NY Times:
One night several years ago, my mom slipped and broke a bone in her neck. I stayed late at the hospital with her. Driving home on a mostly deserted road, I checked my cellphone messages.
I didn’t notice either the red light coming up or the car stopped at the light. I banged into the back of it, and even though the damage was minor, it was a scary moment.
I admitted that I was upset and distracted, took the blame and swore to myself I’d never use a cellphone in a car again. But, of course, I did. D.C. police will pull you over if they see you using a cellphone that you’re holding up to your ear, but not if you’re hands-free.
Ominously, research by the National Highway Traffic Safety Administration — suppressed for years and released on Tuesday after petitions were filed by advocacy groups — shows that there are “negligible differences” in accident risk whether you’re holding the phone or not. Hands-free devices may even enhance the danger by lulling you into complacency.
It is the conversation that pulls focus. My greatest fear is that I’m going to be in a taxi when the driver gets a call from his wife to tell him that she’s run off with his sexy cousin.
In a March New Yorker profile, Tony Gilroy, the screenwriter of “Michael Clayton” and “Duplicity,” told the nightmare tale of being in a New York taxi when the cell-chatting driver ran a red light and hit another car.
“So they’re lifting the other guy out of the car, and I’m thinking, I’m lucky,” he said, adding: “Then I see them come at my cab with those things, the Jaws of Life.” He’d fractured his rib and hip.
Studies show that drivers who talk on cellphones are four times more likely to be in a crash and drive just as erratically as people with an 0.08 percent blood-alcohol level.
In one study cited by the highway safety agency, “drivers found it easier to drive drunk than to drive while using a phone, even when it was hands-free.”
The agency buried its head in the sand, keeping the research to itself for years and ignoring the fact that soon nearly all Americans would own cellphones and that the phones are always getting smarter and more demanding, putting a multimedia empire at your fingertips while you’re piloting a potentially lethal piece of artillery.
Americans are so addicted to techno-surfing that they’ve gotten hubristic about how many machines they can juggle simultaneously. One reporter I know recently filed a story from his laptop while driving on the Pacific Coast Highway.
As John Ratey, the Harvard professor of psychiatry who specializes in the science of attention, told The Times’s Matt Richtel for his chilling series, “Driven to Distraction,” using digital devices gives you “a dopamine squirt.”
That explains the Pavlovian impulse of people who are out with friends or dates to ignore them and check their BlackBerrys and cellphones, even if 99 out of 100 messages are uninteresting. They’re truffle-hunting for that scintillating one.
Americans woke up one day to find that they were don’t-miss-a-moment addicts who feel compelled to respond to all messages immediately.
The tech industry is our drug dealer, feeding the intense social and economic pressure to stay constantly in touch with employers, colleagues, friends and family.
It also explains why Christopher Hill, a 21-year-old from Oklahoma who killed a woman last September when he ran a red light while on his cellphone and rammed into her S.U.V., tried to keep dialing and driving with a headset his mother gave him two months after the accident.
He “found his mind wandering into his phone call so much that ‘I nearly missed a light,’ ” he told Richtel. Now he says he rarely uses the phone.
Hollywood offered a cautionary story with the depressing “Seven Pounds,” which begins with Will Smith spoiling his perfect life when he BlackBerrys while driving in his fancy car with his gorgeous new fiancée. He crashes into another car, killing six strangers and his girlfriend. The movie ends with a poisonous jellyfish in an icy bathtub. Don’t ask.
Left, literally, to our own devices, we spiral out of control. States should outlaw drivers from talking on phones — except in an emergency — and using digital devices that cause you to drift and swerve; or at least mandate a $10,000 fine for getting in an accident while phoning or Twittering.
Auto companies are busy creating new crack hits for our self-destructive cravings. Ford is developing a system that would let drivers use phones and music players and surf the Internet with voice commands and audible responses.
Sounds like a computerized death machine. But, as our dealers know, we’ll never disconnect.
Thursday, July 23, 2009
Wednesday, July 22, 2009
POLITICO's 10 questions for Obama
By: Jonathan Martin and Josh Gerstein
For the first time in his presidency, Barack Obama is using a prime-time news conference Wednesday night to play catch-up.
With the public souring on both his handling of health-care reform and the economy, Obama is stepping to the podium for the fourth time in six months in hopes of convincing the public he’s got a plan, to get the economy back on track and a health overhaul that will expand care to all without busting the budget.
With Democrats fractured on health-care and the GOP sensing a major political opportunity, Obama is engaged in an inside-outside strategy, cajoling members of Congress in private White House sessions while using his bully pulpit to rally public support for his plan.
So it’s health care where we start with our 10 Questions for President Obama.
1) Is it still realistic that both chambers of Congress will pass health care bills before their summer recess in August? And how worried are you that missing the deadline could endanger your hopes of getting a bill this year?
A former senator himself, Obama knows Congress works best under a deadline – and he called on both houses to pass a health bill before heading off on summer vacation. So far anyway, it’s not working. Obama suggested Monday that he was willing to bend his oft-stated deadline, saying it would be OK if the legislation is “going to spill over by a few days or a week.”
But even that may not be realistic. Senators of both parties have publicly warned against rushing through the process, and rank-and-file members in both chambers have raised concerns over everything from the high costs to whether a government-run insurance option is the best way to go, as Obama has sought.
Neither the House nor the Senate has scheduled floor votes and key committees in both have yet to even approve a bill – meaning it might be see you in September time for the president’s health-care goals.
On Tuesday, House Majority Leader Steny Hoyer (D-Md.) seemed to defy Obama, saying: “If we get consensus, we'll move on it. If we don't get consensus, I don't think staying in session is necessarily necessary.”
2) Who are you referring to when you cite, as you did in your radio address last week, those “special interests” in health care who “make the same old arguments, and use the same scare tactics?” And what’s the difference between honest objections to a massive overhaul of the U.S. healthcare system, and what you consider obstructionism?
Obama has actually worked assiduously, and successfully, to court many of the stakeholders with a financial interest in healthcare – drug-makers, insurance companies and others who could strike a serious blow at his plan if they came out strongly against it.
He has hosted a variety of them at the White House, trumpeted the financial agreements struck with pharmaceutical companies and hospitals and used some of their endorsements in recent days to underline the support behind getting a bill passed.
Just on Tuesday, Obama touted such groups and others — he actually singled out the American Nurses Association and the American Medical Association — to highlight “the consensus” for legislation. So who are the bad guys that are trying to scuttle reform? Perhaps Obama will name names tonight.
3) You have sought to focus attention on Sen. Jim DeMint’s comments alluding to the political benefit for the GOP in blocking healthcare reform, but it’s mostly Democratic members of Congress that your own political apparatus is targeting in TV ads now on the air. Why haven’t you been more successful in convincing members of your own party on this issue so far, and how does DeMint figure into your effort to lobby Democrats?
Obama and his allies have been harping on DeMint’s reference to health care as Obama’s potential “Waterloo,” but the South Carolina senator is one of just 40 GOP senators.
It’s not the conservative DeMint but rather moderate Democrats and Republicans in the Senate and the conservative Blue Dog Democrats in the House who ultimately will decide health care’s fate. And right now, they’re not happy – particularly the fiscally conservative Blue Dogs who fear a deficit explosion if Obama gets his way.
It’s these members who have been brought down to the White House for meetings with the president.
So why is it DeMint who the White House is singling out? Clearly it’s part of the “Party of No” mantra the White House likes to use against Republicans. But perhaps it’s also to send a reminder to those recalcitrant members of Obma’s own party that failure on health care is what the opposition is pulling for – and that such failure would have grave political consequences for all Democrats.
4) You said during the campaign that you would negotiate the health care bill on C-SPAN. But now you won't even release the names of health care executives who visit the White House for what are closed door discussions. How do you reconcile what you said during the campaign with your approach now?
As part of his stump speech, Obama would often describe his vision for the process behind health care reform.
At a campaign stop in Virginia last summer, he said: "We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies -- they'll get a seat at the table, they just won't be able to buy every chair. But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies.”
Now, though, none of the White House negotiations are open for public consumption. And the Obama administration has rejected a request from a watchdog group to disclose the health care industry executives who have come to the White House to discuss the issue. The group, Citizens for Responsibility and Ethics, is poised to sue Obama’s administration to obtain the records.
5) On Monday you said that “folks on Wall Street don’t feel any remorse for taking all these risks; you don’t get a sense that there’s been a change of culture and behavior as a consequence of what has happened." What do you think Wall Street needs to do to show remorse and to change its culture? And isn’t the problem with the economy right now not some Wall Streeters getting bonuses, but the fact that recession is much tougher and deeper than even your administration projected?
While nothing like the AIG bonuses that fueled so much populist resentment this spring, news of Goldman Sachs’ monster second-quarter profits and subsequent billions worth of bonuses has again focused attention on Wall Street excesses.
According to a New York Times estimate, Goldman workers could earn an average of $770,000 this year, about the same as they did during the go-go boom years. Goldman paid back the $10 billion in federal bailout money they received, freeing them of compensation restrictions.
Republicans have scored points recently by pointing out that Congress approved nearly $800 billion in stimulus spending, and yet the unemployment rate is 9.5 percent and rising. Look for Obama to ask for patience from the public that his administration is focused every day on turning around the economy.
6) Attorney General Eric Holder is considering appointing an independent prosecutor to investigate alleged abuses of detainees during the Bush era. When the White House was asked about this, officials repeated your mantra that the country should look forward, not back. What’s your view about when it’s appropriate for the White House to send signals to the Justice Department about what action it should take in regarding a criminal investigation?
Holder is wrestling with the issue of whether to appoint an independent prosecutor to determine whether crimes were committed as part of the Bush administration’s “enhanced interrogation techniques”—or outside of them. While the White House has stressed Holder’s independence, it hasn’t been bashful about putting a little English on the ball. “My best guidance for you and others on this would be to look back at what the President has said over the course of the past many weeks…that our efforts are better focused looking forward than looking back,” Press Secretary Robert Gibbs said last week when asked about Holder’s dilemma.
7) In announcing the delay of up to six months in the report on detainee policy, White House officials said the issues were “hard” and “complicated” and that you wanted them to “get this right.” Weren’t they hard and complicated when you set the deadline earlier this year? What has changed? And are you still committed to closing Guantanamo Bay prison by January?
On his second full day in office, Obama held an Oval Office ceremony to sign executive orders setting a one-year deadline for closing Guantanamo and six-month deadlines for government task forces revamping detainee and interrogation policies. This week, the administration blew past the task force deadlines, even as it claims to be on track to close Gitmo.
“These are hard, complicated and consequential decisions. I mean, let’s not kid ourselves,” a senior administration official said at a White House briefing Monday. “We wanted to get this right,” another official said. However, the officials had no real explanation for how or why the issues turned out to be more complicated than they thought in January. They also insisted, though somewhat less than forcefully, that they are still working towards Obama’s goal of closing the controversial facility in January, even though an uproar in Congress has complicated his ability to bring prisoners to the U.S.
8) Your Secretary of State recently compared the North Korean regime attention-craving adolescents. Do you agree with that assessment, and either way, how do plan to proceed toward reining in North Korea’s missile program?
In an interview with ABC News earlier this week, Secretary of State Hillary Clinton offered a colorful description of Pyongyang: "What we've seen is this constant demand for attention, and maybe it's the mother in me or the experience that I've had with small children and unruly teenagers and people who are demanding attention.”
Continuing, she said: "Don't give it to them. They don't deserve it. They are acting out in a way to send a message that is not a message we're interested in receiving."
9) Harvard professor Henry Louis Gates Jr. was recently arrested by Cambridge police at his own home. Now the African-American scholar said he plans to use the experience to focus attention on racial profiling and the black experience in the criminal justice system. Do you think Gates was justified in accusing the police of being harassed for being “a black man in America?”
Obama has avoided intervening in such racially charged incidents in the past – even drawing criticism for not speaking up more about such controversies as Jena, Louisiana in two years ago – but given Gates’ prominence (and ties to Obama’s alma mater) and his intent to draw attention to the matter, it may be tough for the president to avoid weighing in on what happened in Cambridge and larger issues relating to African-Americans and law enforcement.
