Can there be such a thing as too much money? Apparently. There can be situations where the amount becomes an embarrassment.

That point of embarrassment may come when you are among the very top recipients of bribes from the healthcare industry. A little blush in the cheeks does not quell the desire for financial rewards, however.

All that is necessary to keep the money coming in is to find another pathway. Last night, some time after publishing my last post, I was relaxing, watching the news. There it was.

Or rather, there he was. Up on my large flat screen was, large as life, a picture of a smiling Bart Gordon. It was much like a fluffy campaign spot. But last night wasn’t open season on voters, was it?

The spot was a paean to Bart, trumpeting his heroic bipartisanship, his concern for hard working Americans (is there any other kind in the land of McPolitics?), his incessant exertions on behalf of our healthcare needs, his sacrifices for saving the taxpayer from all of those unAmerican Congressmen.

The ad urged everyone to contact Bart to thank him for his epic efforts on our behalf. At the bottom of the screen, before the spot faded from the pixels, was the clue. It was paid for by al-PhARMA. Wow! A stroke of genius. Bart gets the benefit of a campaign donation without having to get his fingerprints on any of that filthy lucre.

In looking up the amounts of bribes Bart and his cohorts have taken (the above will not be included in the official bribery reports), I discovered that he has received more from labor unions than from the health industry. His position on healthcare reform is antithetical to the aims of labor.

This can be partially explained by the fact that he gets about three times as much from business interests, in toto, as from labor. I say that explains it in part. It fails to explain why the unions give him any money.

I was explaining this to my wife this morning as we were driving to Micky D’s for breakfast but she was confused. It turns out she was wondering why farmers were paying for the television spot.

If any of you out there in blogland have an actual Representative, one who represents your interests, treasure him or her. They are obviously a rare and endangered species. Most have been lost to polluted money.

p.s. I find it interesting that my posts on Bart have engendered so much curiosity from Blackberry users. There were a handful of hits this morning on the Stupid and Useless post from last night. Some of these hits were from a couple of Blackberry users, 6 minutes apart, in the Nashville area. Shortly thereafter my site received several hits from Blackberry users coming from .gov hosts.

Hello out there in Blackberryland. Let me know how you like my takes on Bart. As a former journalist, I still abide by the rules of the game. I can always use another source.

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I finally received a response from Bart Gordon, my Congressman. He totally ignored my request for a debate. Now I know why.

I had challenged him before the August recess. As September has arrived, that means it took him a month to respond. It is obvious from his email that he would have had to come unarmed to any battle of wits. I will present that email as proof. Remember, he sits on the Health Subcommittee of the House Committee on Energy and Commerce.

Dear Crawford,

Thank you for contacting me about national health care reform legislation. Like most hard-working Americans, I believe we need to make health care more affordable for everyone.  But, on an issue this important, it is much better to take the time and get it right than to get it done quickly.  That is why I helped ensure that no bill would be considered in the House this summer.

I am disappointed in his response to the concerns I expressed about healthcare reform. First, I offered to debate him in a public forum during the August recess. There is no mention of that in his email. Also, I find his email regrettable in its lack of consistency, facts and logic.

Notice also that he brags about delaying consideration of any reform bill. Let’s be honest. Delay is no more nor less than the favored tactic of the health industry. He is taking credit for following orders. Teddy Roosevelt  included a universal healthcare proposal as a part of his campaign platform in 1912. FDR proposed it. HST proposed it. JFK proposed it. Jimmy Carter proposed it. Bill Clinton proposed it. And, Bart Gordon thinks we need to take our time. How many have died and will die while Bart diddles?

Currently, we spend one out of every six dollars in the United States on health care, and the cost of health care is rising twice as fast as inflation with no end in sight.  Tennessee’s small business owners and other hard working people are telling me they can’t keep up with the cost of their health insurance premiums.  Insurance costs for small businesses have risen 129% since 2000.  If we do nothing, these costs will further strain families and businesses, and will threaten to bankrupt the country as well.  It will be impossible to cut the national debt unless we deal with health care spending.

So, small businesses, families and the national debt will just have to wait while Bart diddles. Also, notice how he begins speaking of healthcare reform but quickly changes the subject to health insurance.

There are several principles that I believe must be addressed in any health care reform measure: the package must be deficit neutral;

Other than single-payer (HR676), none of the proposals can be deficit neutral without significant tax increases or massive cuts in other necessary programs. Such “savings” as al-PhARMA’s $80 billion concession are silly promises from proven liars. The bulk of that $80 billion goes to seniors in the do-nut hole to buy brand name drugs instead of generics. It will be a bonanza for the drug companies. And, that is only $8 billion per year. The immediate savings of single-payer are more than $400 billion annually from one category alone. Every other plan increases the number of customers, income and profits for AHIP and al-PhARMA. Much of that will cost the government in massive subsidies. The other plans are not deficit neutral. Delay is not deficit neutral. Bart can’t count.

it must make health coverage more affordable for individuals and small businesses;

Eliminating preexisting condition bans will require higher premiums. Requiring small businesses to cover more people doesn’t seem to be a way to make it more affordable. The first point of this paragraph would also apply to individual coverage.

it must ensure coverage is portable when you change or lose your job;

He wants to maintain our traditional method of employer-based plans. Can you imagine the complexities and inefficiencies of making these portable? Will your new employer provide the same plan, or any? Will the government or your former employer pay for your policy while you are unemployed? Some will lose a gold-plated plan along with their job. Others will lose a less attractive plan. Will both plans be maintained? Will there not be cries of that being inequitable?

it must end barriers to coverage for people who get sick or have a pre-existing medical condition; and it must ensure that insurance companies are not able to deny, limit, or specially price your insurance because of a pre-existing condition.

The insurance companies publicly and explicitly promised the Congress that they would accomplish universal coverage and eliminate preexisting condition prohibitions in 1993. Who will guarantee that if not the government?

I do not support a single-payer health care system.  Health care reform must preserve the employer-based health care system so Americans can choose their own doctors and hospitals. No one, including the government or your insurance company, should be able to make life-and-death decisions for you.

