On Politco.com’s “Arena,” Rory Cooper, Director of Strategic Communications for the Heritage Foundation recently accused President Obama of lying during yesterday’s press conference.
It is one thing to disagree on how best to reform healthcare, but claiming that the president is telling a bald-faced lie seems to me an unwarranted ad hominem attack . When it comes to being candid, this president has a pretty good track record. (Today he even admitted that he’s a not-quite-reformed smoker, though he never smokes in front of his children.) But I guess if a pundit doesn’t have any ideas about reform, only an ideology, resorting to personal attack (without evidence) is the best he can do. (If I were the subjects of these attacks, I would be tempted to have a once-a-month cigarette too. )
Here is what Cooper had to say: “On Health Care: he was again 'not truthful' about how a public plan won’t eliminate private coverage. Even White House officials ‘suggest his rhetoric shouldn't be taken literally’ on this subject according to AP. Then why continue the lie?” Cooper asks.
I am a contributor to Arena, and so I replied to Cooper’s comment. Below, a slightly revised version of what I wrote:
Who exactly is lying here? Begin with the Associated Press piece that Cooper links to. Even if readers “click” on the link, probably most people won’t read the whole piece. Cooper seems to be counting on that.
Cooper takes the quote out of context. Here is the context:
“White House officials suggest the president's rhetoric shouldn't be taken literally: What Obama really means is that government isn't about to barge in and force people to change insurance. . .” Obviously, President Obama has no control over whether employers decide to drop health benefits. AP goes on to quote “MIT's Jonathan Gruber, a leading health economist . . . ‘His [the president’s] point is that the government is not going to force you to give up what you have, but that's not to say other circumstances won't make that happen.’"
Consider Cooper’s strategy. He appears to be providing evidence; he even links to it. And he seems to be quoting White House officials saying that the president is speaking metaphorically—and not quite truthfully– when he assures us that a public-sector option won’t drive the private insurance industry over a cliff. Except that isn’t what the officials were talking about.
I can remember a time when conservatives made arguments. In recent years, however, they have begun to rely, more and more, on “spin”—distorting what someone else said, and then twisting it to suit their purpose.
More importantly, Cooper totally ignores what the president said about what might cause employees to lose the coverage they have now. If we do not have health care reform that contains costs, many more employers will have no choice but to drop coverage, or hike premiums in the near future –to a point where many employees will not be able to afford the benefit. Without the reforms that Obama proposes—including a public sector option that would set a model for affordable, comprehensive insurance–many more Americans will lose their coverage.
Would a public sector plan drive private insurers out of the business? Not if those private insurers operate efficiently. They will have a hard time competing if they continue to over-spend on CEO salaries (as high as $24 million), lobbying (up 15% to 34% in the first quarter) , marketing and underwriting (deciding how much to charge patients suffering from pre-existing conditions). The good news is that, under health care reform, insurers will no longer be able to demand higher premiums from sick customers; as a result, their underwriting costs should plummet. Then, if insurance companies follow the public-sector model, realigning financial incentives to reward quality rather than quantity, they, too, should be able to steer patients toward the most effective care, lowering costs, and premiums.
As President Obama pointed out in the press conference, to say that for-profit insurers “can’t compete” is to suggest that the private sector just isn’t as innovative and efficient as government. If that is true, all I can say is that taxpayers cannot afford to bail out another industry that can’t figure out how to compete in the 21st century.
Here’s what Source Watch has on the Heritage Foundation:
http://www.sourcewatch.org/index.php?title=Heritage_Foundation
“While corporations provided only $1.5 million – 4% of Heritage’s contributions in 2006 – they none the less have significant interest in the foundations policy output. There’s defence contractors Boeing and Lockheed Martin, finance and insurance companies such as Allstate Insurance, Mortgage Insurance Companies of America, and American International Group (AIG), auto company Honda, tobacco company Altria Group (Philip Morris), drug and medical companies Johnson & Johnson, GlaxoSmithKline, Novartis, and Bristol-Myers Squibb Foundation, oil companies ChevronTexaco and Exxon Mobil, software giant Microsoft, and chipping in over $100,000 each, Alticor (Amway), Pfizer, PhRMA, and United Parcel Service (UPS).”
The list of funders is equally revealing. All the usual libertarian backers are in the list.
The old motto still applies: He who pays the piper gets to pick the tune.
These “pundits” are paid to lie.
Robert–
I’m afraid you are right.