10) Do you still plan on joining a Washington-area church and attending services?
Six months into his presidency, Obama has attended Sunday services just once in Washington, D.C. – at St. Johns Episcopal across from Lafayette Square on Easter.
The White House knocked down a report that the president would make the non-denominational chapel at Camp David his church home, saying that the president continues to look for a congregation. Aides say the president is concerned about disrupting the worship experience of others.
For the first time in his presidency, Barack Obama is using a prime-time news conference Wednesday night to play catch-up.
With the public souring on both his handling of health-care reform and the economy, Obama is stepping to the podium for the fourth time in six months in hopes of convincing the public he’s got a plan, to get the economy back on track and a health overhaul that will expand care to all without busting the budget.
With Democrats fractured on health-care and the GOP sensing a major political opportunity, Obama is engaged in an inside-outside strategy, cajoling members of Congress in private White House sessions while using his bully pulpit to rally public support for his plan.
So it’s health care where we start with our 10 Questions for President Obama.
1) Is it still realistic that both chambers of Congress will pass health care bills before their summer recess in August? And how worried are you that missing the deadline could endanger your hopes of getting a bill this year?
A former senator himself, Obama knows Congress works best under a deadline – and he called on both houses to pass a health bill before heading off on summer vacation. So far anyway, it’s not working. Obama suggested Monday that he was willing to bend his oft-stated deadline, saying it would be OK if the legislation is “going to spill over by a few days or a week.”
But even that may not be realistic. Senators of both parties have publicly warned against rushing through the process, and rank-and-file members in both chambers have raised concerns over everything from the high costs to whether a government-run insurance option is the best way to go, as Obama has sought.
Neither the House nor the Senate has scheduled floor votes and key committees in both have yet to even approve a bill – meaning it might be see you in September time for the president’s health-care goals.
On Tuesday, House Majority Leader Steny Hoyer (D-Md.) seemed to defy Obama, saying: “If we get consensus, we'll move on it. If we don't get consensus, I don't think staying in session is necessarily necessary.”
2) Who are you referring to when you cite, as you did in your radio address last week, those “special interests” in health care who “make the same old arguments, and use the same scare tactics?” And what’s the difference between honest objections to a massive overhaul of the U.S. healthcare system, and what you consider obstructionism?
Obama has actually worked assiduously, and successfully, to court many of the stakeholders with a financial interest in healthcare – drug-makers, insurance companies and others who could strike a serious blow at his plan if they came out strongly against it.
He has hosted a variety of them at the White House, trumpeted the financial agreements struck with pharmaceutical companies and hospitals and used some of their endorsements in recent days to underline the support behind getting a bill passed.
Just on Tuesday, Obama touted such groups and others — he actually singled out the American Nurses Association and the American Medical Association — to highlight “the consensus” for legislation. So who are the bad guys that are trying to scuttle reform? Perhaps Obama will name names tonight.
3) You have sought to focus attention on Sen. Jim DeMint’s comments alluding to the political benefit for the GOP in blocking healthcare reform, but it’s mostly Democratic members of Congress that your own political apparatus is targeting in TV ads now on the air. Why haven’t you been more successful in convincing members of your own party on this issue so far, and how does DeMint figure into your effort to lobby Democrats?
Obama and his allies have been harping on DeMint’s reference to health care as Obama’s potential “Waterloo,” but the South Carolina senator is one of just 40 GOP senators.
It’s not the conservative DeMint but rather moderate Democrats and Republicans in the Senate and the conservative Blue Dog Democrats in the House who ultimately will decide health care’s fate. And right now, they’re not happy – particularly the fiscally conservative Blue Dogs who fear a deficit explosion if Obama gets his way.
It’s these members who have been brought down to the White House for meetings with the president.
So why is it DeMint who the White House is singling out? Clearly it’s part of the “Party of No” mantra the White House likes to use against Republicans. But perhaps it’s also to send a reminder to those recalcitrant members of Obma’s own party that failure on health care is what the opposition is pulling for – and that such failure would have grave political consequences for all Democrats.
4) You said during the campaign that you would negotiate the health care bill on C-SPAN. But now you won't even release the names of health care executives who visit the White House for what are closed door discussions. How do you reconcile what you said during the campaign with your approach now?
As part of his stump speech, Obama would often describe his vision for the process behind health care reform.
At a campaign stop in Virginia last summer, he said: "We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies -- they'll get a seat at the table, they just won't be able to buy every chair. But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies.”
Now, though, none of the White House negotiations are open for public consumption. And the Obama administration has rejected a request from a watchdog group to disclose the health care industry executives who have come to the White House to discuss the issue. The group, Citizens for Responsibility and Ethics, is poised to sue Obama’s administration to obtain the records.
5) On Monday you said that “folks on Wall Street don’t feel any remorse for taking all these risks; you don’t get a sense that there’s been a change of culture and behavior as a consequence of what has happened." What do you think Wall Street needs to do to show remorse and to change its culture? And isn’t the problem with the economy right now not some Wall Streeters getting bonuses, but the fact that recession is much tougher and deeper than even your administration projected?
While nothing like the AIG bonuses that fueled so much populist resentment this spring, news of Goldman Sachs’ monster second-quarter profits and subsequent billions worth of bonuses has again focused attention on Wall Street excesses.
According to a New York Times estimate, Goldman workers could earn an average of $770,000 this year, about the same as they did during the go-go boom years. Goldman paid back the $10 billion in federal bailout money they received, freeing them of compensation restrictions.
Republicans have scored points recently by pointing out that Congress approved nearly $800 billion in stimulus spending, and yet the unemployment rate is 9.5 percent and rising. Look for Obama to ask for patience from the public that his administration is focused every day on turning around the economy.
6) Attorney General Eric Holder is considering appointing an independent prosecutor to investigate alleged abuses of detainees during the Bush era. When the White House was asked about this, officials repeated your mantra that the country should look forward, not back. What’s your view about when it’s appropriate for the White House to send signals to the Justice Department about what action it should take in regarding a criminal investigation?
Holder is wrestling with the issue of whether to appoint an independent prosecutor to determine whether crimes were committed as part of the Bush administration’s “enhanced interrogation techniques”—or outside of them. While the White House has stressed Holder’s independence, it hasn’t been bashful about putting a little English on the ball. “My best guidance for you and others on this would be to look back at what the President has said over the course of the past many weeks…that our efforts are better focused looking forward than looking back,” Press Secretary Robert Gibbs said last week when asked about Holder’s dilemma.
7) In announcing the delay of up to six months in the report on detainee policy, White House officials said the issues were “hard” and “complicated” and that you wanted them to “get this right.” Weren’t they hard and complicated when you set the deadline earlier this year? What has changed? And are you still committed to closing Guantanamo Bay prison by January?
On his second full day in office, Obama held an Oval Office ceremony to sign executive orders setting a one-year deadline for closing Guantanamo and six-month deadlines for government task forces revamping detainee and interrogation policies. This week, the administration blew past the task force deadlines, even as it claims to be on track to close Gitmo.
“These are hard, complicated and consequential decisions. I mean, let’s not kid ourselves,” a senior administration official said at a White House briefing Monday. “We wanted to get this right,” another official said. However, the officials had no real explanation for how or why the issues turned out to be more complicated than they thought in January. They also insisted, though somewhat less than forcefully, that they are still working towards Obama’s goal of closing the controversial facility in January, even though an uproar in Congress has complicated his ability to bring prisoners to the U.S.
8) Your Secretary of State recently compared the North Korean regime attention-craving adolescents. Do you agree with that assessment, and either way, how do plan to proceed toward reining in North Korea’s missile program?
In an interview with ABC News earlier this week, Secretary of State Hillary Clinton offered a colorful description of Pyongyang: "What we've seen is this constant demand for attention, and maybe it's the mother in me or the experience that I've had with small children and unruly teenagers and people who are demanding attention.”
Continuing, she said: "Don't give it to them. They don't deserve it. They are acting out in a way to send a message that is not a message we're interested in receiving."
9) Harvard professor Henry Louis Gates Jr. was recently arrested by Cambridge police at his own home. Now the African-American scholar said he plans to use the experience to focus attention on racial profiling and the black experience in the criminal justice system. Do you think Gates was justified in accusing the police of being harassed for being “a black man in America?”
Obama has avoided intervening in such racially charged incidents in the past – even drawing criticism for not speaking up more about such controversies as Jena, Louisiana in two years ago – but given Gates’ prominence (and ties to Obama’s alma mater) and his intent to draw attention to the matter, it may be tough for the president to avoid weighing in on what happened in Cambridge and larger issues relating to African-Americans and law enforcement.
10) Do you still plan on joining a Washington-area church and attending services?
Six months into his presidency, Obama has attended Sunday services just once in Washington, D.C. – at St. Johns Episcopal across from Lafayette Square on Easter.
The White House knocked down a report that the president would make the non-denominational chapel at Camp David his church home, saying that the president continues to look for a congregation. Aides say the president is concerned about disrupting the worship experience of others.
Comments on CANADA vs USA HealthCare from CNN
July 6th, 2009 11:54 am ET
Just a quick note. I’m a 32 year old Canadian with hypothyroidism and rheumatoid Arthritis if I lived in the states I would be homeless not being able to afford the doctors visits or medication. Our is not perfect but it’s works for all people not just those with money.
Patti July 6th, 2009 12:13 pm ET
No system will ever be perfect, and there are always exceptions to the rule. Canada is constantly working to improve its health care system, just as the US is…but I think we have much less work to do. Dana Bash’s report seemed to only give lip service to the positive side of Canadian health care.
Yes, we sometimes have long wait periods for treatment in Canada. But everyone in this country has equal access to quality health care, and if we’re seriously ill, we get bumped to the top of the list…as it should be.
We don’t avoid the doctor as long as possible, hoping symptoms will go away because we can’t afford the bills. As a consequence, many more major illnesses are caught early, in their more treatable stages. This has got to translate into lower health care costs per capita. People shouldn’t have to lose their homes or go bankrupt because they got sick, and that’s what’s happening in the US because of your faulty healthcare “system.”
Marissa July 6th, 2009 12:20 pm ET
My 79 year old aunt is going for a Dr. requested colonoscopy but could not afford the $75.00 for the prescription needed to cleans her colon. Because her SSI benefits were reduced drastically on a technicality she’s unable to go for the necessary procedure. If we lived in Canada she would not have to worry about a $75 expense versus affording food for the month.
What option is Mitch McConnell and the Republicans offering, oh yeah non. Their option is only to criticize the Obama administration instead of helping Americans.
Jason July 6th, 2009 12:43 pm ET
Canadians may wait in the waiting room for a half hour to forty five minute. While most in the USA wait six or seven months to save up money it will cost in order to get a check up.
Blaine Norum July 6th, 2009 12:45 pm ET
I was very disturbed by this morning’s biased report on the Canadian health system. It was observed that some Canadians had to wait a long time for elective procedures. But, how does their wait compare to the lifelong wait of the 47 MILLION Americans without health insurance? You also failed to mention that the cost of the Canadian system is about 1/2 to 2/3 or ours per capita. If they spent as much per capita as we did waits would be nonexistent. You cited the fact that Canadian taxes are higher than ours but when you compare the sum of our taxes AND our health insurance premiums to their taxes then you get the real, and much different, picture. And the bottom line is this: the life expectancy in Canada is a full 2 years greater than in the US, even after you factor in variables such as murder rate, auto death rate, smoking rate, and our significantly greater propensity towards obesity.
Having lived in both countries and used the health care systems of both countries I personally prefer the Canadian system. However, I recognize that Canadians and Americans are different peoples, with different histories, priorities, and world views. Hence, I would not argue strongly that we should adopt the Canadian system outright. I just wish we could have a factual discussion of its merits and drawbacks without distortions, without focusing on non-representative isolated cases, and without meaningless ideological labels.
Rob Redfearn July 6th, 2009 2:22 pm ET
I am originally from Canada (moved here in 96)
I grew up in a doctor’s family and I also was married to one for 20 years.
I am also a business owner AND a consumer of medical care. I have a perspective from both inside and outside the the system, on both sides of the border.