Here is where Bart proclaims his devotion to employer-based plans. Why? So that we can choose our own doctors and hospitals. In the past 6 years I have had more than 30 doctors and more than 15 surgical procedures. Nashville is known as a national center for healthcare. Medicare has never questioned any choice of doctor or hospital. I have friends whose private insurance has refused to pay for certain doctors or hospitals. I consider myself knowledgeable enough to find the best doctors in the area. Such nonsense as Bart is spouting are mere scare tactics straight from the lobbyist-supplied playbook of talking points. He is on a government-run healthcare plan. Does it deny him his choices? I think not.

As here, I frequently hear, explicitly or implicitly, that we must preserve our private health insurance system. However, no one has dared to say why. The reason for that lack of an answer is that there is no reason. No health insurance company has ever cured a single malady. They are, however, responsible for innumerable deaths through denial and other forms of rationing. I don’t give a fig for the insurance companies. They add absolutely no value to healthcare.

The best analogy I can come up with for the health insurance industry is the Mafia. If someone comes in and insists that you must pay them 30% of the value of your inventory for protection, you consider that a protection racket, a criminal enterprise. That analogy fails because the Mafia will actually protect you as long as you make payments.

The private insurance companies commonly make life and death decisions for their customers. I have yet to run into that with Medicare. It seems unlikely that people on Medicare would rate their plan more favorably than any other group if the government was trying to kill them. The intended inference is that only single-payer will take those decisions from you. Bart is full of bat feces.

There has been a great deal of misinformation out there.  AARP and other organizations are working to clarify this information. To read about myths and facts related to health care reform, you can visit AARP’s health page at http://www.aarp.org/health.

True. There is a great deal of misinformation out there, and in his email. He and his owners are the ones responsible for promulgating it. He suggests checking with AARP. Does that make sense? AARP receives the bulk of its income from selling insurance and publishing ads for the health industry.

There is no single bill before Congress right now, there are five different health care reform proposals in the House and Senate and several more steps in the legislative process before any legislation will be enacted.

Actually, there are only four bills. The Senate Finance Committee members, aside from the Gang of 6, have been complaining of being kept in the dark. Their bill has not surfaced. Again, Bart can’t count.

Passing no bill at all is better than passing something that makes things worse.

That is a truism. It’s difficult to imagine creating worse than what we presently have but politicians such as Bart are fully capable of pulling it off.

I hope that we can improve the health care system for everyone, and will continue to work with my Democratic and Republican colleagues to accomplish this.

Other than the select group of Blue Dogs, I see no evidence of his working with the Democrats. I hope he is not wasting his time working with the Republicans on this issue.

Thank you again for contacting me.

G

How cutesy.

Sincerely,

BART GORDON

Member of Congress

It should now be obvious why he fails to respond to my challenge.

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A few of us are unfortunate enough to be able to remember the decade of the 1950s. I’ll refrain from naming names. But, I will if I have to.

There was a major scare back in that strange, misbegotten decade. The “Bomb,” of course. No. Even scarier. The Communists had an even more devious plot to destroy the US of A.

What was this nefarious plan? It’s almost too horrible to relate, even after more than half a century.

The plot involved the fluoridation of our water. Yes. Can you believe it? They actually wanted to put fluoride in our water supply. Not just our drinking water. They even wanted to put it in the water we used to wash our most precious possessions: our cars.

Those Communists were so sneaky they tried to trick us by putting fluoride into their own water. Our leaders in government let it happen. Look. See what has become of us. Cruelly, most of our children miss out on the experience of tooth decay, of dental caries.

Not all terrorists ride around on camels. We were terrorized by the regressives here in our own country. For their own purposes they scared us with the threat of good dental health.

In the next decade they threatened us with abortion. Then came prayer in the schools. And they even sneaked in sex education. Now it’s death panels. When will we ever learn?

The regressives told us Roe v. Wade meant that the government eventually would decide whether your own fetus would be permitted to survive. Your kids would be forced to fornicate in class.

They told us that Christian children would be put in prison, or worse, kicked out of school for praying instead of studying before a test. They warned us that kids would have to memorize passages from the Koran, or even worse, learn to read the Apocrypha in Latin (Southern Baptists only).

During the past 40 years that these have been used as wedge issues, those dastardly Democrats have held the White House only 12 years. The Republicans have had control of the Congress for a number of years. They have had both at the same time. Yet, abortions have not been terminated. Schools are at least as secular as ever. There are more teenage parents than ever (The rate is even higher in church-run schools).

If anything, the situation in all of these areas is worse from the standpoint of those who focus on these issues. Why? Because politicians cynically use those issues specifically to make people angry. It is easier to motivate people to action through anger than through logic and positive appeals to enlightened self-interest.

Dealing with those issues in a way that accomplished their goals would merely eliminate the threats that the politicians have for manipulating those people. They have neither desire nor intent to see those putative goals realized.

The politicians use social issues to mobilize the masses. They need numbers of people sufficiently motivated to actually vote. With these angry, motivated voters putting them in office and not paying attention to what they are actually up to, they are free to work on behalf of the corporations that fund them, that fete them, that tell them how to vote.

If people begin to actually look at these other issues, look out; here comes another scare campaign.

Most of the politicians in Washington and all of the corporate lobbyists there see the players as being divided into two teams: tools and fools.

Obama desperately wants something he can call healthcare reform. He also wants bipartisanship. It appears he thinks both are possible. What did he get for those three Senate votes on the stimulus package? He got 40% of that $787 billion as stimulus, and that not focused on the most effective ways. He got most of that 40% delayed until next year. Yea! bipartisan team.

Now he’s working with six centrists, 3 Republican Senators. 3 Blue Dog Democrats, or whatever they are. He has met secretly with them and the president and vp of PhARMA. To get $150 million of Harry and Louise supporting some vague reform he gave up single-payer. He gave up a public option. He gave up Medicare negotiating drug prices (worth far, far more than $80 billion). He gave up re-importation. He gave up rebates to Medicare. He gave up his promise to put all negotiations on C-SPAN.

Sure he got a promise, for whatever their word is worth, of some possible $12 billion tax increase on PhARMA members. Even if this were to see the light of day, it would probably be more than offset by increases in the subsidies the government already provides them.