Interesting article, Maggie.
My local newspaper reported recently on North Carolina Senator Kay Hagan’s reluctance to support President Obama on health care because she is concerned about how it will affect the insurance industry (I live in NC, so it’s relevant to me).
It was a frustrating article to read. As you cite the President as saying, if the insurance industry can’t adapt to the effects of a public option, then they shouldn’t be in business and don’t deserve any help from government.
Used to be fire insurance paid the fire fighters to put out the fire in your house. But if your neighbors house burned, they did nothing until it jumped to yours. We did away with that model, and made firefighting a public service. Insurance companies adapted by insurance replacement costs of property.
I don’t see why healthcare should be any different.
Panacea–
Yes, it is frustrating.
And your anaology to fire insurance is apt.
We all hope that we don’t have to use our fire insurance (that our homes don’t burn.) But we all contribute to the pool to help those who are unlucky.
(In an earlier era, in the West, this is what Americans did. If somone’e barn burned down (usually because struck by lighting), everyone in the area came forward to help build a new barn. They all realized “there but for fortune . . ”
First of all, let me say that I am a Democrat who voted for Obama and a physician who favors a single payor system much like Medicare.
Having said that, I think it is likely true that a government funded and sponsored health care plan will take a huge “divot” (and no I don’t play golf) out of private insurance plans and probably drive more than a few out of business. In this respect the Republicans do have a point.
And if I was wedded to Republican ideology; that the private sector always does things better than the government and that competition solves all ills. I too would be upset. But I am not.
From my perspective Medicare is a better form of insurance than private insurance – they pay us better, have fewer silly rules and are less capricious. Personally, I will not mourn the death of private insurers or HMOs (the former darling of various pundits) for that matter.
Legacy–
You write Medicare “is a better form of insurance than private insurance – they pay us [doctors] better, have fewer silly rules and are less capricious”
When I was writing the book, this is what I heard from many doctors.
Even if Medicare paid less, they paid on time, and without all of the phone conversations. It was clear what Medicare paid for.
I am hopeful that a public sector option that followed an imporoved, updated Medicare (and Medicare rerom will happen this year) could be as popular among doctors–especially if it pays pimrary care docs more (which Medicare will start doing this year) and paying bonuses for qualilty, not quantity.
If some for-profit insurers are driven out of business, this is not a tragedy–just as it is not a tragedy when sub-par hopsitals close their doors.
Healthcare is a necessity–we just don’t want sub-par businesses in this industry.
Finally, I’ll admit– I have no idea what a “divot” is! (But I’m assuming it has something to do with golf. Not my sport.)
Maggie,
I ordered your book through Amazon. I paid $10 (including shipping). Hope to get my $10 worth.
Legacy–
Thank you.
And if you don’t get $10 worth of information I will send you a check. (Truly.)
cheers, Maggie
The GAO and numerous organizations had found that Medicare Advantage plans can cost beneficiaries more than traditional Medicare. I would gather that the GAO would eventually find that single-profiteer health care plans would cost more than a public option health care plan.
Since its inception, only about 20 – 25 percent of the the 43 million Medicare beneficiaries had enrolled in Medicare Advantage. What real advantage were they to switch? So it would go without saying, there will be numerous people who have single-profiteer health care plans opting out to the public option plan.
The private insurance industry is so huge, you think they would walk away from this market?
“Personally, I will not mourn the death of private insurers or HMOs (the former darling of various pundits) for that matter.”
Aren’t accountable care organizations (ACO’s) just HMO’s in another name and form? Also, I keep hearing from Maggie and others about the great, cost-effective care provided by Kaiser (especially in Northern CA) and Group Health of Puget Sound. Aren’t these organizations HMO’s? I don’t see how we can ever drive down cost-ineffective utilization or wasteful regional (and even local) variations in practice patterns without moving away from the fee for service payment structure and toward some form of capitation for the management of chronic disease. My understanding is that current attempts at capitation for large multi-specialty group practices include reinsurance and carve outs for extraordinary needs like a liver transplant. I also continue to think that we need to move toward bundled payments for expensive surgical procedures recognizing that some patients are more complex than others. For the extraordinary cases, some form of outlier compensation is probably appropriate.
Regarding the concept of risk adjustment, large insurers who participate in the Medicare Advantage market tell me that CMS’ risk adjustment mechanism works pretty well in the middle of the bell curve but tends to underpay for very sick patients and overpay for the healthy. I think that means that some sort of reinsurance approach is necessary to mitigate the financial burden of caring for the very high cost patients.