I just had 2 disks removed from my neck and had the vertebrae fused. The total bill (”list price”) was $107,000 and I was in the hospital for 26 hours TOTAL.
I got the surgery quickly (under 4 weeks from diagnosis)… and had great care. My insurance covered all but the $1000 deductible. I pay $500/month for the insurance (blue cross).
In Canada I would have waited a LONG time for the surgery (not to mention getting the MRIs Xrays, etc required before hand). It may have cost me “nothing” out of pocket … but the care DOES cost.. its just paid in taxes. It would cost the same $500/month in insurance there as here.. its just coming out of tax dollars (which, make NO mistake, is STILL coming out of your pocket)
The reason Canada’s per capita cost is LESS than the US is because the average person does not get the average level of care available here in the US. … and socialized medicine is ALL ABOUT THE AVERAGE!!! And, on average, I was NOT happy with the standard of care there, nor were my father or ex-wife happy with the standard of care dictated TO them by the government bureaucrats who were making the decisions as to whom got what level of treatment.
As a business owner I am very wary of a plan imposed by government to ensure adequate care. However, I also recognize that my recent $100k surgery is one of the reasons healthcare costs (including the cost of insurance) is SO high!!!
The solution is a hybrid of private and public and TWO levels of care is going to be inevitable. As always, we are gonna get what we pay for!!!
Ed Keppel July 6th, 2009 2:24 pm ET
You talked about health care in Canada, your report made it sound like it was for free. It is not for free, they offer this free service thru higher taxes. The higher tax is not just on the wealthy, everyone in Canada is paying higher taxes because of the free health care.
The cost of living in Canada is much higher than in the U.S.
Larry July 6th, 2009 2:56 pm ET
So what is McConnell’s solution? Oh yeah, he’s Republican. He doesn’t have any solutions. Just criticism of people trying hard to fix what the Republicans have destroyed over the past eight years.
Give it up McConnell. Your connections with special interests in Washington are about to be severed.
RON TACKET July 6th, 2009 6:23 pm ET
You have to wonder at the hypocracy of congress. Each of them is covered by a Government run health care system at no cost to them. Yet Mcconnell and others oppose a similar program for the masses.
Purple Spider July 6th, 2009 6:49 pm ET
I said this once, I will say it again….Obama’s Health Care Plan could be beneficial to those who have no coverage. Obama’s Health Care Plan will not be beneficial to those who are covered and have their private doctor and have it taken away from them.
What is sad about this, is that Washington does not take time to work out details that will help everyone – THEY JUST SHOVE EVERYTHING THROUGH AND DOWN ALL AMERICANS “THROATS”! That is not a democracy and that is not America! THAT IS BEING UNDER A DICTATORSHIP!
Mark Coan July 6th, 2009 7:06 pm ET
Wolf, et al., It is not reasonable to asses and compare the Canadian Health System, or the US system, or any other, based upon anecdotal stories even if one from “each side” is revealed. And, descriptions of wait-times at a hospital are valueless, too, really. These are complex issues, immense businesses that have been studied from many perspectives analytically, and we are faced with a needed compromise, a decision which will be painful one way or t’other (and require constant adjustment / innovation)!! The present system doesn’t work, not for the patient, the physician, or the hospital.
Jacqueline July 6th, 2009 7:28 pm ET
I’m so tired of hearing biased reports on the Canadian healthcare system, that use scare tactics to frighten unknowing Americans against universal healthcare. As a Canadian RN who has lived in Florida for 17 years, I’ve seen cancer patients, who at diagnosis were at Stage IV, because they couldn’t afford to see a Dr. until their symptoms brought them to an ER. Had they had access to healthcare, they would have been diagnosed at a much earlier stage and had a shot at survival. I’ve seen the elderly make decisions about food vs. medicine, I’ve seen families financially ruined because Mom or Dad had cancer, or a devastating car accident. I’ve seen people stay in jobs they loathe, because they couldn’t afford to let their health insurance lapse. When are we going to wake up? We spend 2-3 times as much on healthcare than other industrialized nations, yet our infant mortality and overall survival numbers are lower. We have access to the best Dr’s, medicines and machinery, but outcomes aren’t any better. Wake up people, pay a little more in taxes, have cradle to grave coverage and live a happier, healthier life.
Two years ago, Canadians voted Tommy Douglas, the politician who ushered in universal healthcare, greatest Canadian of all time. What does that tell you? That despite it’s flaws, Canadians are proud of their healthcare system.
sharon July 6th, 2009 7:43 pm ET
I am a Canadian. Americans, you should consider a couple of very important points regarding the interview with Hugh Segal.
1. Our senators are not elected–they are appointed until the age of 75 and are NOT accountable to any Canadian voter.
2. Our health care system is also unaccountable to any Canadian citizen who uses it. Yes, we have universal health care but we have no idea how much a medical procedure costs –it is paid through taxes–very HIGH taxes. Nationwide, 1/2 of our total provincial budgets are health care costs.
3. We DO have long waiting lists and long emergency room line-ups-3-4 hours in Calgary Alberta seems to be the average wait time. Depending upon the time of week and year, it can be a day’s wait. We cannot see a specialist without a referral from a GP and the wait time to see a specialist is months, if not a year for some specialties.
4. Procedures ARE limited–for example, cataract surgery. You can wait for up to a year to have this surgery done. A colonoscopy has a wait list from 2-5 years!! I know this from having been on the list for 2 years. I cannot book any procedure myself, nor can I pay to have it done. I am at the mercy of the centralized system.
Don’t believe everything you read or hear about the Canadian system. Do some independent research and discover the truth.
Tina July 7th, 2009 12:43 am ET
I think that we should have a Canadian type healthcare system. It is quite obvious that our system sucks now. It is solely run by greed. Greed of insurance companies, a lot of hospitals and doctors. I am sorry, they cannot justify the high cost of premiums, medications and treatments. The same prescriptions bought in another country is 50 to 75% less than what we pay. HOW IS THAT SO? It is called GREED. So call me a socialist. If a government run insurance is cheaper and better for us then let it be so! I am so tired of these politicians claiming that it will cost millions. WELL HELLO. What do you think it is costing us now. Wake up and smell the roses. Our country is ready for big change. Do you know that our country is the only country that does not have a government run healthcare and we are also the most expensive. Wake up people. A government run medical plan will not ruin lives, it will not deminish quality of care and it would be a hell of a lot cheaper. I am so tired of hearing about insurance companies dropping people for no reason or for a reason that is ludicrus. They run our lives and for what? So the hospitals, doctors and insurance companies can live in their McMansions and take trips to other countries two or three times a year. Give me a break. I want a government runned healthcare system. Let the private sector stay, but I will guarentee that they will loose money in droves once people realize that they will get the exact same care as private.
Jason July 7th, 2009 5:04 pm ET
I hear all this talk about “oh government run health care do you want a burocrat dictating wether or not you get the procedure you need” I live in Canada and have had many medical problems and never had a politician tell me I can’t have a procedure. That is pure nonsense do not listen to those who speak such rubish.
daniel July 8th, 2009 6:59 am ET
Lets keep it simple. Let every US citizen log in to the same web site that
senators do and buy health care at the same cost they do now or when they leave office. This won’t require a new government agency. If it is good enough for them it is good enough for me.
Marc B July 12th, 2009 11:09 am ET
Being a Canadian living in the USA, I experienced both systems.
The coverage is a major problem that everybody is discussing but we have to talk about the Cost of Health Care in the US. If we increase the coverage to all Americans and the productivity is not improved, we have in front of us a big disaster.
1. We have to reduce the cost, reduce the # of medical staff that we see in a single visit.
2. Reduce the cost to educate new doctors, otherwise, we will have a shortage and foreign doctors will increase
3. Create Government insurance for doctor malpractice
4. Reduction of law suit in health care
5. Creation of a national medication insurance exactly like Quebec did few years ago where you can have the private program and if you don’t have one, you are forced to join the government one.
One element that we don’t discuss is the fact that HealthCare in Canada is a State (province) jurisdiction therefore; the Federal is not managing Healthcare but help funding the expenses. We have to ask the question if the US Federal Government is the appropriate organization to run Healthcare insurance.
Just a quick note. I’m a 32 year old Canadian with hypothyroidism and rheumatoid Arthritis if I lived in the states I would be homeless not being able to afford the doctors visits or medication. Our is not perfect but it’s works for all people not just those with money.
Patti July 6th, 2009 12:13 pm ET
No system will ever be perfect, and there are always exceptions to the rule. Canada is constantly working to improve its health care system, just as the US is…but I think we have much less work to do. Dana Bash’s report seemed to only give lip service to the positive side of Canadian health care.
Yes, we sometimes have long wait periods for treatment in Canada. But everyone in this country has equal access to quality health care, and if we’re seriously ill, we get bumped to the top of the list…as it should be.
We don’t avoid the doctor as long as possible, hoping symptoms will go away because we can’t afford the bills. As a consequence, many more major illnesses are caught early, in their more treatable stages. This has got to translate into lower health care costs per capita. People shouldn’t have to lose their homes or go bankrupt because they got sick, and that’s what’s happening in the US because of your faulty healthcare “system.”
Marissa July 6th, 2009 12:20 pm ET
My 79 year old aunt is going for a Dr. requested colonoscopy but could not afford the $75.00 for the prescription needed to cleans her colon. Because her SSI benefits were reduced drastically on a technicality she’s unable to go for the necessary procedure. If we lived in Canada she would not have to worry about a $75 expense versus affording food for the month.
What option is Mitch McConnell and the Republicans offering, oh yeah non. Their option is only to criticize the Obama administration instead of helping Americans.
Jason July 6th, 2009 12:43 pm ET
Canadians may wait in the waiting room for a half hour to forty five minute. While most in the USA wait six or seven months to save up money it will cost in order to get a check up.
Blaine Norum July 6th, 2009 12:45 pm ET
I was very disturbed by this morning’s biased report on the Canadian health system. It was observed that some Canadians had to wait a long time for elective procedures. But, how does their wait compare to the lifelong wait of the 47 MILLION Americans without health insurance? You also failed to mention that the cost of the Canadian system is about 1/2 to 2/3 or ours per capita. If they spent as much per capita as we did waits would be nonexistent. You cited the fact that Canadian taxes are higher than ours but when you compare the sum of our taxes AND our health insurance premiums to their taxes then you get the real, and much different, picture. And the bottom line is this: the life expectancy in Canada is a full 2 years greater than in the US, even after you factor in variables such as murder rate, auto death rate, smoking rate, and our significantly greater propensity towards obesity.
Having lived in both countries and used the health care systems of both countries I personally prefer the Canadian system. However, I recognize that Canadians and Americans are different peoples, with different histories, priorities, and world views. Hence, I would not argue strongly that we should adopt the Canadian system outright. I just wish we could have a factual discussion of its merits and drawbacks without distortions, without focusing on non-representative isolated cases, and without meaningless ideological labels.
Rob Redfearn July 6th, 2009 2:22 pm ET
I am originally from Canada (moved here in 96)
I grew up in a doctor’s family and I also was married to one for 20 years.
I am also a business owner AND a consumer of medical care. I have a perspective from both inside and outside the the system, on both sides of the border.
I just had 2 disks removed from my neck and had the vertebrae fused. The total bill (”list price”) was $107,000 and I was in the hospital for 26 hours TOTAL.
I got the surgery quickly (under 4 weeks from diagnosis)… and had great care. My insurance covered all but the $1000 deductible. I pay $500/month for the insurance (blue cross).
In Canada I would have waited a LONG time for the surgery (not to mention getting the MRIs Xrays, etc required before hand). It may have cost me “nothing” out of pocket … but the care DOES cost.. its just paid in taxes. It would cost the same $500/month in insurance there as here.. its just coming out of tax dollars (which, make NO mistake, is STILL coming out of your pocket)
The reason Canada’s per capita cost is LESS than the US is because the average person does not get the average level of care available here in the US. … and socialized medicine is ALL ABOUT THE AVERAGE!!! And, on average, I was NOT happy with the standard of care there, nor were my father or ex-wife happy with the standard of care dictated TO them by the government bureaucrats who were making the decisions as to whom got what level of treatment.
