Tuesday, March 16, 2010
Democratic leaders say health bill will pass
Democratic leaders scrambled Sunday to pull together enough support in the House for a make-or-break decision on health-care reform later this week, expressing optimism that a package will soon be signed into law by President Obama despite a lack of firm votes for passage.
The rosy predictions of success, combined with the difficult realities of mustering votes, underscore the gamble that the White House and congressional Democrats are poised to make in an attempt to push Obama's health-care plans across the finish line. The urgency of the effort illustrates growing agreement among Democratic leaders that passing the legislation is key to limiting damage to the party during this year's perilous midterm elections.
But House Minority Leader John A. Boehner (R-Ohio) pledged to do "everything we can to make it difficult for them, if not impossible, to pass the bill." He also joined other Republicans Sunday in warning that Democrats would pay for the legislation by losing even more seats than expected in November.
The most optimistic talk on Sunday came from the White House. Obama senior adviser David Axelrod predicted that Democrats "will have the votes to pass this," and press secretary Robert Gibbs declared that "this is the climactic week for health-care reform."
But Rep. James E. Clyburn (S.C.), the Democrats' chief head-counter in the House, cautioned that the party has not yet found the 216 votes needed to win approval of the health-care bill passed by the Senate in December. "We don't have them as of this morning, but we've been working this thing all weekend," Clyburn said on NBC's "Meet the Press." "I'm also very confident that we'll get this done."
Democratic leaders are struggling to assemble support amid opposition to the Senate legislation from conservative Democrats, who object to abortion-related language in the bill, and from liberals, who are disappointed about the lack of a public insurance option and other measures. Obama has postponed a trip to Indonesia and Australia to help whip up support for the package.
Republicans pressed ahead Sunday with a battery of arguments against the Democratic plans, saying that polls show firm public opposition to the legislation and that Senate leaders are using parliamentary gimmicks in an attempt to win final passage. Sen. Lindsey O. Graham (R-S.C.), who has signaled a willingness to work with the administration on immigration and detention issues, said Obama's "arrogant" push for health-care reform has divided the country and threatens bipartisan cooperation.
"When it comes to health care, he's been tone-deaf, he's been arrogant and they're pushing a legislative proposal and a way to that legislative proposal that's going to destroy the ability of this country to work together for a very long time," Graham said on ABC's "This Week."
The Democrats' strategy calls for the House to pass the Senate version of reform, followed by consideration of a package of fixes to that legislation known as a reconciliation bill. The fixes must meet specific budget requirements allowing it to be approved in the Senate with a simple majority vote. The approach avoids having to muster 60 votes to overcome a threatened GOP filibuster; Democrats control 59 seats.
House Democrats expect to receive a final cost estimate by Monday afternoon, when the House Budget Committee is scheduled to vote on the reconciliation package. It would then go to the House Rules Committee, where Chairman Louise M. Slaughter (D-N.Y.) could package it with the $875 billion measure the Senate passed on Christmas Eve. The package is also expected to include Obama's proposed overhaul of the student-loan system.
The full House is expected to vote on both measures by week's end, with the climactic moment coming as soon as Thursday but, more likely, Friday or Saturday, aides said.
An undead corpse
Almost nobody is happy with what Sarah Palin dismisses as President Obama's "hopey-changy stuff," but the worst outbreak of hopey-changy just won't stay dead. The president's health care "reform," regarded as road kill only a month ago, is headed for a close vote in the House that he might still win.
There's abundant evidence that Mr. Obama's toxic agenda seems to be disintegrating before our very eyes. Democrats with a bad case of nerves (this includes most of them) finally admit that Obamacare has "problems," and several Democratic office-holders in Missouri suddenly had business elsewhere when the president showed up for a rally in St. Louis this week. Robin Carnahan, the Missouri secretary of state who is the leading Democratic candidate in pursuit of the Senate seat that Kit Bond, a Republican, is relinquishing, wanted ever so to be there but she had to wash her hair, or buy a stamp, or couldn't find a taxi to get to the airport for a flight home. Or whatever.
Blanche Lincoln of Arkansas, the most vulnerable Democratic incumbent, got roughed up at a tea party and is running now against the Democratic Party. "I don't answer to my party," she says. "I answer to Arkansas." Actually, she slavishly answered to her party until she stumbled into the tea party, and, as they say down on the farm, "got a little religion." Her free fall in the public-opinion polls continues.
