who take antipsychotic drugs at ...
A large study of older Ontario diabetics found that those who were newly treated ... treatment of choice for psychotic behaviours in people with schizophrenia ...
www.lethbridgeherald.com/content/view/80380/38 - 38k - Cached
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