As a business owner I am very wary of a plan imposed by government to ensure adequate care. However, I also recognize that my recent $100k surgery is one of the reasons healthcare costs (including the cost of insurance) is SO high!!!
The solution is a hybrid of private and public and TWO levels of care is going to be inevitable. As always, we are gonna get what we pay for!!!
Ed Keppel July 6th, 2009 2:24 pm ET
You talked about health care in Canada, your report made it sound like it was for free. It is not for free, they offer this free service thru higher taxes. The higher tax is not just on the wealthy, everyone in Canada is paying higher taxes because of the free health care.
The cost of living in Canada is much higher than in the U.S.
Larry July 6th, 2009 2:56 pm ET
So what is McConnell’s solution? Oh yeah, he’s Republican. He doesn’t have any solutions. Just criticism of people trying hard to fix what the Republicans have destroyed over the past eight years.
Give it up McConnell. Your connections with special interests in Washington are about to be severed.
RON TACKET July 6th, 2009 6:23 pm ET
You have to wonder at the hypocracy of congress. Each of them is covered by a Government run health care system at no cost to them. Yet Mcconnell and others oppose a similar program for the masses.
Purple Spider July 6th, 2009 6:49 pm ET
I said this once, I will say it again….Obama’s Health Care Plan could be beneficial to those who have no coverage. Obama’s Health Care Plan will not be beneficial to those who are covered and have their private doctor and have it taken away from them.
What is sad about this, is that Washington does not take time to work out details that will help everyone – THEY JUST SHOVE EVERYTHING THROUGH AND DOWN ALL AMERICANS “THROATS”! That is not a democracy and that is not America! THAT IS BEING UNDER A DICTATORSHIP!
Mark Coan July 6th, 2009 7:06 pm ET
Wolf, et al., It is not reasonable to asses and compare the Canadian Health System, or the US system, or any other, based upon anecdotal stories even if one from “each side” is revealed. And, descriptions of wait-times at a hospital are valueless, too, really. These are complex issues, immense businesses that have been studied from many perspectives analytically, and we are faced with a needed compromise, a decision which will be painful one way or t’other (and require constant adjustment / innovation)!! The present system doesn’t work, not for the patient, the physician, or the hospital.
Jacqueline July 6th, 2009 7:28 pm ET
I’m so tired of hearing biased reports on the Canadian healthcare system, that use scare tactics to frighten unknowing Americans against universal healthcare. As a Canadian RN who has lived in Florida for 17 years, I’ve seen cancer patients, who at diagnosis were at Stage IV, because they couldn’t afford to see a Dr. until their symptoms brought them to an ER. Had they had access to healthcare, they would have been diagnosed at a much earlier stage and had a shot at survival. I’ve seen the elderly make decisions about food vs. medicine, I’ve seen families financially ruined because Mom or Dad had cancer, or a devastating car accident. I’ve seen people stay in jobs they loathe, because they couldn’t afford to let their health insurance lapse. When are we going to wake up? We spend 2-3 times as much on healthcare than other industrialized nations, yet our infant mortality and overall survival numbers are lower. We have access to the best Dr’s, medicines and machinery, but outcomes aren’t any better. Wake up people, pay a little more in taxes, have cradle to grave coverage and live a happier, healthier life.
Two years ago, Canadians voted Tommy Douglas, the politician who ushered in universal healthcare, greatest Canadian of all time. What does that tell you? That despite it’s flaws, Canadians are proud of their healthcare system.
sharon July 6th, 2009 7:43 pm ET
I am a Canadian. Americans, you should consider a couple of very important points regarding the interview with Hugh Segal.
1. Our senators are not elected–they are appointed until the age of 75 and are NOT accountable to any Canadian voter.
2. Our health care system is also unaccountable to any Canadian citizen who uses it. Yes, we have universal health care but we have no idea how much a medical procedure costs –it is paid through taxes–very HIGH taxes. Nationwide, 1/2 of our total provincial budgets are health care costs.
3. We DO have long waiting lists and long emergency room line-ups-3-4 hours in Calgary Alberta seems to be the average wait time. Depending upon the time of week and year, it can be a day’s wait. We cannot see a specialist without a referral from a GP and the wait time to see a specialist is months, if not a year for some specialties.
4. Procedures ARE limited–for example, cataract surgery. You can wait for up to a year to have this surgery done. A colonoscopy has a wait list from 2-5 years!! I know this from having been on the list for 2 years. I cannot book any procedure myself, nor can I pay to have it done. I am at the mercy of the centralized system.
Don’t believe everything you read or hear about the Canadian system. Do some independent research and discover the truth.
Tina July 7th, 2009 12:43 am ET
I think that we should have a Canadian type healthcare system. It is quite obvious that our system sucks now. It is solely run by greed. Greed of insurance companies, a lot of hospitals and doctors. I am sorry, they cannot justify the high cost of premiums, medications and treatments. The same prescriptions bought in another country is 50 to 75% less than what we pay. HOW IS THAT SO? It is called GREED. So call me a socialist. If a government run insurance is cheaper and better for us then let it be so! I am so tired of these politicians claiming that it will cost millions. WELL HELLO. What do you think it is costing us now. Wake up and smell the roses. Our country is ready for big change. Do you know that our country is the only country that does not have a government run healthcare and we are also the most expensive. Wake up people. A government run medical plan will not ruin lives, it will not deminish quality of care and it would be a hell of a lot cheaper. I am so tired of hearing about insurance companies dropping people for no reason or for a reason that is ludicrus. They run our lives and for what? So the hospitals, doctors and insurance companies can live in their McMansions and take trips to other countries two or three times a year. Give me a break. I want a government runned healthcare system. Let the private sector stay, but I will guarentee that they will loose money in droves once people realize that they will get the exact same care as private.
Jason July 7th, 2009 5:04 pm ET
I hear all this talk about “oh government run health care do you want a burocrat dictating wether or not you get the procedure you need” I live in Canada and have had many medical problems and never had a politician tell me I can’t have a procedure. That is pure nonsense do not listen to those who speak such rubish.
daniel July 8th, 2009 6:59 am ET
Lets keep it simple. Let every US citizen log in to the same web site that
senators do and buy health care at the same cost they do now or when they leave office. This won’t require a new government agency. If it is good enough for them it is good enough for me.
Marc B July 12th, 2009 11:09 am ET
Being a Canadian living in the USA, I experienced both systems.
The coverage is a major problem that everybody is discussing but we have to talk about the Cost of Health Care in the US. If we increase the coverage to all Americans and the productivity is not improved, we have in front of us a big disaster.
1. We have to reduce the cost, reduce the # of medical staff that we see in a single visit.
2. Reduce the cost to educate new doctors, otherwise, we will have a shortage and foreign doctors will increase
3. Create Government insurance for doctor malpractice
4. Reduction of law suit in health care
5. Creation of a national medication insurance exactly like Quebec did few years ago where you can have the private program and if you don’t have one, you are forced to join the government one.
One element that we don’t discuss is the fact that HealthCare in Canada is a State (province) jurisdiction therefore; the Federal is not managing Healthcare but help funding the expenses. We have to ask the question if the US Federal Government is the appropriate organization to run Healthcare insurance.
Imperfect Health Reform Still Beats the Status Quo
Washington Post By Steven Pearlstein
Among the range of options for health-care reform, there's one that is sure to raise your taxes, increase your out-of-pocket medical expenses, swell the federal deficit, leave more Americans without insurance and guarantee that wages will remain stagnant.
That's the option of doing nothing, letting things continue to drift as they have for the past two decades as we continue to search in vain for the perfect plan that would let everyone have everything they want and preserve everything they already have while getting someone else to pay for it.
So the next time you hear someone throwing a hissy fit because health reform might raise taxes on some people, or steer people into managed care, or require small businesses to contribute $2 a day for each employee's coverage, just remember to ask yourself: And that's compared with what?
In recent days, the rumors of the death of health-care reform have been greatly exaggerated. While each of the various proposals snaking their way through the legislative maze has its flaws, the outlines of a good reform plan are there -- universal coverage, insurance market reform, cost controls, computerized medical records, emphasis on effectiveness research and quality improvements. You might have to squint a bit, but they're all there.
The bigger problem now is that, in trying to build public support for reform, President Obama has made promises that will make it even more difficult to bring all the pieces together into an effective and viable reform plan.
Let's start with the promise, repeated often by the president and written explicitly into both House and Senate proposals, that if you like the insurance you have, you can keep it. But if we're aiming to fundamentally restructure the system, is it really credible to say that we can have all the good parts of the old one with none of the bad parts?
We know, for example, that people like to decide for themselves what medical care they will consume and send the bill off to their insurer. And doctors and hospitals like being paid for whatever they do, no matter whether it is needed or is the most cost-effective treatment. We also know, however, that moving away from "fee-for-service medicine," as it is called, is the key to taming runaway health spending and improving health outcomes. That will be a better system, but it will be a different one, and it won't come unless it is pushed and prodded into being by the government.
The president and legislative leaders have also put themselves in a box by promising that any health reform will not add a dime to the federal deficit, as projected by the Congressional Budget Office. The right way to think about health reform is to consider its impact on the whole economy, not just on the government.
Providing affordable health insurance to all Americans is a pretty expensive proposition, but the mechanisms set up to achieve that goal should also produce tens of billions of dollars in savings each year to workers and businesses who already buy insurance. Just looking at the government impact without also considering those private-sector savings gives an incomplete and distorted picture of the economic impact of health reform. It's not just about the deficit. One way to pay for universal coverage, of course, would be to tax those who are likely to benefit most from slowing the growth of health insurance premiums, such as workers who already get their health insurance tax-free. But Obama has also boxed himself in on that issue by reiterating his promise never to raise taxes on anyone who makes less than $250,000 a year. Having a little flexibility on that issue would go a long way to putting together a final package.
The promise of deficit "neutrality" also runs up against the natural conservatism of the CBO's budget analysts, particularly when it comes to the long-term cost savings that might come from restructuring the way doctors and hospitals are paid or moving patients from solo practitioners to clinics that make better use of nurses and coordinate care among a variety of specialists. There is a general consensus among health-care experts that these are the reforms that will finally "bend the curve" of ever-increasing health-care spending, and CBO Director Douglas Elmendorf made headlines the other day by telling Congress that lawmakers had not been aggressive enough in embracing these reforms.
Ironically, even if Congress had been more aggressive, Elmendorf and his CBO colleagues would probably not have given them very much weight in their deficit calculations. The reason: There isn't enough knowledge to say with any precision how much would be saved and when the savings would materialize. By lashing himself to the mast of CBO-certified "deficit neutrality," Capt. Obama has made it even more difficult to steer health reform through the rough political seas that lie ahead.
Among the range of options for health-care reform, there's one that is sure to raise your taxes, increase your out-of-pocket medical expenses, swell the federal deficit, leave more Americans without insurance and guarantee that wages will remain stagnant.
That's the option of doing nothing, letting things continue to drift as they have for the past two decades as we continue to search in vain for the perfect plan that would let everyone have everything they want and preserve everything they already have while getting someone else to pay for it.
So the next time you hear someone throwing a hissy fit because health reform might raise taxes on some people, or steer people into managed care, or require small businesses to contribute $2 a day for each employee's coverage, just remember to ask yourself: And that's compared with what?
In recent days, the rumors of the death of health-care reform have been greatly exaggerated. While each of the various proposals snaking their way through the legislative maze has its flaws, the outlines of a good reform plan are there -- universal coverage, insurance market reform, cost controls, computerized medical records, emphasis on effectiveness research and quality improvements. You might have to squint a bit, but they're all there.
The bigger problem now is that, in trying to build public support for reform, President Obama has made promises that will make it even more difficult to bring all the pieces together into an effective and viable reform plan.
Let's start with the promise, repeated often by the president and written explicitly into both House and Senate proposals, that if you like the insurance you have, you can keep it. But if we're aiming to fundamentally restructure the system, is it really credible to say that we can have all the good parts of the old one with none of the bad parts?