The president no doubt feels her pain, since it's similar to his own. A new Gallup Poll finds that the president's approval rating has fallen to 46 percent, against a 45 percent disapproval. Some polls find bad news worse than that. Some Democrats ask bluntly whether Mr. Obama is losing his base. Indeed, the only people more contemptuous of the president than the conservatives are the liberals on the president's left-most flank. A growing number of them, even those who insist on calling themselves progressives, warn - or boast - that they've had it with the messiah of Hyde Park and intend to pay him back in November with the handiest club they can find, i.e., sacrificial congressional candidates.
"The liberal wing of the Democratic Party is now in shock," Chris Bowland of Santa Rosa, Calif., once a community activist like Barack Obama, tells USA Today. "It's very clear that the party hates us and has no respect for [the] base. ... Obama has broken his campaign promises and now, 'We've had it. I'm done.' "
The conventional rap on the president is that he has been aloof and disengaged, reluctant to impose discipline and leadership, and allowed his radical agenda to drift into the congressional swamp presided over by Nancy Pelosi and Harry Reid.
But wait. Maybe he hasn't been so disengaged as the conventional wisdom supposes. His strategy of imposing no discipline on Congress may be a deliberate act of leadership. Barack Obama came to Washington with an agenda from his community-organizing days. He made his bones with Saul Alinsky, the evangelist of radical politics who put down the blueprint for making America over into a European-style welfare state, with commissars empowered to supervise every detail of how Americans would live lives regimented for their own good. The debate over health care reform has been messy and often chaotic, but here we are a year later and Barack Obama and his radical agenda might yet win. If it does, he will have put in place the structure for taking over everything else.
His remark several months ago that he was willing to be a one-term president if that's what it takes to reorder America was dismissed as an irrelevancy, an aside from a man having a bad hair day. But the remark revealed an insight into the man and his mission. Karl Rove, "the architect" of George W. Bush's two successful campaigns, thinks an Obama victory over Obamacare would be a pyrrhic victory, that it might insure a Republican takeover of both House and Senate. Perhaps. But it might be a price that the president is willing to pay to get his structure in place.
The Republicans could come to office determined to repeal the monstrous "reform," but that would be easier said than done. A new Republican Congress wouldn't have the numbers to override a presidential veto. Besides, boldness is not a Republican virtue. The Republican takeover of '94 is not a reassuring omen. Killing the corpse graveyard-dead is easier now.
If the Democrats break it, they bought it
If Obamacare passes this week, every American will rightly blame every problem they have with American medicine in the future on the Democrats.
Every inability to get an appointment with a specialist or even a general practitioner. Every increase in insurance rates. Every incomprehensible bill received. Every pharmacist's refusal to fill a prescription without charge or with the drug called for with the pill actually prescribed by the doctor. And especially every inability to actually get insurance or treatment.
Democrats from the president and the House speaker on down have told us over and over again that Obamacare is the salvation of American medicine. When it turns out not to be, and premiums skyrocket and the supply of doctors dwindles, the ownership of the scheme and the method of its passage -- by partisan trickery after clear expressions of voter will in polling and at polls in Massachusetts, Virginia and New Jersey -- will embed in every voter.
"You break it, you bought it" is a phrase familiar to and accepted by most Americans. Democrats are about to break American health care -- which is extraordinary in the cures it delivers and works quite well for hundreds of millions of Americans -- and they are doing so for partisan reasons.
The consequences of the jam-down, if it succeeds, will reshape American politics. Five Ohio Democratic members of Congress, for example, face a choice this week between the demands of Speaker Nancy Pelosi and the president, and the desires of their constituents.
Zack Space, Charles Wilson, Marcy Kaptur, Steve Driehaus and John Boccieri have districts that range across the Buckeye State, but each of those districts could easily turn red this fall and punish the members who voted for the deeply unpopular Obamacare. Space, Wilson, Kaptur, Driehaus and Boccieri are being asked to vote for the Cornhusker Kickback, the Louisiana Purchase and special deals for Florida's elderly, but not Ohio's. Are they that deeply in Pelosi's pocket?
At least 50 House Democrats, from Tim Bishop on Long Island, N.Y., to Gabrielle Giffords in Tucson, Ariz., are in the same bind, but the Ohio representatives come from a state that is reeling from job loss and is seeing a sharp turn back to common sense, led by the campaigns of John Kasich for governor and Rob Portman for senator. A wave is building in Ohio, and a vote for Obamacare will only increase the exposure of these incumbents.