What about the $80 billion they agreed to? Well, they actually agreed to no more than $80 billion over 10 years. This is about 2% of what the government is expected to spend on drugs over the next 10 years. Most of that is a 50% discount on brand name drugs only for seniors in the donut hole of Part D. Only the promised $12 billion tax cut would be applied to the trillion dollar plus cost they are talking about.

None of the agreement provides for any way to ensure that PhARMA actually contributes a penny. And, every plan being considered by the House and Senate, except HR 676, the Medicare For All Act, with 93 co-sponsors, provides greater income for members of PhARMA.

On Tuesday, Obama praised two Republican Senators. Charles Grassley, the Republican point man in these backroom negotiations stabbed Obama in the back the very next day by claiming his opposition to “death panels” in the reform plans.

Since only one of three House plans and none of the two Senate plans have been written, it’s hard to know where he found those panels. The fact that they don’t exist didn’t bother Charley.

Johnny Isakson (R-GA) was praised by Obama for co-sponsoring what is being mis-characterized as death panels. The next day little Johnny rejected Obama’s praise by saying that Obama lied. It turns out someone was lying, and it wasn’t the President.

Grassley, as one of the three Republicans involved in the negotiations, did all of the damage he could do in those talks. It was necessary for him to sabotage Obama publicly to ensure the continuance of those millions of dollars of bribes from the healthcare industry. Anyone who has even casually watched his career was not surprised that he had no intention of crossing the aisle. A dead giveaway was the lack of criticism Charley received from his fellow Republicans while supposedly cozying up to the dreaded Kenyan citizen.

If these are the friendly Republicans, can bipartisanship be far behind? Every amendment that we know has been offered as part of any of the reform plans has, at a minimum, increased the costs. Many have been designed simply to fatally damage any reform. Obama’s quest for this unholy grail has required him to bar those who support his campaign rhetoric from the table. He declared single-payer off the table before any reform talks commenced.

How about a perspective you don’t normally get? An internal poll of the Republican National Committee showed that 54% thought we have “the best health care system in the world.” That’s surprising only in how low the number is. In response to another question, this poll showed 70% felt that the system is “badly in need of reform.” Does it seem strange to anyone else that the best system in the world is badly in need of reform?

You constantly hear the claim that the majority are satisfied with their health insurance coverage. Just what does that mean? Let’s break it down. Fifty-nine percent of those with private plans get it through their employer. Most pay little or nothing out of pocket. Most have never used it for anything other than maternity and the occasional cold or flu. What’s not to like? Also, they don’t complain about the government subsidizing ALL of these plans.

The highest satisfaction rate is among those with Medicare. There are only two ways I can think of to lose your Medicare coverage. Either move out of the country permanently or die. Private plans can be lost when you lose your job. Private plans have annual and lifetime spending limits. Private plans constantly ration care. Averaging more than two operations a year since being on Medicare, the spectre of rationing has never appeared.

They also seem only to ask for the opinions of people who still have insurance. There are other problems with the methodologies employed by the quoted polls. That may be influenced by the fact that the polls you are most likely to see were paid for by the health insurance industry.

Are you scared yet?

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America is the greatest country in the world. I grew up hearing that and I used to believe it. I still hear people saying it.

Is it true? What did people mean when they made that claim? What does it mean now? Are people now just saying it out of habit? What criteria are they using? Perhaps we need to look in the mirror.

We aren’t the richest country in the world. We don’t have the longest life expectancy. We rank way down the list on satisfaction with our lives. We have the highest crime rate in the world. One of every four prisoners in the world is one of us.

We spend half of all the military funding in the world. Is this what they mean when they call us the greatest? I think not.

Our politicians collect more bribes than those of any other country. Is this what they mean when they call us the greatest? I hope not.

America isn’t so much a place with amber grain waving between shining seas. It is essentially an idea, an experiment. Can the people govern themselves? Do we need a monarch or a dictator to make those decisions for us? That is the idea. That is the experiment.

Many people actually think us incapable of making decisions for ourselves. They may be right, or not. The funny thing is, those that believe it just happen to think that they are the only ones qualified and suited to impose those decisions on us.

Who are these exemplars of omniscience? Who are these people worthy to replace democracy? There are two groups of such exalted beings that bless us with their very presence. One group, ironically, acquired their lofty stations via the democratic process they hold in such low esteem. The others are the economic elite, known historically as plutocrats.

These two groups, composing government and corporations, work as a team. The problem is that we make up the other side. There are two political parties: the corporatists and the populists. One side holds the interest of corporations supreme. The other considers actual human beings of greater importance.

There are two quotes that I feel appropriate. The first I commend to you comes from Benito Mussolini, “Fascism should more properly be called corporatism because it is the merger of state and corporate power.” Those corrupting our country should take note of the other, by Charles de Gaulle, “The cemeteries of the world are full of indispensable men.”

We came to expect W, Cheney, Rumsfeld, Bolton, Wolfowitz, and the others of that ilk to repair to their authoritarian bent, whether they felt challenged or not. They were essentially sociopaths. We hoped those eight years were an aberration. We sat back and waited.

We found someone who promised change. Were those sincere promises that became sullied in the rough and tumble of political combat? Or, were those promises no more than a marketing ploy to attract those who were desperate for a government that valued the people.

Obama is being assaulted by the “birthers,” people who make their own reality. He is being compared to Hitler, by people who have no understanding or appreciation of what Hitler represented. He is called a socialist, by people who couldn’t find the word in a dictionary. From Newt Gingrich to the droolers who think he cares about them we hear claims of government plans for euthanasia.

UnAmerican crowds are denying others the right to express themselves, as democracy requires. They threaten bodily harm to anyone with the temerity to hold a different position. Those are the tactics employed by the Brown Shirts back in the 1930s. Rational discourse is disappearing from the American body politic.

The President is doing his fair share of damage to this American idea. He campaigned on the accurate claim that the government and people are being ripped off by al-PhARMA. He proclaimed that banning Medicare from negotiating drug prices had to change. He promised that all negotiations with the health industry would be covered by C-SPAN. Boy, that sounded great. It was just what was needed to restore some confidence in our government.

http://www.youtube.com/watch?v=NCRO0g9CfAw

C-SPAN is ready. The people are waiting. Stand down. There has been no coverage by C-SPAN. The ban on negotiation has been ratified by fiat from the Oval Office. So much for change. Hope felt nice, while it lasted.