We know, for example, that people like to decide for themselves what medical care they will consume and send the bill off to their insurer. And doctors and hospitals like being paid for whatever they do, no matter whether it is needed or is the most cost-effective treatment. We also know, however, that moving away from "fee-for-service medicine," as it is called, is the key to taming runaway health spending and improving health outcomes. That will be a better system, but it will be a different one, and it won't come unless it is pushed and prodded into being by the government.
The president and legislative leaders have also put themselves in a box by promising that any health reform will not add a dime to the federal deficit, as projected by the Congressional Budget Office. The right way to think about health reform is to consider its impact on the whole economy, not just on the government.
Providing affordable health insurance to all Americans is a pretty expensive proposition, but the mechanisms set up to achieve that goal should also produce tens of billions of dollars in savings each year to workers and businesses who already buy insurance. Just looking at the government impact without also considering those private-sector savings gives an incomplete and distorted picture of the economic impact of health reform. It's not just about the deficit. One way to pay for universal coverage, of course, would be to tax those who are likely to benefit most from slowing the growth of health insurance premiums, such as workers who already get their health insurance tax-free. But Obama has also boxed himself in on that issue by reiterating his promise never to raise taxes on anyone who makes less than $250,000 a year. Having a little flexibility on that issue would go a long way to putting together a final package.
The promise of deficit "neutrality" also runs up against the natural conservatism of the CBO's budget analysts, particularly when it comes to the long-term cost savings that might come from restructuring the way doctors and hospitals are paid or moving patients from solo practitioners to clinics that make better use of nurses and coordinate care among a variety of specialists. There is a general consensus among health-care experts that these are the reforms that will finally "bend the curve" of ever-increasing health-care spending, and CBO Director Douglas Elmendorf made headlines the other day by telling Congress that lawmakers had not been aggressive enough in embracing these reforms.
Ironically, even if Congress had been more aggressive, Elmendorf and his CBO colleagues would probably not have given them very much weight in their deficit calculations. The reason: There isn't enough knowledge to say with any precision how much would be saved and when the savings would materialize. By lashing himself to the mast of CBO-certified "deficit neutrality," Capt. Obama has made it even more difficult to steer health reform through the rough political seas that lie ahead.
Tuesday, July 21, 2009
HELP BO pass real health care reform!
Last week, Republican Senator Jim DeMint made it pretty clear why the opponents of health care reform are fighting so hard. As he told a special interest attack group, "If we're able to stop Obama on this, it will be his Waterloo. It will break him."
Here's how the President responded:
Think about that. This isn't about me. This isn't about politics. This is about a health care system that is breaking America's families, breaking America's businesses and breaking America's economy. And we can't afford the politics of delay and defeat when it comes to health care. Not this time, not now. There are too many lives and livelihoods at stake.
With Congress only days away from finalizing their plans for reform, it's time to stand up with the President and fight back against this disastrous brand of old-style politics. So we need as many people as possible to publicly support the President's principles for health care reform and call on Congress to act.
Before the first full votes in Congress, we'll publish the signatures in newspaper ads across the nation, to make sure your voice is heard.
Watch President Obama's full response, then add your name in support of reform. Or if you've already signed, please forward this message to every one of your friends and neighbors so they can join you.
The President is more dedicated than ever to passing health care reform that satisfies the three requirements he's been talking about for months: Health care reform must reduce costs, guarantee choice -- including the choice of a strong public insurance option -- and ensure all Americans have quality, affordable health care.
If we do not reform our broken health care system this year, we will only shackle future generations with spiraling costs and deteriorating care. The cost of inaction is simply more than this country can afford.
But the special interests who profit from the status quo won't go down without a fight. The ads, the smears, and the attacks -- targeting both President Obama and members of Congress who support reform -- will only get worse. So it's crucial that we show huge backing before Congress finalizes their plans this month.
Stand with President Obama on health care reform:
http://my.barackobama.com/hcdeclare
Here's how the President responded:
Think about that. This isn't about me. This isn't about politics. This is about a health care system that is breaking America's families, breaking America's businesses and breaking America's economy. And we can't afford the politics of delay and defeat when it comes to health care. Not this time, not now. There are too many lives and livelihoods at stake.
With Congress only days away from finalizing their plans for reform, it's time to stand up with the President and fight back against this disastrous brand of old-style politics. So we need as many people as possible to publicly support the President's principles for health care reform and call on Congress to act.
Before the first full votes in Congress, we'll publish the signatures in newspaper ads across the nation, to make sure your voice is heard.
Watch President Obama's full response, then add your name in support of reform. Or if you've already signed, please forward this message to every one of your friends and neighbors so they can join you.
The President is more dedicated than ever to passing health care reform that satisfies the three requirements he's been talking about for months: Health care reform must reduce costs, guarantee choice -- including the choice of a strong public insurance option -- and ensure all Americans have quality, affordable health care.
If we do not reform our broken health care system this year, we will only shackle future generations with spiraling costs and deteriorating care. The cost of inaction is simply more than this country can afford.
But the special interests who profit from the status quo won't go down without a fight. The ads, the smears, and the attacks -- targeting both President Obama and members of Congress who support reform -- will only get worse. So it's crucial that we show huge backing before Congress finalizes their plans this month.
Stand with President Obama on health care reform:
http://my.barackobama.com/hcdeclare
Thank You NRA! Just the 'American Way of Life!' Aren't you PROUD?
SLAIN AS HE SAVES HIS BRO
July 21, 2009
A beloved and "brilliant" Bronx businessman was shot dead trying to protect his older brother from an armed mugger, police and witnesses said yesterday.
The tragedy unfolded Sunday night after Eric Baxter, 53, parked his car in front of the three-story brick home he shared with his brother, Sydney, 51, in Williamsbridge and was confronted by a thug demanding money, witnesses said.
Eric ran into the house, "screaming out, 'Call the police! Call the police!' " said pal and tenant Jacob Adams, 71.
Eric was still trying to close the door when Sydney rushed past him, Adams said.
"Sydney pushed his brother aside" to safety, Adams said. "Eric fell, and Sydney jumped over him and confronted the man. That's when the shots came."
The gunman shot Sydney three times in the chest. He died minutes later at Jacobi Hospital.
"What a soul," Adams said of Sydney. "He was a spark. He was a brilliant mind."
Adams said Eric -- "the softer one of the two" -- was beside himself with grief.
"He said to me, 'Rather than going out, if only my brother had helped me push the door so that the man wouldn't come in,' " Adams said.
The brothers, who owned the house at Lavonia Avenue and East 216th Street, were born in Jamaica and grew up in London before coming to The Bronx.
They ran a used-car dealership.
Sydney, who went to college in Wales, got a master's degree in business administration from Baruch College.
He worshipped at the First Ghana Seventh Day Adventist Church and became assistant treasurer of the Northeast Conference of the Seventh Day Adventists.
Adams said Sydney had raised up to $10 million for the church.
"He was a very hardworking person, very intelligent," the tenant said. "He was well-liked, very honored."
Sydney was the youngest of five brothers. Two of his brothers live in London, and a third lives in Maryland.
Neighbor Edna Sterling, 65, said she was asleep when she heard the shots.
"I heard a 'Boom! Boom!' when I was in my bedroom, and I thought it was firecrackers," she said.
She said she last saw Sydney Saturday morning.
"He was dressed for church," she said. " 'What a beautiful day,' he said. "That was the last time I saw him."
July 21, 2009
A beloved and "brilliant" Bronx businessman was shot dead trying to protect his older brother from an armed mugger, police and witnesses said yesterday.
The tragedy unfolded Sunday night after Eric Baxter, 53, parked his car in front of the three-story brick home he shared with his brother, Sydney, 51, in Williamsbridge and was confronted by a thug demanding money, witnesses said.
Eric ran into the house, "screaming out, 'Call the police! Call the police!' " said pal and tenant Jacob Adams, 71.
Eric was still trying to close the door when Sydney rushed past him, Adams said.
"Sydney pushed his brother aside" to safety, Adams said. "Eric fell, and Sydney jumped over him and confronted the man. That's when the shots came."
The gunman shot Sydney three times in the chest. He died minutes later at Jacobi Hospital.
"What a soul," Adams said of Sydney. "He was a spark. He was a brilliant mind."
Adams said Eric -- "the softer one of the two" -- was beside himself with grief.
"He said to me, 'Rather than going out, if only my brother had helped me push the door so that the man wouldn't come in,' " Adams said.
The brothers, who owned the house at Lavonia Avenue and East 216th Street, were born in Jamaica and grew up in London before coming to The Bronx.
They ran a used-car dealership.
Sydney, who went to college in Wales, got a master's degree in business administration from Baruch College.
He worshipped at the First Ghana Seventh Day Adventist Church and became assistant treasurer of the Northeast Conference of the Seventh Day Adventists.
Adams said Sydney had raised up to $10 million for the church.
"He was a very hardworking person, very intelligent," the tenant said. "He was well-liked, very honored."
Sydney was the youngest of five brothers. Two of his brothers live in London, and a third lives in Maryland.
Neighbor Edna Sterling, 65, said she was asleep when she heard the shots.
"I heard a 'Boom! Boom!' when I was in my bedroom, and I thought it was firecrackers," she said.
She said she last saw Sydney Saturday morning.
"He was dressed for church," she said. " 'What a beautiful day,' he said. "That was the last time I saw him."
Industry Cash Flowed To Drafters of Reform
Key Senator Baucus Is a Leading Recipient
Dan Eggen Washington Post
As liberal protesters marched outside, Sen. Max Baucus sat down inside a San Francisco mansion for a dinner of chicken cordon bleu and a discussion of landmark health-care legislation under consideration by his Senate Finance Committee.
At the table on May 26 were about 20 donors willing to fork over $10,000 or more to the Democratic Senatorial Campaign Committee, including executives of major insurance companies, hospitals and other health-care firms.
"Most people there had an agenda; they wanted the ear of a senator, and they got it," said Aaron Roland, a San Francisco health-care activist who paid half price to attend the gathering. "Money gets you in the door. The only thing the other side can do is march around and protest outside."
As his committee has taken center stage in the battle over health-care reform, Chairman Baucus (D-Mont.) has emerged as a leading recipient of Senate campaign contributions from the hospitals, insurers and other medical interest groups hoping to shape the legislation to their advantage. Health-related companies and their employees gave Baucus's political committees nearly $1.5 million in 2007 and 2008, when he began holding hearings and making preparations for this year's reform debate.
Top health executives and lobbyists have continued to flock to the senator's often extravagant fundraising events in recent months. During a Senate break in late June, for example, Baucus held his 10th annual fly-fishing and golfing weekend in Big Sky, Mont., for a minimum donation of $2,500. Later this month comes "Camp Baucus," a "trip for the whole family" that adds horseback riding and hiking to the list of activities.
To avoid any appearance of favoritism, his aides say, Baucus quietly began refusing contributions from health-care political action committees after June 1. But the policy does not apply to lobbyists or corporate executives, who continued to make donations, disclosure records show.
Baucus declined requests to comment for this article. Spokesman Tyler Matsdorf said the senator "is only driven by one thing: what is right for Montana and the country. And he will continue his open process of working together with the president, his colleagues in Congress, and groups and individuals from across the nation to get this legislation passed."
Baucus's fundraising prowess underscores the enduring political strength of the health-care lobby, which led all other sectors in donations to federal candidates during the last election cycle and has shifted its giving to Democrats as the party has tightened its control of Congress.
The sector gave nearly $170 million to federal lawmakers in 2007 and 2008, with 54 percent going to Democrats, according to data compiled by the Center for Responsive Politics, which tracks money in politics. The shift in parties was even more pronounced during the first three months of this year, when Democrats collected 60 percent of the $5.4 million donated by health-care companies and their employees, the data show.
Many of these contributions have been focused on Baucus, Charles E. Grassley (R-Iowa) and other senators in the moderate camps of their respective parties, whose votes could prove crucial in a final health-care reform deal, as well as the leaders of five key committees leading the debate. Grassley, the Finance Committee's ranking Republican, received more than $2 million from the health and insurance sectors since 2003. House Ways and Means Chairman Charles B. Rangel (D-N.Y.) took in $1.6 million from the health sector and its employees over the past two years; ranking Republican Dave Camp (Mich.) received nearly $1 million.