Rank-and-file Democrats in office all across the country have to be asking themselves, why this rush to self-destruct? Not only will a "triumph" on Obamacare cost the party its huge majorities in both houses in 2010, it will saddle the party with the legacy of damaging American health care that will define it for generations.
This is the sort of risk that has brought other major legislative overhauls forward under bipartisan banners. In recent decades, the prescription drug benefit, No Child Left Behind and welfare reform advanced major change with bipartisan backing from Congress, thus immunizing either party from the political costs of major change.
But those programs were small compared with the massive assault on American medicine reaching its crucial vote this week. If enough congressional arms are twisted and the savaging of American medicine proceeds, it has "Democrat" written all over it. And from that day forward, every tragedy that isn't averted because a doctor wasn't there or a medicine hadn't been developed or a hospital had been obliged to close will be the fault of Democrats who gambled with the lives of Americans even as the country fairly screamed, "Don't do it."
Obama's sick obsession
Nationalized health care is the progressives' Golden Fleece. It is their obsession, the ultimate prize that was denied to previous administrations but is closer than it ever has been. As the ability of government to take over the health care system draws tantalizingly near, the president and leaders of the majority party have become infected with a kind of mania. President Obama and Democratic congressional leaders seem determined to ram through a severely flawed piece of legislation by any means necessary, heedless of the desires of the American people or the negative impact on the system they mistakenly say needs to be saved.
A large majority of Americans are satisfied with their current health care plans, though most also think the system could be improved. Yet proponents of the Democrats' radical health care overhaul brazenly claim the system is irretrievably broken and only radical surgery will save it. According to the latest Gallup poll numbers, less than a fifth of even those who favor health reform agree with that position. The majority of Americans are divided between those who want a scaled-back health care measure and those who want the current project dropped entirely. If any system is broken, it is the legislative process.
Long-time Democratic pollsters Patrick H. Caddell and Douglas E. Schoen warned last week that "the battle for public opinion has been lost" on heath care. Democrats have backed themselves into a corner. If the bill fails, they suffer a defeat. But if they win, they also lose because Democrats "will face a far greater calamitous reaction" in November. "Wishing, praying or pretending will not change these outcomes," they caution.
But the glittering prize is too near for such sage counsel. The liberal leadership is infused with a sense of mission. They are the midwives to history, shepherding landmark legislation that will revise the American social contract and usher in a new era, or some such foolishness. All they need to do is pass the bill, and the poor, frightened, deluded American people will see the wisdom of their decisions. Hence House Speaker Nancy Pelosi's memorable (and revealing) comment, "We have to pass the [health care] bill so that you can find out what is in it." In her imagination, once the bill is signed, voters won't remember the struggle, just the glow of the accomplishment. Rip off the bandage; you'll feel better after the sting.
The Democrats' headlong drive is leading to bouts of political insanity, such as the aptly named Slaughter rule, which potentially could allow the House of Representatives to "deem" the health bill passed without a final vote. That the Democratic leadership would consider resorting to such a stunt betrays a high degree of contempt for the electorate, whom they presumably think will not remember or care that their representatives would not go on the record on such a major piece of legislation.
Disaffected voters, however, will recognize cowardice for what it is. Add to this the Louisiana Purchase, the Cornhusker Kickback, the backroom dealing, special-interest loopholes and fundamental unsoundness of placing government at the center of the health care system, and November will be a slaughter indeed.
Betrayal of 20,000 cancer patients: British rationing body rejects ten drugs (allowed in Europe) that could have extended lives
Up to 20,000 people have died needlessly early after being denied cancer drugs on the NHS, it was revealed yesterday. The rationing body NICE has failed to keep a promise to make more life-extending drugs available. Treatments used widely in the U.S. and Europe have been rejected on grounds of cost-effectiveness, yet patients and their loved ones have seen the NHS waste astronomical sums. Last week it emerged that £21billion - a fifth of the entire annual budget - was spent on failed schemes to tackle inequality.
NICE, the National Institute of health and Clinical Excellence, promised a year ago to make it easier for drugs for rarer cancers to be approved. But since then four drugs which could have benefited 16,000 people have been turned down outright and a further six which could have helped 4,000 more have been provisionally rejected. Just five drugs have been accepted - benefiting 8,500 people - says a damning report by the Rarer Cancers Forum. Drugs for rarer forms of cancer are often much more expensive than those for common tumours because pharmaceutical companies cannot make economies of scale.