Regarding single payer, which I strongly oppose, Dr. Ezekiel Emanuel, now part of the Obama Administration and brother of Chief of Staff, Rahm Emanuel, suggests that a single payer system is not a good idea because (1) it would lock in all of the inefficiencies of the current fee for service payment approach and (2) it would likely reduce innovation. He favors a voucher approach funded by a Value Added Tax (VAT).
My main issue with the most robust form of the public insurance option that would piggy back on Medicare, pay Medicare rates or up to a 10% premium, and require providers to accept it if they want to continue to do business with Medicare is that it relies on dictated prices as opposed to negotiated prices. While that model has worked OK for Medicare because there is a large private sector to shift costs to, I’m not convinced it would work if the public sector controlled all of most of the healthcare system. If hospitals and doctors can really make money by providing services at Medicare rates or a slight premium, they should be prepared to agree to them on an arms length negotiated basis rather than a take it or leave it dictated basis. My bottom line is that I consider dictated prices to be unsustainable and dishonest competition and I don’t see why we need dishonest competition from government to keep private insurers honest. Tighter regulation and true level playing field competition is a different matter.
Barry,
I didn’t mean my comments to be an exhaustive analysis of the pluses and minuses of a government run program vs. private insurance – it was just a statement of my beliefs.
If I were designing a health care system for the US, I would give everyone a good BASIC plan – in car terms the equivalent of a Toyota Corolla with a manual transmission and no options. (This plan would NOT cover liver transplants for the most part.)
I would then allow people to buy add on policies at their own expense – similar to Medigap insurance or pay for “optional” care with their own funds.
This approach would allow us as a country to give everyone good BASIC care without bankrupting us – while allowing freedom of choice.
In my opinion Obama did well on ABC’s “Rx for America” last night.
Reality is that we will ALL have to compromise. Biggest losers will be Big PhRMA, Big Insurance, the Hospital Industry and the excesses of high tech-high cost medicine.
Biggest winners will be primary care, chronic disease managment,prevention and public health,palliative end- of life-medicine and finally THE AVERAGE AMERICAN HEALTH CARE CONSUMER!
Also the overall US economy will be a required winner.
Dr. Rick Lippin
Southampton,Pa
Talking about cost control, see http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.4.w719.
This really really needs to be done, but I think it is disingenuous of the author to try and keep cost effectiveness away from the initial analysis. Sort of like the ostrich effect when facing reality. It sort of reminds me of those words of Churchill once again:
“You can always count on Americans to do the right thing – after they’ve tried everything else.”
Another phrase that applies might be, “be careful what you wish for, you might get it.”
The link in the post I just put up should be:
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.4.w719
Barry,
The “over-paying for the healthy” means that in any capitated system, the organization will reap a premium for attracting the well. This results in another form of cherry picking. Free marathon training with our plan. How many diabetics with neuropathy are going to seek that option?
Regarding regional variation: the public bears some responsibility when they chose the doctors that “do” more over those who observe.
NG, your link is faulty.
Maggie,
As a primary care doc, I would fully agree with Legacy Flyer that there are less hassles foised upon us by Medicare and less fear that your claim will be denied or held up as the insurance company asks for more information. Medicare is by far a more efficient system, but the pieces must be in place to restrain the unsustainable growth that likely will occur if Medicare for all came to pass. Some of this might occur through comparitive effectiveness research which will eliminate some unnecessary treatments and eliminate the introduction of expensive new treatments which offer little improvement in outcome over the old therapies.
One thing that scares me though, is the ability of the goverment to get it right when it comes to determining the payment schedule for medical services. If Medicare were to be offered to all today, it would essentially drive my primary care practice out of buisiness. the rates are simply too low to support the infrastructure of a medical practice and have anything left for the doc to live on. While there is alot of buzz about how undervalued primary care services are, this has been buzzing for years with no change having occured. Having Medpac run the show might be helpful, but I would have great concern that medical specialties, hospitals, and insurance companies will eventually extend their tentacles of influence into this “independent organization” once it is granted such immense powers, and give us the same old fudged up system we now have, expcept it will be a single payer system.
Keith, Christopher, NG, Dr. Rick,Barry, Gregory
Keith– I don’t understand why so many doctors fail to realize that Medicare reform that would raise salaries for primary care docs is already in the works.