But Baucus, a senator from a sparsely populated and conservative Western state who is serving his sixth term, stands out for the rising tide of health-care contributions to his campaign committee, Friends of Max Baucus, and his political-action committee, Glacier PAC. Baucus collected $3 million from the health and insurance sectors from 2003 to 2008, about 20 percent of the total, data show. Less than 10 percent of the money came from Montana.
Top out-of-state corporate contributors included Schering-Plough, New York Life Insurance, Amgen, and Blue Cross and Blue Shield; individual executives such as Richard T. Clark, chief executive and president of drugmaker Merck, have also made regular donations. Most of these companies, particularly major insurers, strongly oppose a public insurance option, which is favored by President Obama and top House Democrats but has not received support from Baucus's committee.
Baucus is a longtime centrist in the Democratic caucus, and his committee chairmanship has made him a key broker in the health-reform debate. Many former Baucus staff members, including two chiefs of staff, lobby on behalf of the pharmaceutical industry and other health-care players and have been closely involved in negotiations on the legislation.
John Jonas, a Patton Boggs health-care lobbyist who has attended a Baucus fly-fishing event and other fundraisers, said the Montana senator is "key to getting anything done" when it comes to health-care legislation.
"This is not an overwhelmingly liberal Congress, and it's certainly not a liberal Senate," said Jonas, whose clients include Bristol-Myers Squibb, Pfizer and Northwestern Mutual. "I think Max is uniquely situated to try to accomplish that, because he's more of a centrist and moderate Democrat than others are."
But Jerry Flanagan, a health-care analyst with Consumer Watchdog, a California-based advocacy group, said the tide of campaign contributions amounts to "a huge down payment" by companies that expect favorable policies in return. "That is the cold reality of big-money politics," he said.
Baucus won easy reelection in the fall, but he has continued to hold fundraisers since then. In addition to the fly-fishing event, he held his "Eighth Annual Ski and Snowmobile Weekend" in Big Sky in February and celebrated the start of his sixth term with a $10,000-a-table dinner at the Washington Court Hotel later that month. Aides say another fundraiser scheduled for July 7 at Bistro Bis in Capitol Hill was scrapped.
Baucus's office declined to provide attendance and donation details about his fundraising events, and federal records laws do not require such disclosures. Starting in June, aides say, Baucus adopted an internal office policy to refuse contributions from health-care PACs and to continue doing so until after Congress passes reform legislation.
But new Federal Election Commission documents filed last week show that individual lobbyists and others with health-care connections continued to make contributions to Baucus committees throughout June. Examples from Baucus's Glacier PAC include $5,000 from the Independent Insurance Agents and Brokers of America and $2,500 from lobbyists with U.S. Strategies, which represents numerous health-care firms. Overall, half of the $110,000 in donations to the PAC from April to June came from health-care firms and lobbyists, including Schering-Plough, Medtronic and New York Life.
Craig Holman, government affairs lobbyist for the Public Citizen advocacy group, said the continued fundraising by Baucus during the health-care debate is "very troubling."
"He's doing all this fundraising right in the middle of this effort to mark up a bill," Holman said. "When you put these events close to matters concerning these lobbyists, clearly it's a signal. You are expected to show up with a check."
Baucus and his aides strongly dispute any assertion that campaign contributions have an impact on the senator's policy views and proposals. Aides say he has frequently backed policies opposed by health-care companies, including support for greater availability of generic drugs, allowing drug imports from Canada and cutting payments to the Medicare Advantage plan.
During an interview earlier this year with the Missoulian newspaper, Baucus said that "no one gets special treatment." He added: "Your word is your bond back there."
Dan Eggen Washington Post
As liberal protesters marched outside, Sen. Max Baucus sat down inside a San Francisco mansion for a dinner of chicken cordon bleu and a discussion of landmark health-care legislation under consideration by his Senate Finance Committee.
At the table on May 26 were about 20 donors willing to fork over $10,000 or more to the Democratic Senatorial Campaign Committee, including executives of major insurance companies, hospitals and other health-care firms.
"Most people there had an agenda; they wanted the ear of a senator, and they got it," said Aaron Roland, a San Francisco health-care activist who paid half price to attend the gathering. "Money gets you in the door. The only thing the other side can do is march around and protest outside."
As his committee has taken center stage in the battle over health-care reform, Chairman Baucus (D-Mont.) has emerged as a leading recipient of Senate campaign contributions from the hospitals, insurers and other medical interest groups hoping to shape the legislation to their advantage. Health-related companies and their employees gave Baucus's political committees nearly $1.5 million in 2007 and 2008, when he began holding hearings and making preparations for this year's reform debate.
Top health executives and lobbyists have continued to flock to the senator's often extravagant fundraising events in recent months. During a Senate break in late June, for example, Baucus held his 10th annual fly-fishing and golfing weekend in Big Sky, Mont., for a minimum donation of $2,500. Later this month comes "Camp Baucus," a "trip for the whole family" that adds horseback riding and hiking to the list of activities.
To avoid any appearance of favoritism, his aides say, Baucus quietly began refusing contributions from health-care political action committees after June 1. But the policy does not apply to lobbyists or corporate executives, who continued to make donations, disclosure records show.
Baucus declined requests to comment for this article. Spokesman Tyler Matsdorf said the senator "is only driven by one thing: what is right for Montana and the country. And he will continue his open process of working together with the president, his colleagues in Congress, and groups and individuals from across the nation to get this legislation passed."
Baucus's fundraising prowess underscores the enduring political strength of the health-care lobby, which led all other sectors in donations to federal candidates during the last election cycle and has shifted its giving to Democrats as the party has tightened its control of Congress.
The sector gave nearly $170 million to federal lawmakers in 2007 and 2008, with 54 percent going to Democrats, according to data compiled by the Center for Responsive Politics, which tracks money in politics. The shift in parties was even more pronounced during the first three months of this year, when Democrats collected 60 percent of the $5.4 million donated by health-care companies and their employees, the data show.
Many of these contributions have been focused on Baucus, Charles E. Grassley (R-Iowa) and other senators in the moderate camps of their respective parties, whose votes could prove crucial in a final health-care reform deal, as well as the leaders of five key committees leading the debate. Grassley, the Finance Committee's ranking Republican, received more than $2 million from the health and insurance sectors since 2003. House Ways and Means Chairman Charles B. Rangel (D-N.Y.) took in $1.6 million from the health sector and its employees over the past two years; ranking Republican Dave Camp (Mich.) received nearly $1 million.
But Baucus, a senator from a sparsely populated and conservative Western state who is serving his sixth term, stands out for the rising tide of health-care contributions to his campaign committee, Friends of Max Baucus, and his political-action committee, Glacier PAC. Baucus collected $3 million from the health and insurance sectors from 2003 to 2008, about 20 percent of the total, data show. Less than 10 percent of the money came from Montana.
Top out-of-state corporate contributors included Schering-Plough, New York Life Insurance, Amgen, and Blue Cross and Blue Shield; individual executives such as Richard T. Clark, chief executive and president of drugmaker Merck, have also made regular donations. Most of these companies, particularly major insurers, strongly oppose a public insurance option, which is favored by President Obama and top House Democrats but has not received support from Baucus's committee.
Baucus is a longtime centrist in the Democratic caucus, and his committee chairmanship has made him a key broker in the health-reform debate. Many former Baucus staff members, including two chiefs of staff, lobby on behalf of the pharmaceutical industry and other health-care players and have been closely involved in negotiations on the legislation.
John Jonas, a Patton Boggs health-care lobbyist who has attended a Baucus fly-fishing event and other fundraisers, said the Montana senator is "key to getting anything done" when it comes to health-care legislation.
"This is not an overwhelmingly liberal Congress, and it's certainly not a liberal Senate," said Jonas, whose clients include Bristol-Myers Squibb, Pfizer and Northwestern Mutual. "I think Max is uniquely situated to try to accomplish that, because he's more of a centrist and moderate Democrat than others are."
But Jerry Flanagan, a health-care analyst with Consumer Watchdog, a California-based advocacy group, said the tide of campaign contributions amounts to "a huge down payment" by companies that expect favorable policies in return. "That is the cold reality of big-money politics," he said.
Baucus won easy reelection in the fall, but he has continued to hold fundraisers since then. In addition to the fly-fishing event, he held his "Eighth Annual Ski and Snowmobile Weekend" in Big Sky in February and celebrated the start of his sixth term with a $10,000-a-table dinner at the Washington Court Hotel later that month. Aides say another fundraiser scheduled for July 7 at Bistro Bis in Capitol Hill was scrapped.
Baucus's office declined to provide attendance and donation details about his fundraising events, and federal records laws do not require such disclosures. Starting in June, aides say, Baucus adopted an internal office policy to refuse contributions from health-care PACs and to continue doing so until after Congress passes reform legislation.
But new Federal Election Commission documents filed last week show that individual lobbyists and others with health-care connections continued to make contributions to Baucus committees throughout June. Examples from Baucus's Glacier PAC include $5,000 from the Independent Insurance Agents and Brokers of America and $2,500 from lobbyists with U.S. Strategies, which represents numerous health-care firms. Overall, half of the $110,000 in donations to the PAC from April to June came from health-care firms and lobbyists, including Schering-Plough, Medtronic and New York Life.
Craig Holman, government affairs lobbyist for the Public Citizen advocacy group, said the continued fundraising by Baucus during the health-care debate is "very troubling."
"He's doing all this fundraising right in the middle of this effort to mark up a bill," Holman said. "When you put these events close to matters concerning these lobbyists, clearly it's a signal. You are expected to show up with a check."
Baucus and his aides strongly dispute any assertion that campaign contributions have an impact on the senator's policy views and proposals. Aides say he has frequently backed policies opposed by health-care companies, including support for greater availability of generic drugs, allowing drug imports from Canada and cutting payments to the Medicare Advantage plan.
During an interview earlier this year with the Missoulian newspaper, Baucus said that "no one gets special treatment." He added: "Your word is your bond back there."
Monday, July 20, 2009
U.S. Withheld Data on Risks of Distracted Driving
Driven to Distraction By MATT RICHTEL
In 2003, researchers at a federal agency proposed a long-term study of 10,000 drivers to assess the safety risk posed by cellphone use behind the wheel.
They sought the study based on evidence that such multitasking was a serious and growing threat on America’s roadways.
But such an ambitious study never happened. And the researchers’ agency, the National Highway Traffic Safety Administration, decided not to make public hundreds of pages of research and warnings about the use of phones by drivers — in part, officials say, because of concerns about angering Congress.
On Tuesday, the full body of research is being made public for the first time by two consumer advocacy groups, which filed a Freedom of Information Act lawsuit for the documents. The Center for Auto Safety and Public Citizen provided a copy to The New York Times, which is publishing the documents on its Web site.
In interviews, the officials who withheld the research offered their fullest explanation to date.
The former head of the highway safety agency said he was urged to withhold the research to avoid antagonizing members of Congress who had warned the agency to stick to its mission of gathering safety data but not to lobby states.
Critics say that rationale and the failure of the Transportation Department, which oversees the highway agency, to more vigorously pursue distracted driving has cost lives and allowed to blossom a culture of behind-the-wheel multitasking.
“We’re looking at a problem that could be as bad as drunk driving, and the government has covered it up,” said Clarence Ditlow, director of the Center for Auto Safety.
The group petitioned for the information after The Los Angeles Times wrote about the research last year. Mother Jones later published additional details.
The highway safety researchers estimated that cellphone use by drivers caused around 955 fatalities and 240,000 accidents over all in 2002.
The researchers also shelved a draft letter they had prepared for Transportation Secretary Norman Y. Mineta to send, warning states that hands-free laws might not solve the problem.
That letter said that hands-free headsets did not eliminate the serious accident risk. The reason: a cellphone conversation itself, not just holding the phone, takes drivers’ focus off the road, studies showed.
The research mirrors other studies about the dangers of multitasking behind the wheel. Research shows that motorists talking on a phone are four times as likely to crash as other drivers, and are as likely to cause an accident as someone with a .08 blood alcohol content.
The three-person research team based the fatality and accident estimates on studies that quantified the risks of distracted driving, and an assumption that 6 percent of drivers were talking on the phone at a given time. That figure is roughly half what the Transportation Department assumes to be the case now.