If, as Obama and most everyone else agrees, healthcare reform is the most important issue, what are we to do now that it is official there will be no real reform? The White House staff is putting together a marketing campaign to support their empty claim that they have achieved reform. Marketing is hardly an adequate substitute for democracy.

We will be told again that we have the greatest healthcare system in the world. The 47 million uninsured has grown to 52 million. The last study from the World Health Organization listed us as 37^th. Before you gloat too much at that wonderful ranking, you should know that report came out in the year 2000. Before that, the U.S. was falling. It is only natural to assume that the decline wasn’t reversed. Why has there been no updated report? The WHO says that correlating those eight factors is just too complex. My personal opinion is that the U.S. exerted some influence to avoid further embarrassment.

While the cheerleaders shout about our healthcare system being the best in the world, the cost rises. The number without healthcare rises. And The Changer promises the the greediest group in the system a bigger piece of pie. Meanwhile, polls in every country with national healthcare systems shows overwhelming support for their systems. Not a single one of those countries has any interest in adopting our “Greatest Healthcare System in the World.”

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Who’s in charge? Here is an article from the New York Times illuminating the real role that al-PhARMA is playing and how the administration is prostituting itself, unnecessarily.

Be prepared to be sickened. Understanding what they are doing and how they are doing it spotlights just who is in control and why the final result of “reform” will end up costing far, far more than needs be.

August 6, 2009
White House Affirms Deal on Drug Cost
By DAVID D. KIRKPATRICK

WASHINGTON — Pressed by industry lobbyists, White House officials on Wednesday assured drug makers that the administration stood by a behind-the-scenes deal (emphasis added) to block any Congressional effort to extract cost savings from them beyond an agreed-upon $80 billion.

They are assuring the drug dealers of their intent to keep their promises. This while caving on their promises to those who elected them. Obama pretends that he is standing back and letting the Congress develop the plans but, as that sentence says, he is prepared to interfere with the Congress by blocking their efforts – not that Congress is doing us many favors.

It is important to understand the $80 billion concession the drug dealers have promised. First, that is over 10 years. The bulk of it is directed at the Medicare Part D donut hole. When seniors reach $2,700 (composed of their premiums, deductibles and co-pays plus what the insurance company has paid) the donut hole appears. The senior pays 100% while in the hole. To get out of the hole $4,350 must be reached. This upper level is composed of only the seniors’ expenditures, so a senior must pay much more than the $1,650 you get by subtracting the first number from the second. The seniors still must pay their premiums while the insurance company is paying nothing. Few get out of the hole.

The drug dealers have agreed to only charge 50% of retail to seniors while they are stuck in the hole. But, this applies only to their brand names. They will continue to make obscene profits at that reduced rate and hope to entice seniors to stay on brand names rather than purchase generics.

Drug industry lobbyists reacted with alarm this week to a House health care overhaul measure that would allow the government to negotiate drug prices and demand additional rebates from drug manufacturers.

This is the key. al-PhARMA wrote the Part D bill. They included the prohibition on Medicare negotiating any pricing. The Veteran Administration has been negotiating all along. They pay about half of what Medicare pays. Since Medicare is by far the largest purchaser of medical goods and services, you might imagine keeping that provision is worth far, far more than $8 billion a year. Individual companies have paid fines in the neighborhood of $1 billion for fraud against the government. While we think that is a lot of money, they consider it the cost of doing business, pocket change.

In response, the industry successfully demanded that the White House explicitly acknowledge for the first time that it had committed to protect drug makers from bearing further costs in the overhaul. The Obama administration had never spelled out the details of the agreement.

Notice that they feel they can demand the administration do their bidding. They are willing to make the “behind-the-scenes deal” public in order to hold Obama’s feet to the fire. Have you ever tried to demand that the president follow your demands?

“We were assured: ‘We need somebody to come in first. If you come in first, you will have a rock-solid deal,’ ” Billy Tauzin, the former Republican House member from Louisiana who now leads the pharmaceutical trade group, said Wednesday. “Who is ever going to go into a deal with the White House again if they don’t keep their word? You are just going to duke it out instead.”

Billy Tausin was the one responsible for shepherding the Part D bill through Congress. He then left Congress to become president of al-PhARMA, at a salary of $2 million per year.

A deputy White House chief of staff, Jim Messina, confirmed Mr. Tauzin’s account of the deal in an e-mail message on Wednesday night.

“The president encouraged this approach,” Mr. Messina wrote. “He wanted to bring all the parties to the table to discuss health insurance reform.”

Why anyone would want to bring the enemy, those who created the mess, to the table for planning the strategy of the battle is beyond comprehension, beyond the realm of sanity.

The new attention to the agreement could prove embarrassing to the White House, which has sought to keep lobbyists at a distance, including by refusing to hire them to work in the administration.

Is there any doubt that they deserve to be embarrassed?

The White House commitment to the deal with the drug industry may also irk some of the administration’s Congressional allies who have an eye on drug companies’ profits as they search for ways to pay for the $1 trillion cost of the health legislation.

But failing to publicly confirm Mr. Tauzin’s descriptions of the deal risked alienating a powerful industry ally currently helping to bankroll millions in television commercials in favor of Mr. Obama’s reforms.

Go ahead. Alienate them. Requiring negotiations and a few more easy changes could pay for at least half of that $1 trillion, a number that is artificially and unnecessarily high anyway. Their power will become more of a nuisance than a threat.

The pressure from Mr. Tauzin to affirm the deal offers a window on the secretive and potentially risky game the Obama administration has played as it tries to line up support from industry groups typically hostile to government health care initiatives, even as their lobbyists pushed to influence the health measure for their benefit.

Are the drug dealers really on Obama’s side? Do you think that the largest, most powerful lobbying machine is sitting on its hands. Before this reform issue came to the fore, al-PhARMA had 638 lobbyists on Capitol Hill. They outnumbered the 435 Representatives and 100 Senators. They are angling for more. Universal care gives them more customers. You’ve heard that 47 million have no coverage. That figure is old. The latest number is 52 million and growing daily as more jobs are lost.