Don’t you folks read the newspapers–or your own medical journals?
This from the most recent NEJM: ” For the short term, the Medicare Payment Advisory Commission (MedPAC) has recommended that Medicare primary care evaluation and management services receive an increase of 5 to 10% next year.
“Congress is exploring such an increase, perhaps also for additional years. To close the income gap, annual increases of this magnitude would need to compound for several years, and private payers would have to follow suit. Medicare would also have to split physicians’ services into separate buckets so that primary care payments would not be reduced as a result of rapid growth in expenditures for procedures and imaging.
“An additional strategy to make primary care financially attractive would be providing more relief from medical education debt for clinicians entering primary care. The stimulus package — the American Recovery and Reinvestment Act of 2009 (ARRA) — included expanded funding for the National Health Service Corps, which provides debt-relief opportunities for primary care physicians. Congress is considering further growth of the corps.
“For the longer term, Congress is weighing alternatives to fee-for-service compensation of physicians. Currently, reimbursement for office visits does not capture many activities that primary care practices must perform for their patients, especially those with chronic conditions. Under the Medicare Patient-Centered Medical Home demonstration, additional payments would be made to qualifying practices for care-coordination activities, including communication with patients and families by telephone and secure e-mail. Even more ambitiously, Congress may expand the modestly successful Physician Group Practice Demonstration for primary care–oriented integrated care systems, such as the Geisinger Health System and Kaiser Permanente. Under this approach, groups would be rewarded for improved performance on quality measures and assessments of patients’ experience by being allowed to share in the savings if costs for their Medicare patients were lower than projected. Under both of these approaches, primary care physicians should receive higher incomes. Moreover, these models provide resources and incentives for enhanced practice capabilities and team orientation to make primary care practice more satisfying and manageable.”
All of these things are happening. The raise for primary care docs under Medicare is a done deal.
And over the next few years, there will be more and more opportunities for primary care dcos to earn more as they are paid for talkng to patients on the phone, e-maling them, creating a medical home, etc.
The Public Sector Plan Be Modeled on the Reformed Medicare That Pays More for Primary Care –While Paying Less for Certain Very Lucrative SErvices.
The conservatives are fear-mongering when they suggst that the public-sector option will be using the current Medciare Fee Schedule. By 2010 Medicare won’t be using the current Medicare Fee
Schedule.
In addition, under the Obama administration we are going to be seeing mmuch more debt relief for poorer students, and as I have written in the past, students from poorer families are much more likely to go into primary care, and to work in underserved communities.
This debt relief is what we had in the late 1960s and 1970s, and it will make a huge difference in expanding the pool of primary care docs, and giving us a diverse pool of docs that better reflects the patient population.
We’re also going to be making much greater use of nurse-practioners devliering primary care. We just need to raise salaries for teachers in nursing schools, and we will be able to take more applicants.
Finally, I understand your concern that MedPac is going to be corrupted.
But we have a White House that is going to stand up to the lobbyists. Already, many of the lobbyists are very, very surprised.
The insurance industry, for instance, can’t quite believe that the president is hanging tough on a robust public sector option.
At his press conference he referred to it as a “necessary tool to discipline the insurance industry.”
Pharma, device-makers, non-profit hospitals that run surpluses, operate inefficiently, and don’t do enough for the community to justify their tax breaks–all in for a schock.
This administration isn’t’ conducting business as usual.
And going forward, this administration will be backing Congressional candidates who share its views.
Christopher–
Insurance regulation means that insurers will have to offer reasonable annual caps on out-of-pocket spending, comprehensive coverage, low or no co-pays for preventive care that we know works, etc. etc.
By the time they offer all of that– at a price that can compete with a public-sector plan–they are not going to be able to offer free gym memberships or marathon training.
Of course, they could offer premiums plans that are more expensive than average and try to attract the healthy wealthy. But since the average family plan will cost $12,000–$13,000, that means trying to sell plans that cost $15,000–or more.
Since the upper-middle class and upper-class won’t be receiving subsidies, and since employers cannot afford to offer such expensive plans, the market for such plans would be very, very small.
NG– I think the author is wise to separate “comparative effectiveness” from “cost effectiveness.”
In the U.S. system there is so much low-hanging waste–so much completely ineffective care that we really don’t need to ask is it cost-effective?
We just need to ask is it effective?