More precise data does not exist because most police forces have not collected long-term data connecting cellphones to accidents. That is why the researchers called for the broader study with 10,000 or more drivers.
“We nevertheless have concluded that the use of cellphones while driving has contributed to an increasing number of crashes, injuries and fatalities,” according to a “talking points” memo the researchers compiled in July 2003.
It added: “We therefore recommend that the drivers not use wireless communication devices, including text messaging systems, when driving, except in an emergency.”
Dr. Jeffrey Runge, then the head of the highway safety agency, said he grudgingly decided not to publish the Mineta letter and policy recommendation because of larger political considerations.
At the time, Congress had warned the agency not to use its research to lobby states. Dr. Runge said transit officials told him he could jeopardize billions of dollars of its financing if Congress perceived the agency had crossed the line into lobbying.
The fate of the research was discussed during a high-level meeting at the transportation secretary’s office. The meeting included Dr. Runge, several staff members with the highway safety agency and John Flaherty, Mr. Mineta’s chief of staff.
Mr. Flaherty recalls that the group decided not to publish the research because the data was too inconclusive.
He recalled that Dr. Runge “indicated that the data was incomplete and there was going to be more research coming.”
He recalled summing up his position as, the agency “should make a decision as to whether they wanted to wait for more data.”
But Dr. Runge recalled feeling that the issue was dire and needed public attention. “I really wanted to send a letter to governors telling them not to give a pass to hands-free laws,” said Dr. Runge, whose staff spent months preparing a binder of materials for their presentation.
His broader goal, he said, was to educate people about the dangers of distracted driving. “Based on the research, there was a possibility of this becoming a really big problem,” he said.
But “my advisers upstairs said we should not poke a finger in the eye of the appropriations committee,” he recalled.
He said Mr. Flaherty asked him, “Do we have enough evidence right now to not create enemies among all the stakeholders?”
Those stakeholders, Dr. Runge said, were the House Appropriations Committee and groups that might influence it, notably voters who multitask while driving and, to a much smaller degree, the cellphone industry.
Mr. Mineta, who left as transportation secretary in 2006, said he was unaware of the meeting.
“I don’t think it ever got to my desk,” he said of the research. Mr. Ditlow, from the Center for Auto Safety, said the officials’ explanations for withholding the research raised concerns. He said the research did not constitute lobbying of states.
And he said it was consistent with the highway safety agency’s research in other areas, like seat belts.
Mr. Ditlow said that putting fears of the House panel ahead of public safety was an abdication of the agency’s responsibility.
“No public health and safety agency should allow its research to be suppressed for political reasons,” he said. Doing so “will cause deaths and injuries on the highways.”
State Senator Joe Simitian of California, who tried from 2001 to 2005 to pass a hands-free cellphone law over objections of the cellphone industry, said the unpublished research would have helped him convince his colleagues that cellphones cause serious — deadly — distraction.
“Years went by when lives could have been saved,” said Mr. Simitian, who in 2006 finally pushed through a hands-free law that took effect last year.
The highway safety agency, rather than commissioning a study with 10,000 drivers, handled one involving 100 cars. That study, done with the Virginia Tech Transportation Institute, placed cameras inside cars to monitor drivers for more than a year.
It found that drivers using a hand-held device were at 1.3 times greater risk of a crash or near crash, and at three times the risk when dialing compared with other drivers.
Not all the research went unpublished. The safety agency put on its Web site an annotated bibliography of more than 150 scientific articles that showed how a cellphone conversation while driving taxes the brain’s processing power, reducing reaction time. But the bibliography included only a list of the articles, not the one-page summaries of each one written by the researchers.
Chris Monk, who researched the bibliography for 18 months, said the exclusion of the summaries took the teeth out of the findings.
“It became almost laughable,” Mr. Monk said. “What they wound up finally publishing was a stripped-out summary.”
Mr. Monk and Mike Goodman, a division head at the safety agency who led the research project, theorize that the agency might have felt pressure from the cellphone industry. Mr. Goodman said the industry frequently checked in with him about the project and his progress. (He said the industry knew about the research because he had worked with it to gather some data).
But he could offer no proof of the industry’s influence. Mr. Flaherty said he was not contacted or influenced by the industry.
The agency’s current policy is that people should not use cellphones while driving. Rae Tyson, a spokesman for the agency, said it did not, and would not, publish the researchers’ fatality estimates because they were not definitive enough.
He said the other research was compiled as background material for the agency, not for the public.
“There is no report to publish,” he said.
In 2003, researchers at a federal agency proposed a long-term study of 10,000 drivers to assess the safety risk posed by cellphone use behind the wheel.
They sought the study based on evidence that such multitasking was a serious and growing threat on America’s roadways.
But such an ambitious study never happened. And the researchers’ agency, the National Highway Traffic Safety Administration, decided not to make public hundreds of pages of research and warnings about the use of phones by drivers — in part, officials say, because of concerns about angering Congress.
On Tuesday, the full body of research is being made public for the first time by two consumer advocacy groups, which filed a Freedom of Information Act lawsuit for the documents. The Center for Auto Safety and Public Citizen provided a copy to The New York Times, which is publishing the documents on its Web site.
In interviews, the officials who withheld the research offered their fullest explanation to date.
The former head of the highway safety agency said he was urged to withhold the research to avoid antagonizing members of Congress who had warned the agency to stick to its mission of gathering safety data but not to lobby states.
Critics say that rationale and the failure of the Transportation Department, which oversees the highway agency, to more vigorously pursue distracted driving has cost lives and allowed to blossom a culture of behind-the-wheel multitasking.
“We’re looking at a problem that could be as bad as drunk driving, and the government has covered it up,” said Clarence Ditlow, director of the Center for Auto Safety.
The group petitioned for the information after The Los Angeles Times wrote about the research last year. Mother Jones later published additional details.
The highway safety researchers estimated that cellphone use by drivers caused around 955 fatalities and 240,000 accidents over all in 2002.
The researchers also shelved a draft letter they had prepared for Transportation Secretary Norman Y. Mineta to send, warning states that hands-free laws might not solve the problem.
That letter said that hands-free headsets did not eliminate the serious accident risk. The reason: a cellphone conversation itself, not just holding the phone, takes drivers’ focus off the road, studies showed.
The research mirrors other studies about the dangers of multitasking behind the wheel. Research shows that motorists talking on a phone are four times as likely to crash as other drivers, and are as likely to cause an accident as someone with a .08 blood alcohol content.
The three-person research team based the fatality and accident estimates on studies that quantified the risks of distracted driving, and an assumption that 6 percent of drivers were talking on the phone at a given time. That figure is roughly half what the Transportation Department assumes to be the case now.
More precise data does not exist because most police forces have not collected long-term data connecting cellphones to accidents. That is why the researchers called for the broader study with 10,000 or more drivers.
“We nevertheless have concluded that the use of cellphones while driving has contributed to an increasing number of crashes, injuries and fatalities,” according to a “talking points” memo the researchers compiled in July 2003.
It added: “We therefore recommend that the drivers not use wireless communication devices, including text messaging systems, when driving, except in an emergency.”
Dr. Jeffrey Runge, then the head of the highway safety agency, said he grudgingly decided not to publish the Mineta letter and policy recommendation because of larger political considerations.
At the time, Congress had warned the agency not to use its research to lobby states. Dr. Runge said transit officials told him he could jeopardize billions of dollars of its financing if Congress perceived the agency had crossed the line into lobbying.
The fate of the research was discussed during a high-level meeting at the transportation secretary’s office. The meeting included Dr. Runge, several staff members with the highway safety agency and John Flaherty, Mr. Mineta’s chief of staff.
Mr. Flaherty recalls that the group decided not to publish the research because the data was too inconclusive.
He recalled that Dr. Runge “indicated that the data was incomplete and there was going to be more research coming.”
He recalled summing up his position as, the agency “should make a decision as to whether they wanted to wait for more data.”
But Dr. Runge recalled feeling that the issue was dire and needed public attention. “I really wanted to send a letter to governors telling them not to give a pass to hands-free laws,” said Dr. Runge, whose staff spent months preparing a binder of materials for their presentation.
His broader goal, he said, was to educate people about the dangers of distracted driving. “Based on the research, there was a possibility of this becoming a really big problem,” he said.
But “my advisers upstairs said we should not poke a finger in the eye of the appropriations committee,” he recalled.
He said Mr. Flaherty asked him, “Do we have enough evidence right now to not create enemies among all the stakeholders?”
Those stakeholders, Dr. Runge said, were the House Appropriations Committee and groups that might influence it, notably voters who multitask while driving and, to a much smaller degree, the cellphone industry.
Mr. Mineta, who left as transportation secretary in 2006, said he was unaware of the meeting.
“I don’t think it ever got to my desk,” he said of the research. Mr. Ditlow, from the Center for Auto Safety, said the officials’ explanations for withholding the research raised concerns. He said the research did not constitute lobbying of states.
And he said it was consistent with the highway safety agency’s research in other areas, like seat belts.
Mr. Ditlow said that putting fears of the House panel ahead of public safety was an abdication of the agency’s responsibility.
“No public health and safety agency should allow its research to be suppressed for political reasons,” he said. Doing so “will cause deaths and injuries on the highways.”
State Senator Joe Simitian of California, who tried from 2001 to 2005 to pass a hands-free cellphone law over objections of the cellphone industry, said the unpublished research would have helped him convince his colleagues that cellphones cause serious — deadly — distraction.
“Years went by when lives could have been saved,” said Mr. Simitian, who in 2006 finally pushed through a hands-free law that took effect last year.
The highway safety agency, rather than commissioning a study with 10,000 drivers, handled one involving 100 cars. That study, done with the Virginia Tech Transportation Institute, placed cameras inside cars to monitor drivers for more than a year.
It found that drivers using a hand-held device were at 1.3 times greater risk of a crash or near crash, and at three times the risk when dialing compared with other drivers.
Not all the research went unpublished. The safety agency put on its Web site an annotated bibliography of more than 150 scientific articles that showed how a cellphone conversation while driving taxes the brain’s processing power, reducing reaction time. But the bibliography included only a list of the articles, not the one-page summaries of each one written by the researchers.
Chris Monk, who researched the bibliography for 18 months, said the exclusion of the summaries took the teeth out of the findings.
“It became almost laughable,” Mr. Monk said. “What they wound up finally publishing was a stripped-out summary.”
Mr. Monk and Mike Goodman, a division head at the safety agency who led the research project, theorize that the agency might have felt pressure from the cellphone industry. Mr. Goodman said the industry frequently checked in with him about the project and his progress. (He said the industry knew about the research because he had worked with it to gather some data).
But he could offer no proof of the industry’s influence. Mr. Flaherty said he was not contacted or influenced by the industry.
The agency’s current policy is that people should not use cellphones while driving. Rae Tyson, a spokesman for the agency, said it did not, and would not, publish the researchers’ fatality estimates because they were not definitive enough.
He said the other research was compiled as background material for the agency, not for the public.
“There is no report to publish,” he said.
Liberal Suicide March DAVID BROOKS
It was interesting to watch the Republican Party lose touch with America. You had a party led by conservative Southerners who neither understood nor sympathized with moderates or representatives from swing districts.
They brought in pollsters to their party conferences to persuade their members that the country was fervently behind them. They were supported by their interest groups and cheered on by their activists and the partisan press. They spent federal money in an effort to buy support but ended up disgusting the country instead.
It’s not that interesting to watch the Democrats lose touch with America. That’s because the plotline is exactly the same. The party is led by insular liberals from big cities and the coasts, who neither understand nor sympathize with moderates. They have their own cherry-picking pollsters, their own media and activist cocoon, their own plans to lavishly spend borrowed money to buy votes.
This ideological overreach won’t be any more successful than the last one. A Washington Post-ABC News poll released Monday confirms what other polls have found. Most Americans love Barack Obama personally, but support for Democratic policies is already sliding fast.
Approval of Obama’s handling of health care, for example, has slid from 57 percent to 49 percent since April. Disapproval has risen from 29 percent to 44 percent. As recently as June, voters earning more than $50,000 preferred Obama to the Republicans on health care by a 21-point margin. Now those voters are evenly split.