In an interview on Wednesday, Representative Raul M. Grijalva, the Arizona Democrat who is co-chairman of the House progressive caucus, called Mr. Tauzin’s comments “disturbing.”

“We have all been focused on the debate in Congress, but perhaps the deal has already been cut,” Mr. Grijalva said. “That would put us in the untenable position of trying to scuttle it.”

He added: “It is a pivotal issue not just about health care. Are industry groups going to be the ones at the table who get the first big piece of the pie and we just fight over the crust?”

Congress needs  to wake up.

The Obama administration has hailed its agreements with health care groups as evidence of broad support for the overhaul among industry “stakeholders,” including doctors, hospitals and insurers as well as drug companies.

Everyone is at the table but the people. They are not working on healthcare reform. They are modifying insurance coverage.

But as the debate has heated up over the last two weeks, Mr. Obama and Congressional Democrats have signaled that they value some of its industry enemies-turned-friends more than others. Drug makers have been elevated to a seat of honor at the negotiating table, while insurers have been pushed away.

“To their credit, the pharmaceutical companies have already agreed to put up $80 billion” in pledged cost reductions, Mr. Obama reminded his listeners at a recent town-hall-style meeting in Bristol, Va. But the health insurance companies “need to be held accountable,” he said.

“We have a system that works well for the insurance industry, but it doesn’t always work for its customers,” he added, repeating a new refrain.

He needs to realize that it works even better for the far more profitable drug industry. Prescription drugs, taken as prescribed, are the 4^th leading cause of death in this country.

Administration officials and Democratic lawmakers say the growing divergence in tone toward the two groups reflects a combination of policy priorities and political calculus.

With polls showing that public doubts about the overhaul are mounting, Democrats are pointedly reminding voters what they may not like about their existing health coverage to help convince skeptics that they have something to gain.

“You don’t need a poll to tell you that people are paying more and more out of pocket and, if they have some serious illness, more than they can afford,” said David Axelrod, Mr. Obama’s senior adviser.

The insurers, however, have also stopped short of the drug makers in their willingness to cut a firm deal. The health insurers shook hands with Mr. Obama at the White House in March over their own package of concessions, including ending the exclusion of coverage for pre-existing ailments.

This is just one of their broken promises to Congress in 1993.

But unlike the drug companies, the insurers have not pledged specific cost cuts. And insurers have also steadfastly vowed to block Mr. Obama’s proposed government-sponsored insurance plan — the biggest sticking point in the Congressional negotiations.

The drug industry trade group, the Pharmaceutical Research and Manufacturers of America, also opposes a public insurance plan. But its lobbyists acknowledge privately that they have no intention of fighting it, in part because their agreement with the White House provides them other safeguards.

Mr. Tauzin said the administration had approached him to negotiate. “They wanted a big player to come in and set the bar for everybody else,” he said. He said the White House had directed him to negotiate with Senator Max Baucus, the business-friendly Montana Democrat who leads the Senate Finance Committee.

Mr. Tauzin said the White House had tracked the negotiations throughout, assenting to decisions to move away from ideas like the government negotiation of prices or the importation of cheaper drugs from Canada. The $80 billion in savings would be over a 10-year period. “80 billion is the max, no more or less,” he said. “Adding other stuff changes the deal.”

They don’t need to be in a position of making demands. They need to be the target of demands.

After reaching an agreement with Mr. Baucus, Mr. Tauzin said, he met twice at the White House with Rahm Emanuel, the White House chief of staff; Mr. Messina, his deputy; and Nancy-Ann DeParle, the aide overseeing the health care overhaul, to confirm the administration’s support for the terms.

How many people mentioned in that paragraph represent your interests? The answer is zero.

“They blessed the deal,” Mr. Tauzin said. Speaker Nancy Pelosi said the House was not bound by any industry deals with the Senate or the White House.

But, Mr. Tauzin said, “as far we are concerned, that is a done deal.” He said, “It’s up to the White House and Senator Baucus to follow through.”

As for the administration’s recent break with the insurance industry, Mr. Tauzin said, “The insurers never made any deal.”

- 30-

So, we have deals in the back rooms and under the table. We have a primary culprit in creating our healthcare mess making demands and threats. The President is going to force Congress to its will (ironic when they are showing no backbone) as a part of his bipartisanship, I’m guessing.

I am disheartened. I am sick. We are no longer citizens. We are subjects. Plutocracy rules.

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No servant can serve two masters: for either he will hate the one, and love the other; or else he will hold to the one, and despise the other.

The Biblical citation is also found, excepting one word, in Matthew 6:24. Matthew substitutes man for servant. Since the subject is public servants, I lean toward Luke.

In my last two posts I mentioned my challenge to Bart Gordon, Blue Dog extraordinaire, to debate me on healthcare reform. I made a mistake.

I wanted to debate the representative of my congressional district, which includes the counties of Sumner, Rutherford, Wilson, Robertson, Macon, Trousdale, Clay, Jackson, Smith, Overton, Putnam, Dekalb, Cannon, Bedford and Marshall. It appears that this district is unrepresented. Perhaps it’s time to break out the old rallying cry of “No taxation without representation.” It certainly applies.

It seems that Representative Gordon’s district includes Blue Cross, Cigna, Aetna and the other members of AHIP, as well as the American Hospital Association, al-PhARMA and AARP. The challenge stands, however. Otherwise I would have to find some other representative to debate.

I was just ruminating about the Blue Dogs and thought that their constituents must have a very weak case if it costs so many millions to get their side out. Another thought was that they are always attacking the ephemeral “public option.”

Their version of the public option is socialistic, government-run, rationed care, expensive, denial of choice, et cetera, ad nauseum. We are always on the defensive. Someone asked, what’s so good about the private plans. Let’s go there.

Private plans are far more expensive. Not only do they average close to 30% more in administrative costs than Medicare, they have to charge enough to make a profit. Cigna’s CEO makes $12.2 million a year, plus stock options and a $73 million golden parachute. You pay for that. I don’t think any government employees make quite that much. Oh, and they have to buy all of those congressmen and spend all of that money defending lawsuits and paying multi-million dollar fines for fraud.