More than 1/2 of anigoplasties are not effective. (See recent study in NEJM). At least 1/2 of by-passes are not effective.
Maybe half of all diagnostic testing for cancer exposes patients to risks (false positives, unnecessary procedures)
without equal benefits (there is no cure for the cancer, so early diagnosis does no good.)
Drugs and devices that cost twice as much as cheaper alterantives are usually no better for most patients.
WE could cut the nation’s health care spending by 30%–without ever asking “is it cost-effective?”
The problem with asking about cost-effectiveness is that this means we have to decide how much a year of quality life is worth–
$30,000, $75,000, $100,000?
Americans are very uncomfrotable with the idea of putting a price on life. And, if we make the cost of healthcare manageable without going there, I think we should
Politically, it will be much easier.
Dr. Rick–
Yes, I agree. And it is important that the president is making it clear that “the U.S. economy will be a required winner.
Barry–
I never said anything about HMOs been driven out of business. I said “for-profit insurers.”
There is a world of difference between a non-profit HMO and a for-profit HMO.
When originally conceived, all HMOs were non-profit.
The original idea of “health maintenance organizations” and “managed care,” as conceived by Dr. Paul Ellwood and the Jackson Hole Group—and endorsed by Richard Nixon –was a very good one.
(I would add that Nixon was smart enough to realize that healthcare should not be a for-profit enterprise. He gave special tax breaks to non-profit insurers. He also knew that free maket competition didn’t work in healthcare, which is why he and Ted Kennedy were able to come to agreement on creating very generous national health insurance for all.
Unfortunately, this was just a few months before Watergate summer. When the scandal broke, Nixon no longer had the authority to lead the nation on national health reform.)
Today’s reformers avoid the phrase “managed care” because it has been poisoned by the for-profit HMOs who didn’t “manage care” to benefit the patient but simply “managed” their own costs by refusing to pay for needed, effective care.
But, in fact, what I and Peter Orszag, Obama, Gawande, Don Berwick, the Dartmouth reserachers and others are calling for is “managed care” –saying “No’ to ineffective, unnecessary care, while steering patients and doctors toward the most effective care with lower co-pays and higher fees for those things that we know work.
Here’s the history of “managed care” For profit insurers were not in the health insurance market when HMOs were first created. The for-profits didn’t come in until Reagan changed the tax law after 1980 –opening the door to for-profit HMOs.
In the late 80s and early 90s, I did a great deal of reserach at Barron’s, comparing for-profit and non-profit HMOs.
It was clear to me (and my editor) that the non-profits offered much better care. They competed on quality.
The for-profits cut corners, wrote Swiss cheese policies, cherry-picked and competed on price.
But the for-profits had deep pockets and drove most of the non-profits out of business.
A few, like Peugot Sound survived, and they are the model for “accountable care organizations.”
Finally, Barry, “market compeitton” does not work in the health care industry to lift qualtiy or contain prices.
Every other developed country in the world has figured this out.
That’s why every other developed nation regulates health care prices and spending.
Gregory–
I agree, not everyone will want the public-sector option, even if it can offer more coverage at a lower price.
Some people just won’t be comfortable with the idea of “government insurance.”
Some private insurers will be inventive enough to figure out a way to create and market plans that may cost a little more, but are good and do a particularly good job of managing chronic disease.
So I agree, the entire industry is not going to walk away from this market.
They won’t be able to make the double-digit profits that they saw in the past (and that many Wall Street investors still want.) Investors will have to settle for a steady return of, maybe 6%.
Perhaps some insurers will begin offering dividends–like old-fashioned utilities.
They won’t be able to sell themselves as “high-growth” stocks. But these days, a steady 6% return would seem very attractive to many sensible people.
The insurance industry– like other healthcare industries– is going to have to re-think it’s position.
We cannot afford to have healthcare be a growth industry– it can’t grow any faster than GDP or wages– or we won’t be able to afford it.
And since it’s a necessity– like heat or electricity– we have to be able to afford it.
That’s why I bring up old-fashioned utilties. They weren’t sexy stocks, but they paid a reliable dividend. Think the old Bell Atlantic.
Maggie,
You say:
“I don’t understand why so many doctors fail to realize that Medicare reform that would raise salaries for primary care docs is already in the works.
Don’t you folks read the newspapers–or your own medical journals?
This from the most recent NEJM: ” For the short term, the Medicare Payment Advisory Commission (MedPAC) has recommended that Medicare primary care evaluation and management services receive an increase of 5 to 10% next year.”