NICE's promise to approve more drugs was in response to widespread anger over its rejection of sunitinib, also known as Sutent, for advanced kidney cancer - even though it had been proved to double the life expectancy of patients compared to standard treatments.
Andrew Wilson, chief executive of the Rarer Cancers Forum, said: 'Although progress has been made, there is still more to do. 'It is unacceptable that thousands of patients are still missing out on the treatment they need, and their doctors want to give them, because NICE has decided that their treatment does not meet some arbitrary criteria. 'The changes introduced by NICE should be benefiting more patients than they are. An urgent review of NICE's processes is needed.'
The RCF also says NICE works so slowly that it takes 21 months to decide on a drug, during which time many patients die. This is despite promises from NICE bosses to get the decision time down to six months by the end of this year. Mike Hobday, head of campaigns at Macmillan Cancer Support, said: 'The system is failing people with rarer cancers. It's time for a more flexible approach.'
NICE's treatment of rarer cancer drugs contrasts sharply with its breast cancer drug herceptin, which has received far more funding following successful campaigns. If a patient is refused a drug, they are allowed in many cases to appeal to their primary care trust. But the RCF report uncovered a huge postcode lottery, with some trusts much more likely to back down on appeal. Of 62 PCTs, 11 approved all drugs and two approved none. And while 26 per cent of English patients have their 'exceptional case' requests rejected, the figure in Scotland is just 11 per cent.
The RCF says appeals are so expensive in terms of staff time that it would be cheaper just to give everyone the drugs they want. Its report also warns: 'PCTs are frequently using inappropriate processes to determine funding applications and a small minority of commissioners may be breaking the law by operating a blanket ban on the funding of treatments outside their licensed indication.'
In Bromley, for example, cancer treatments were less likely to be funded than cosmetic procedures. Another difference between PCTs is that some reimburse the cost of any private treatment but others do not.
NICE said last night: 'We have introduced significant additional latitude in appraisal of treatments for cancer, particularly where they are designed to extend life. 'Our End of Life Treatments protocol, introduced at the beginning of 2009, has already made it possible for very expensive cancer treatments to be recommended when our standard approach would have resulted in more cautious guidance.'
British retirees died after 'hospital staff ignored warnings over their conditions'
Two patients died after hospital staff repeatedly ignored warnings over their conditions, including one who choked on his false teeth, nursing chiefs admitted. Staff at Royal Sussex County Hospital, in Brighton, East Sussex, “could have done better” to prevent the deaths of two pensioners last year after failing to follow basic procedures, officials admitted.
After a corner’s damning ruling that staff at the hospital were guilty of repeated mismanagement and miscommunication, officials have made "major changes" [major bulldust, more likely] to nursing care and apologised to the patients' families.
An inquest at Hove Crown Court had heard that Brian Waller, 72, died after falling out of bed in April last year while a month later Edward Warneford, 66, died in the same ward after choking on his false teeth. In her ruling Veronica Hamilton-Deeley, the local coroner, strongly criticised the Brighton and Sussex University Hospitals NHS Trust, and said changes needed to be urgently made.
The inquest last month heard that Mr Waller, who was being treated for heart problems, fell out of his hospital bed despite wearing a wrist band with "risk of falls" written on it. He had landed on his head, broke his neck and suffered a massive bleed on his brain, which led to his death six days later. It was later discovered one of the guard rails on his bed had been left down. A doctor had also allegedly missed the fracture in his neck and cleared him to return to his ward, the inquest heard.
Mr Warneford, a former engineer, from Hove, East Sussex, died because staff did not even realise he was wearing dentures, his sister claimed. April Moss, 62, from Gosport, Hampshire, claimed her brother, who had alcohol problems, then choked on them as he ate, causing him to have a fatal heart attack.
Sherree Fagge, Brighton and Sussex University Hospitals’ chief nurse, admitted on Friday that staff could have done better. "We are however profoundly aware that for both Mr Waller and Mr Warneford we could have done better and we have met with both their families to apologise, listen to their concerns and assure them that lessons have been learned,” she said. "We have introduced some major changes focused completely on the quality of our nursing care. Every week all of our most senior nurses, including myself, are working on the wards undertaking direct patient care alongside front line nursing staff. "What I see … is that the majority of our nurses are working hard and carrying out their duties with the kindness and compassion we would want for our own families.”
Posted by JR at 1:06 AM