Private plans ration care. Several months ago a 19-year old girl was told a liver transplant was “experimental.” Tell that to Steve Jobs. National publicity caused the insurance company to reverse itself, the day before she died. Waits for most types of transplants are longer in the U.S. than most European countries and elsewhere.

Private plans also ration care by canceling customers, limiting total expenditures and denying preexisting conditions. Between 1995 and 2008 the percentage of small and medium businesses providing health insurance to employees dropped from 67% to 38%. That’s called rationing by price.

A former New York Times health reporter says that at any given time 65% of us have a prescription drug in our home. Since the health industry has access to pharmacy records (oh, you didn’t know?) they can easily find a “preexisting condition” to use for denying you coverage. Do you take a birth control pill? That means you have the preexisting condition of potentially bearing a child. Did a psychiatrist prescribe an SSRI to help you when a parent, child or spouse died?

Since most private plans are through employers, a pink slip means you just lost your coverage. The stimulus package included some money to help a little with the temporary Cobra plan. That could still run you $700 a month or more. That’s alright though. You can cover that from your unemployment check.

The largest contingent of people filing for bankruptcy are those forced to do so because of medical bills. The majority of these people had private health insurance. I have not found a single case of anyone forced into bankruptcy because of Medicare.

Private plans frequently limit your choice of providers, physicians and hospitals. I have had 32 or 33 doctors in the past 4 years while covered by Medicare. I always ask for referrals from those I already see. I have not had a single problem and, Nashville being one of the major hubs for hospitals and medical care, many of my doctors have national or regional reputations.

Private plans resemble a Keystone Cops version of the Mafia. Consider this. You own a retail shop and the Mafia comes in and asks the value of your inventory. You answer $100,000. They offer protection for 30% of that. You can be certain no one will touch that merchandise, as long as you pay up.

Private plans want 30% or so for their administrative costs plus all of the other costs I mentioned above. So now you are covered. Right? Well, maybe, maybe not. Remember those 14,000 losing their private plan every day? Remember those “experimental procedures?” And, lest we forget, the price will change. It will likely double again in the next six years. The Mafia are bleeding hearts by comparison.

Private plans are socialistic. Hey, I caught you off guard with that one, didn’t I? It’s true. Private insurance plans, as well as hospitals, drug companies, et alia, get direct subsidies. They get indirect subsidies. They get tremendous tax breaks. In fact, without those subsidies and tax breaks it is difficult to see how they could possibly operate. The numbers are interesting.

Private plans put bureaucrats between you and your provider. Yeah, I know how they yell and scream that it will happen with a public option. I also know that no bureaucrat from Medicare has ever gotten between me and any of my providers. But, it happens constantly with private plans.

The private firms actually have layers of bureaucrats. Bureaucrats working for the private plans are often given goals of how many procedures will be turned down. One may also want to ingratiate himself with the boss, or just try to protect his job. They don’t have civil service protection.

Private insurance companies lie, to anyone and everyone. They are now telling Congress they will quit denying people with preexisting conditions and work for universal coverage. If you would like to check, you will find that they made the exact same promises in 1993, in their successful effort to stop any reform.

And speaking of lying, the health industry has formed and funded several “grass roots” nonprofits to help you “get the facts” about our healthcare system. You know the one, the best in the world, that provides a shorter life expectancy for men than Mexico; a higher infant mortality than Cuba.

Those congressmen might find a way to represent us mere citizens, if they were familiar with the Bible.

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Someone recently asked me what the objections to single-payer are from those opposed. I’m glad they didn’t specify that it had to be rational objections. That would leave me searching for another topic.

My job was made somewhat easier by a column in the New York Times by Randy Cohen, former writer for David Letterman. Mr. Cohen suggests that Congress needs a Debate Umpire. He likens that position to a judge in a courtroom. The judge can rule and overrule to require participants to maintain certain standards as to logic, honesty and ethics. He assures that anyone using disingenuous arguments is called to task.

When it comes to trying to maintain the present system, or leach even more from us, the opponents of real reform have been most industrious in creating confusion, distortions, distractions and lies. I will paraphrase and take slight liberties in adapting his efforts to this post.

He addresses their objections to a public option. They say it would be unfair or destroy private options. That is not so with education. Private and parochial schools exist despite a public school option. The University of Tennessee has not driven Vanderbilt out of business.

FedEx, as he puts it, tolerates the U.S. Postal Service. He observes that no one is calling for closing down Yosemite because Six Flags is in bankruptcy court. Public libraries have not chased Barnes & Noble out of the mall.

Here I will simply quote Mr. Cohen, “In his critique of the public option, Representative Paul Ryan, a Republican from Wisconsin, invoked the inability of his 7-year-old daughter’s lemonade stand to compete with McDonald’s. (You’d think she’d thrive, incidentally, what with lemonade not being on the McDonald’s menu.) “It’s impossible to have a level playing field with a public plan,” Ryan said, asserting that private insurers could be driven out of business by the unfair competitive advantages enjoyed by a government-sponsored insurer.”

Further down, he writes, “In an op-ed for The Wall Street Journal, Karl Rove concluded: “If Democrats enact a public-option health-insurance program, America is on the way to becoming a European-style welfare state.” This is a slippery-slope argument, the sort of thing that should set off warning bells. If we impose a 65 miles-per-hour speed limit, we’re on the way to a 55 m.p.h. limit, then down to 5 m.p.h., and ultimately to mandatory driving in reverse.”

You shouldn’t be too surprised if a Congressman couldn’t come up with an appropriate analogy. Nor should it be a shock that the former political genius finds it more convenient to avoid logical arguments. The purpose of both was not to enlighten. Actually, neither were they seeking to debate. They were falling back on their mainstay – fear-mongering.

Some object to single-payer because it would mean the end of bribes. The government isn’t supposed to grease the palms of Congressmen. Others object because it would cause a major spill from their gravy train.