The short answer of why primary care docs “fail to realize” that help is on the way is EXPERIENCE!
Ozarks Community Hospital Vision for Change: Visit the OCH Health care blog to read our health reform plan. http://ochhealthcarereform.blogspot.com
Maggie wrote in reply:
“Americans are very uncomfortable with the idea of putting a price on life. And, if we make the cost of healthcare manageable without going there, I think we should
Politically, it will be much easier.”
———-
I think I hear that you are saying that we are more likely to get reform through now politically if we do not discuss cost effectiveness of treatment in our review of comparative effectiveness of treatments. Politically in the short run this might be true, but it forces many to question quality and/or sustainability of any universal system plan if we don’t deal with such cost effectiveness issues.
The human genome discovery is pointing to many individualized genetic treatments down the road but at great expense. If we allow such discoveries to go forward along with a universal coverage system, what kind of cost sustainability will we have? If we deny discoveries in this area, what kind of political pressure will that generate? If we allow people to spend their own funds only for such discovered individualized treatments, we will be right back to where we are now with so many without access to high quality treatments that are very costly.
I personally do not have the best answer to this dilemma, but I do feel it is worth pointing this out because it is the root cause of much of the fear out there as we strive for universal coverage and cost sustainability.
Maggie,
I do indeed read the papers and get regular information from the ACP. But to put this in historical perspctive, I don’t think I need remind you that years back, we were told that the introduction of RBRVS would improve payment for cognitive services. Look how well that worked out!!
This issue has been recognised for over 20 years and things have only gotten worse over that time.
While I am more optimistic that positive things will occur that will drastically change the distorted incentives of how medical care is delivered, I remain the ultimate cynic that by the time the health insurance industry, the hospitals and all the specialty medical societies get done passing out the bucks, that this may not come to pass or be severely diluted. By the way, Medpac suggests 5-10% increases while the difference in pay is more in the 40% range. Do you really think medical students will flock to primary care when they can still make 30% more on a yearly basis after spending an extra year or two in residency in some cases? It will take more than this to make primary care desireable again. Your only altrnative is to lower specialty rates which, if I was to propose this would have my specialty colleugues stringing me up from the yard arms.
Keith–
MedPac suggests raising primary care docs’ salaries by 5% to 10% this year.
NEJM reports that most think that they will need to continue similar increases– and 5% to 10% increases, compounded, over the next few years will make a huge difference. (10% increases woudl double incomes in just 7 years. I don’t expect that to happen–but I can easily see incomes for primary care docs rising by 30% in the next few years.
Some specialists won’t be happy to see fees for some highly lucrative, minimally effective procedures cut. But this is long overdue–and will happen.
This administration is just not as likely to cave to lobbyists–for many reasons
Also, the Obama administration is definitely interested in making it possible for lower-income students to go to med school. And research shows they are more likely to become primary care docs.
I just don’t think that you realize how different this administration is.
I’ve been watching politics, very closely, for a long time.
The very fact that the president would support the idea of putting MedPac in charge of Medicare– limiting Congress to an up or down vote, with no power to revise MedPac’s recommendations– is absolutely radical.
MedPac is, as I have said, apolitical and very rational. But to put rational, unbiased people in charge of setting fees–that is “radical” in the best sense. (A change that gets to the “root” of the problem)
This reminds me of some of the things that FDR did.
OBAMA IS MESSIAH
” .. It is one thing to disagree on how best to reform healthcare, but claiming that the president is telling a bald-faced lie seems to me an unwarranted ad hominem attack ..”
Oh, yes. The president is Messiah. Not even Jon Stewart should mock him. That would not be “truthy.”
Real journalists, on the front lines of political reality, know they get grossly deceived every day.
Read “The Boys on the Bus” by Timothy Crouse. Note section about how “progressive” politicians in Cleveland “shat on their people.” Despite what the David Axelrods of the world say. So much for “afflict the comfortable.”
Truth by Messiah (c). Coming to a former democracy soon.
Maggie,
I have great faith that this administration is trying to do the right thing, but as Leagacy Flyer has also pointed out, we have been promised before only to be duped.
Under our system of goverment, there are checks and balances, and those that can bring the resources to bear will work on the weak points to stymie any reform. so while I remain hopeful, we have seen health care reform be effectively derailed in the past.
Keith–
You write “we have been promised before only to be duped . . .”
I would say that not every president of the last 45 years duped us.
Jimmy Carter definitely waned to do the right thing, and didn’t dupe anyone, but simply didn’t have the political experience or skills to deal with Congress.
LBJ said he would do certain things –civil rights, Medicare . .
And he actually did.
LBJ was also taken in (duped) by his advisers (and his own lesser angels) when it came to the War in Vietnam.
But on domestic issues, he
was hugely successsful.
Poverty declined significiantly, and civil rights legislation and Medicare were huge accomplishments that have lasted.
Why don’t people remember this? Maybe because so few people study history in college these days. And so many of our pundits are so young (and know so little history) that they are clueless.
But I am just old enough–and have read enough history to know that this administration is truly unusual. I think that Obama wants to do the right thing the way Jimmy Carter did. And I believe that he, Rahm Emanuel and other advisers have the strength and many of the political skills of LBJ.
A democracy is always a gamble, but history suggests that once very 50 years we should get lucky.
WaPo ALSO DUMPS ON OBAMA
http://www.washingtonpost.com/wp-dyn/content/article/2009/06/23/AR2009062303262.html
“In his first daytime news conference yesterday, President Obama preempted “All My Children,” “Days of Our Lives” and “The Young and the Restless.” But the soap viewers shouldn’t have been disappointed: The president had arranged some prepackaged entertainment for them.”
Oh. Mr. Obama is NOT a liar.
He’s a phony and a faker.
Is that a big difference?
Dana–
I assume that you are Dana Millbank, the author of the WaPo article that you point to?
It would seem more honest to have disclosed that you are defending your own story.
Your story seems, to me, thin.
You report that one online reporter was given a head’s up to ask a question about what the Iranian people are thinking–and Obama called on him first.
Focusing on how Iranians themselves see what is happening strikes me as a good way to to begin a discussion on this topic.
Traditionally, presidents call on a well-known reporter first–knowing exactly what he will ask, because the adminstration knows where this reporter is coming from and what he has been writing.
What happened in Obama’s pres confernece is the same deal–setting the tone and topic for the discussion.
But in this case, the reporter who spoke first wasn’t one of the “usual suspects” from the mainstream established press.
He was “Nico Pitney from the Huffington Post.” You write: “reporters looked at one another in amazement.”
In other words, the “boys’ club” from the big-name newspapers wasn’t getting the deference it believes it deserves.
(Obama also calls on women reportrers much more often than other presidents have.)
Finally, I did read your piece in WaP0, and cannot agree with your central premise that, under the Obama administration, the “American press isn’t as free as advertised.”
You’re wrong: eveyrone there (including Pitney) was free to ask what he wanted to ask.
Pitney could have said “NO, I don’t want to ask about what Iranian’s are thinking.” (This would have been foolish, not because he might not have been invited to the press conference, but because it is a question any intelligent journalist would want to ask.)
And all of the other reporters there were free to ask what they wanted to ask–which they did– including a very difficult question about whether the president would sign a healhtcare bill that didn’t include a public-sector option.
The president tried to side-step that question. Then, another reporter asked it again. (This tells you something about what reporters have learned about Obama’s press conferences. They won’t be dimissed or exiled if they press, or ask an uncomfortable– but honest and important question.)
This second time around, Obama explained why he had ducked the question: It’s to soon in the process to draw a line in the sand. But he made it clear that he saw the public sector option as “an imporant tool to discipline” private isnurers.
In other words he was very honest. And he said something about “disciplining ” the private insurance industry that many people did not want to hear.
Finally, your commentary is based on the theory that, since the press conference took place in the afternoon, it was a replacement for (and modeled on) afternoon Soaps on TV.
Over the years, I have seen many press confernece scheduled in the afternoon on television.
More importantly, today, these press conferences are broacast online where many people will see and hear them while at work.
The high points of the press conference are then re-broacast on the many evening news outlets on networks and cable stations.
Your conceit, comparring the press confernce to a daytime soap, is a very strange stretch.
Who are these latest posts from?
Who is/are: “Affordable Health coverage”, “Family medical insurance”, “Affordable medical insurance” and “medical insurance”. It seems likely from the style and substance they are all from the same individual (or corporation?).
Personally, I have no problem hearing from all sides in the discussion (and I think market based solutions should certainly be looked at), but lets be honest about who we are and who we represent.
Legacy Flyer–
Yes, those comments were ads. I’ve deleted them.