Then there are the true believers. They believe that government forced all those working for the Wall Street Casino to destroy the global economy. They believe that Halliburton-built showers in Iraq that electrocuted several of our troops were absolutely necessary to accomplishing the mission. They believe that Lockheed’s F-22 could fly in the rain if they were only allowed to sell us more of them. They believe that PhARMA, the AHA and the AHIP are being patriotic by forcing people into bankruptcy court and canceling 14,000 policies every day.

They believe that there is such a thing as a “free market.” They believe that a plutocracy is a democracy. They believe that the collusion of a few corporations is capitalism. They believe their simpleminded economic theology is more important than the lives and welfare of you and me and millions of others. Are you ready to die for their ignorance?

They claim that the government will ration healthcare. Unless lots more people start donating organs there will continue to be rationing of transplants regardless of who pays. I hope rationing means I don’t get a prescription for Nexium. I hope someone saves me from taking an ineffective, expensive, dangerous drug when Pepto-Bismol works better. I hope I don’t have some clerk in an insurance company rationing my healthcare because he wants to impress his boss or meet a quota. We have rationing. We will have rationing. The government is not going to ration care to increase profits or impress Wall Street.

Look at all of the lost jobs if we eliminate the health insurance companies. Two things. There will still be health insurance companies. They will be much smaller but people on Medicare buy medigap policies to cover the 20% that Medicare doesn’t. Those with enough money will be able to buy concierge service. They have that in the UK. It doesn’t improve the outcomes vis-a-vis the National Health Service but some people with money are willing to pay extra to feel that they are special.

Healthcare reform that provides universal coverage, or nearly so, will create far more jobs. These jobs will mostly be involved in caring for people rather than just taking their money. Not a single insurance company treats a single malady.

Whether public option, co-op, Aetna or any other plan, if it isn’t single-payer, it is not economically or fiscally viable. Each is a sham. Each is a diversion.

As I implied earlier, there are no real, honest, logical arguments in favor of any other option. Therefore, the opponents have put forth their efforts to attack single-payer and create fantasies about the plan that makes them wealthy, keeps them in office or assures them their 72 virginal Ayn Rand look-alikes in paradise.

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Guess what the most important issue in Washington is. Healthcare reform? Wrong.

I just saw a news bulletin. The House Democrats have produced HR II, their 1,018 page version of healthcare reform. Well, now, not exactly.

So, what, exactly?

Listen closely. They actually produced a bill calling for marginal changes in health insurance. You think that health insurance and healthcare are synonymous? Not in my thesaurus.

I have no interest in health insurance, reformed or otherwise. My concern is for solving the healthcare crisis the American’s Health Insurance Plans (AHIP), the Pharmaceutical Research and Manufacturers of America (PhARMA), the American Medical Association (AMA) and the American Hospital Association (AHA) have created.

I should make one note here. Fifty-nine percent of physicians find single-payer acceptable or actively support it. The AMA’s membership includes 19 percent of all physicians. Opposing the AMA is not necessarily the same as opposing your family practitioner.

By the way, two Senate committees have also created their own Frankensteins.

The growth in healthcare costs is three times that of the overall economy. That is unsustainable, even for those who might be satisfied with their present coverage. We have no choice. We have to change this system. We already allocate one of every six dollars in our entire economy to this one area.

Let me put the burden on you. Explain how you take the most expensive system in the world, the least efficient system of any advanced country, give the people who created the mess millions of additional subsidized customers, spend an additional trillion dollars and call it healthcare reform. Explain how one justifies calling it a way of saving money.

The House of Representatives alone could save over a thousand pages per copy of their bill by simply making it Medicare-For-All.

The former CEO of HCA, who caused it to have to pay the largest fine in history, who funded the Swift Boat Veterans campaign against Kerry during the 2004 race, is now your champion. He is funding millions of dollars of issue ads to defeat healthcare reform. Do you trust him to have your best interests in mind? Do you believe the claims of those ads about how terrible other systems are? Why are they not screaming at their leaders to adopt our system?

As I was writing, there was an interview on television with a mother who lost her daughter. Why? Because the health insurance company claimed that a liver transplant was experimental. Really? If you want to ask Steve Jobs about his experimental surgery here in Tennessee, I’ll try to get his email address for you. See how well our system works, for billionaires? At least she didn’t have to wait in one of those lines for a flu shot.

Any politician speaking on the subject who supports any reform that is not single-payer should not be taken seriously. S/He is merely repeating the talking points of AHIP, PhARMA, AMA and AHA. It may be because they are being paid to do so or because they are gullible. Does it make a difference which, if they are going to support one of the faux reform bills?

Either it is a single-payer system or it is a fraud.

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You’ve heard all the good news coming out of Washington.

al-PhARMA has generously offered to cut their theft by $80 billion over the next 10 years.

The health insurance industry is promising to reduce their greed by 1.5% for the next 10 years.

HCA and other the poor hospital corporations (ignore all of those construction cranes) are offering to forgo a fraction of their annual increases.

What more could we possibly ask for? How about a bit of honesty and some serious savings?

We should note that with universal healthcare, or something approaching it, there will be more patients for the hospitals and more customers for drugs. The insurance companies are expecting more clients as well. The pie will be bigger and they all want a private system to ensure they can continue to leech off of the misery and misfortune of their fellow Americans.

The insurance companies have signed up one-fourth of those eligible for Medicare for a scam. The companies get the Medicare monies plus an additional $11 billion a year subsidy. They promised it would result in better outcomes. It hasn’t. There’s an attractive saving.

If I say let’s rid ourselves of the prime culprits who created the current mess, some will scream that all of those poor, unnecessary insurance company employees will be out of work. Actually, a single-payer system will create far more jobs than it eliminates. It also gives these people something to do which will benefit rather than harm the rest of us. Savings and more jobs.

The savings would even pay for their retraining. The executives would have to adjust to a significant pay cut. I recommend they begin a savings account now. They might even consider selling 3 or 4 of their mansions and trading down a couple of their private jets.

Hospitals may complain about the government requiring them to behave in a socially responsible manner but most are adequately subsidized. There are numerous areas of possible savings for the government vis-a-vis hospitals. Some are obvious, some not.

Without an autopsy many fatalities are ascribed to auto accidents. Was the driver made drowsy by medication? Did a mixture of drugs prove toxic? Hospitals were required to autopsy 20% of the deaths they handled. They failed to do so. So, once again the government relented to the lawbreakers. We are left with less information about causes of death than we could use. This costs lives and wastes money.

Medicare pays for an autopsy when anyone over 65 dies. They pay for it. The hospitals take the payment. They don’t perform the autopsies. The hospitals don’t want their mistakes known. The same with physicians.

The White House is giving major play today to an announcement that the hospitals are offering a savings of $155 billion over the years. That seems too specific a number when one sees the how vague and lacking in detail the “deal” actually is. Don’t get too excited about it yet.

The drug companies don’t want you to be reminded that prescription drugs, taken as prescribed, are the 4^th leading cause of death. The information gained from knowing the real cause of death in many cases contributes to the saving of lives and money.

Prescribing a drug for something not approved by the FDA is known as prescribing off-label. It is against the law for drug companies to even suggest it. Surprise, they do it anyway. One drug, Neurontin, earned over $9 billion from off-label uses. That is over 90% of its total earnings. Not a single scientific study showed it to be efficacious for any of these off-label problems.

Neurontin was approved for epileptic seizures. It was almost useless, even for that. It was to be used as a second drug to aid a primary drug if it wasn’t doing the job. The company trained their sales force to break the law by recommending it for essentially everything: ADD, manic-depression, sexual dysfunction, hiccups, any neurological disorders they could think of, tremors, Lou Gehrig’s disease, peripheral neuropathy, migraines and a host of other maladies.

John Ford, a senior marketing executive, told a meeting of salespeople, “That’s where we need to be, holding their hand and whispering in their ear. Neurontin for pain, Neurontin for monotherapy, Neurontin for bipolar, Neurontin for everything.” He also stated, “I don’t want to hear that safety crap either. Have you tried Neurontin? Everyone of you should take one just to see there is nothing. It’s a great drug.” This was in response to a question of tripling the approved dosage.

At least $9 billion was wasted on off-label and the remaining billion dollars was spent on something that barely worked in the studies the company itself conducted. Those studies, by the way, were definitely not scientific. They ignored such niceties as randomization, double blinds and placebo-controlled protocols.

Such cavalier behavior, in defiance of the law, is not limited to one drug, or one company. It is rampant. It is costly. There needs to be penalties for physicians prescribing off-label. The government could save billions by refusing to pay for such prescriptions.

They will claim that it is sometimes advantageous. Create a waiver office. Require a waiver in advance if it is to be covered. Records could be kept to see which drugs and which prescribers show up too frequently, prompting an audit. Major savings and fewer lives lost to untested medications.

Presently, the overwhelming majority of research and advertising money spent by the drug companies is aimed at “me-to” drugs. When a competitor has a major success they copy the drug but slightly modify a molecule for the purpose of obtaining a patent. Patents should be given out only one to a class of drugs. Coverage should be for generics only, once they are available. This would provide enormous savings.

The government has no interest in promoting or paying for lifestyle drugs. Yeah, you know what I’m referring to: Viagra, et al. Here is a bit more of a savings.

The members of al-PhARMA are subsidized by the government in many ways. This come through tax advantages that other industries don’t enjoy. It comes through both direct and indirect subsidies.

Some of the biggest breakthroughs in the field came from government labs or academic labs supported by tax monies. The drug lords get to claim credit and profits for these. Why should we taxpayers pay the drug companies to advertise, market and profit from these drugs? Once again, significant savings.

There is no earthly reason for advertising drugs to the public. Only the US and New Zealand permit it. Does the patient know about a drug that was advertised on TV while his physician is unaware of a treatment for the patient’s problem?

Which drugs receive the most airtime and ink? The ones that are the most expensive, the least effective and share the market with the most “me-to” competitors. The savings to the drug companies from not advertising could be passed along. Although probably not, if properly monitored it could be a sizable savings.

Drug companies do not violate the law. The executives do. All legal judgments should be borne by the people who perpetrate the violations. At least tens of thousands of people have died in this country from the illegal actions of pharmaceutical executives. Why have none been imprisoned? Why have none been fined? Why have none been charged?

Eliminate all payments and other considerations of value to physicians from the drug companies. This costs the drug companies and, in turn, the government, insurance companies and you and me. Any physician working for or receiving remuneration from a drug company should be barred from academia and clinical practice for 5 years.

Physicians average an income level that puts them in the upper percentiles financially. If they need free dinners at expensive diners and frequent trips to exclusive resorts in order to read medical studies or listen to paid hawkers of snake oil, they might hold on to their Lexus SUVs an extra year or two. If passed along, the drug companies’ savings would be of considerable help to patients and taxpayers.

Give us real science. We don’t automatically accept the defendant’s account in a courtroom. Why do we accept a drug pusher’s claims for his products? Time after time we see violations of accepted scientific protocols. This isn’t an occasional gotcha. This is de rigueur for the entire industry.

Destroy the FDA and start from scratch. Why are drug companies allowed to pay the FDA to divert their resources? The drug company will only pay for what it thinks is a profitable product. That translates to “me-to” and lifestyle drugs. The FDA’s priority focus of resources should be to needed drugs. The revolving door between the FDA and PhARMA should be boarded up. FDA personnel should not be allowed to work for the drug companies on the side.

When you add up the number of people covered by Medicare, Medicaid, SCHIP, the military, the VA and civilian employees of the government it turns out that the government is already paying 45% of the entire healthcare bill.

Simply extending Medicare to everyone would give us a single-payer system. That would be far more practical and far less expensive than putting the entire population on the Congressional payroll. We would get a better plan though.

The potential savings I have covered are not exhaustive. They are, however, sufficient to pay for a single-payer system without taxing health benefits or being burdened by any of the other straw men the industry is using to scare you.

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Who do you trust? John Belushi got it right. Most academics get it wrong.

Everyone in academia knows just what a symposium is. At least they think they know. Have you read Plato’s Dialogues? One was named Symposium. Yes, the Greeks had a word for it: a drunken party. I could have heard much more intelligent talk at an Animal House toga party than I heard at a medical symposium held at Vanderbilt University.

Just remember, these are the people into whose hands you put your health, well-being and life. Take no aspirin and call me in the morning.

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