Most independents now disapprove of Obama’s health care strategy. In March, only 32 percent of Americans thought Obama was an old-style, tax-and-spend liberal. Now 43 percent do.
We’re only in the early stages of the liberal suicide march, but there already have been three phases. First, there was the stimulus package. You would have thought that a stimulus package would be designed to fight unemployment and stimulate the economy during a recession. But Congressional Democrats used it as a pretext to pay for $787 billion worth of pet programs with borrowed money. Only 11 percent of the money will be spent by the end of the fiscal year — a triumph of ideology over pragmatism.
Then there is the budget. Instead of allaying moderate anxieties about the deficits, the budget is expected to increase the government debt by $11 trillion between 2009 and 2019.
Finally, there is health care. Every cliché Ann Coulter throws at the Democrats is gloriously fulfilled by the Democratic health care bills. The bills do almost nothing to control health care inflation. They are modeled on the Massachusetts health reform law that is currently coming apart at the seams precisely because it doesn’t control costs. They do little to reward efficient providers and reform inefficient ones.
The House bill adds $239 billion to the federal deficit during the first 10 years, according to the Congressional Budget Office. It would pummel small businesses with an 8 percent payroll penalty. It would jack America’s top tax rate above those in Italy and France. Top earners in New York and California would be giving more than 55 percent of earnings to one government entity or another.
Nancy Pelosi has lower approval ratings than Dick Cheney and far lower approval ratings than Sarah Palin. And yet Democrats have allowed her policy values to carry the day — this in an era in which independents dominate the electoral landscape.
Who’s going to stop this leftward surge? Months ago, it seemed as if Obama would lead a center-left coalition. Instead, he has deferred to the Old Bulls on Capitol Hill on issue after issue.
Machiavelli said a leader should be feared as well as loved. Obama is loved by the Democratic chairmen, but he is not feared. On health care, Obama has emphasized cost control. The chairmen flouted his priorities because they don’t fear him. On cap and trade, Obama campaigned against giving away pollution offsets. The chairmen wrote their bill to do precisely that because they don’t fear him. On taxes, Obama promised that top tax rates would not go above Clinton-era levels. The chairmen flouted that promise because they don’t fear him.
Last week, the administration announced a proposal to take Medicare spending decisions away from Congress and lodge the power with technocrats in the executive branch. It’s a good idea, and it might lead to real cost savings. But there’s no reason to think that it will be incorporated into the final law. The chairmen will never surrender power to an administration they can override.
That leaves matters in the hands of the Blue Dog Democrats. These brave moderates are trying to restrain the fiscal explosion. But moderates inherently lack seniority (they are from swing districts). They are usually bought off by leadership at the end of the day.
And so here we are again. Every new majority overinterprets its mandate. We’ve been here before. We’ll be here again.
They brought in pollsters to their party conferences to persuade their members that the country was fervently behind them. They were supported by their interest groups and cheered on by their activists and the partisan press. They spent federal money in an effort to buy support but ended up disgusting the country instead.
It’s not that interesting to watch the Democrats lose touch with America. That’s because the plotline is exactly the same. The party is led by insular liberals from big cities and the coasts, who neither understand nor sympathize with moderates. They have their own cherry-picking pollsters, their own media and activist cocoon, their own plans to lavishly spend borrowed money to buy votes.
This ideological overreach won’t be any more successful than the last one. A Washington Post-ABC News poll released Monday confirms what other polls have found. Most Americans love Barack Obama personally, but support for Democratic policies is already sliding fast.
Approval of Obama’s handling of health care, for example, has slid from 57 percent to 49 percent since April. Disapproval has risen from 29 percent to 44 percent. As recently as June, voters earning more than $50,000 preferred Obama to the Republicans on health care by a 21-point margin. Now those voters are evenly split.
Most independents now disapprove of Obama’s health care strategy. In March, only 32 percent of Americans thought Obama was an old-style, tax-and-spend liberal. Now 43 percent do.
We’re only in the early stages of the liberal suicide march, but there already have been three phases. First, there was the stimulus package. You would have thought that a stimulus package would be designed to fight unemployment and stimulate the economy during a recession. But Congressional Democrats used it as a pretext to pay for $787 billion worth of pet programs with borrowed money. Only 11 percent of the money will be spent by the end of the fiscal year — a triumph of ideology over pragmatism.
Then there is the budget. Instead of allaying moderate anxieties about the deficits, the budget is expected to increase the government debt by $11 trillion between 2009 and 2019.
Finally, there is health care. Every cliché Ann Coulter throws at the Democrats is gloriously fulfilled by the Democratic health care bills. The bills do almost nothing to control health care inflation. They are modeled on the Massachusetts health reform law that is currently coming apart at the seams precisely because it doesn’t control costs. They do little to reward efficient providers and reform inefficient ones.
The House bill adds $239 billion to the federal deficit during the first 10 years, according to the Congressional Budget Office. It would pummel small businesses with an 8 percent payroll penalty. It would jack America’s top tax rate above those in Italy and France. Top earners in New York and California would be giving more than 55 percent of earnings to one government entity or another.
Nancy Pelosi has lower approval ratings than Dick Cheney and far lower approval ratings than Sarah Palin. And yet Democrats have allowed her policy values to carry the day — this in an era in which independents dominate the electoral landscape.
Who’s going to stop this leftward surge? Months ago, it seemed as if Obama would lead a center-left coalition. Instead, he has deferred to the Old Bulls on Capitol Hill on issue after issue.
Machiavelli said a leader should be feared as well as loved. Obama is loved by the Democratic chairmen, but he is not feared. On health care, Obama has emphasized cost control. The chairmen flouted his priorities because they don’t fear him. On cap and trade, Obama campaigned against giving away pollution offsets. The chairmen wrote their bill to do precisely that because they don’t fear him. On taxes, Obama promised that top tax rates would not go above Clinton-era levels. The chairmen flouted that promise because they don’t fear him.
Last week, the administration announced a proposal to take Medicare spending decisions away from Congress and lodge the power with technocrats in the executive branch. It’s a good idea, and it might lead to real cost savings. But there’s no reason to think that it will be incorporated into the final law. The chairmen will never surrender power to an administration they can override.
That leaves matters in the hands of the Blue Dog Democrats. These brave moderates are trying to restrain the fiscal explosion. But moderates inherently lack seniority (they are from swing districts). They are usually bought off by leadership at the end of the day.
And so here we are again. Every new majority overinterprets its mandate. We’ve been here before. We’ll be here again.
Sunday, July 19, 2009
Skepticism on Health Reform Mounts
President Is Set to 'Take the Baton'
As Skepticism on Health Reform Mounts, He Will Intensify His Efforts
Washington Post By Michael D. Shear and Shailagh Murray
Six months into his presidency, Barack Obama may have no greater test of his ability to translate personal popularity into a successful legislative agenda than the upcoming two weeks.
With skepticism about the president's health-care reform effort mounting on Capitol Hill -- even within his own party -- the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time.
Senior White House aides promise "an aggressive public and private schedule" for Obama as he presses his case for reform, including a prime-time news conference on Wednesday, a trip to Cleveland, and heavy use of Internet video to broadcast his message beyond the reach of the traditional media.
"Our strategy has been to allow this process to advance to the point where it made sense for the president to take the baton. Now's that time," said senior adviser David Axelrod. "I don't know whether he will Twitter or tweet. But he's going to be very, very visible."
Another senior White House aide added: "It's time to raise the stakes on this."
But even as Obama returns to full-time campaign mode, he is facing increasing calls to show that his presidency can manage the tough, nitty-gritty of lawmaking by cutting deals with his allies to keep his health-care legislation moving in the House and Senate committees.
Conservative Democrats in the House are promising to vote against reform as it now stands, and are preparing two dozen amendments, including measures aimed at lowering the effort's long-term cost. In the Senate, members from both parties are urging the president to break his campaign promise to preserve the tax-free status of health benefits. And a chorus of weary voices from Capitol Hill is urging him to abandon his demand for passage of bills in the House and Senate by Aug. 7.
"I don't think we should be bound by a timetable that isn't realistic," Sen. Olympia J. Snowe (R-Maine), a key swing-vote on health care, told Obama last week as she reminded him that President Lyndon B. Johnson took 1 1/2 years to pass Medicare.
Obama has not officially budged on the timetable, although he and aides notably have not mentioned the August deadline in recent remarks. But he is quietly working with conservative, Blue Dog Democrats in the House on an amendment to create an independent panel to govern Medicare reimbursement rates that could help reverse crippling health-care inflation.
Most difficult for Obama is the pressure to accept a tax on health benefits as a way of financing the massive insurance reform he wants.
Speaking on "Fox News Sunday," White House budget director Peter Orszag would not rule out support for the benefits tax, but he continued to promote Obama's preference for limiting deductions for wealthy taxpayers.
Some Democrats close to the negotiations say they think it is only a matter of time before Obama backs off. One proposal that has emerged would tax insurance companies, as opposed to beneficiaries, and is considered a potential compromise approach that he may be able to embrace.
Aides said Obama and his team plan a rapid response to new developments, as they did Thursday with a quickly arranged conference call to rebut assertions by the Congressional Budget Office that health-care costs would go up, not down, if the Democratic bills pass.
The effort began Friday with impromptu remarks by Obama from the Diplomatic Room, even as groups allied with the White House launched political ad campaigns this weekend aimed at wavering lawmakers. On Monday, his advisers say, he will do a round of interviews to drive the narrative for the week. Private meetings with lawmakers will become more frequent and urgent.
The decision to vault Obama to the front carries huge risks.
The decades-long drive to reform the health-care system now rests largely on Obama's ability to quell revolts among Democratic allies, many of whom have spent the past several weeks picking at pieces of his proposals.
If conservative House Democrats succeed in sowing fear of rising deficits, it will be seen as Obama's fault that he could not rein them in. If Democrats in the Senate do not agree on financing, Obama must explain the failure despite his party's majorities in both chambers.
The health-care debate was at the center of private discussions at the annual summer meeting of the National Governors Association over the weekend. The health-care legislation under consideration in Congress envisions a significant expansion in eligibility for Medicaid, whose costs are shared by Washington and the states. Their budgets squeezed by the recession, governors fear a costly mandate to cover the newly eligible. The governors devoted most of a private lunch to the issue Saturday and earlier voiced objections to Senate Finance Committee Chairman Max Baucus (D-Mont.) over funding plans.
Obama's top strategists, including Axelrod and Chief of Staff Rahm Emanuel, have repeatedly defended the administration's ambitious agenda by saying that success breeds success -- each legislative victory makes the next one easier to accomplish, they insist. The flip side, then, is that a health-care failure could doom the rest of Obama's agenda.
Obama's advisers express confidence that the setbacks of the past week can be overcome, and they insist they have spent "no time" discussing the impact on his political fortunes if health-care reform does not pass this year.
"We don't do doom-and-gloom," Axelrod.
But the president's top advisers also recognize that the sense of optimism about health-care reform that existed in Washington several months ago has largely evaporated.
Cable news programs repeatedly declare the president's health care program is "teetering" or "embattled," despite a week in which Obama's proposals were endorsed by the doctor and nurses associations and committees in both legislative chambers passed major bills.
"We're swimming upstream against a culture of failure on health care in Washington," said one adviser, who spoke on the condition of anonymity to discuss the administration's strategy.
The White House decided early in the year on a hands-off approach to health-care legislating.
"Had we put a plan out, the entire debate would have been changes to the plan," said Emanuel, a veteran of the failed Clinton health battle. "It would have been how the president is failing or succeeding."
But even as he shifts into a more active role, Obama must be mindful of his legislative allies. Rather than strong-arming these old bulls, the White House must tiptoe around them.
Baucus was a veteran lawmaker in 1994 when the Clinton plan ran aground. House Energy and Commerce Chairman Henry A. Waxman (D-Calif.) is a leading health-care expert. Senate health committee Chairman Edward M. Kennedy (D-Mass.), who is battling brain cancer, voted to create Medicare in 1965.
For health-care reform to succeed, Obama will have to carefully navigate between paying the appropriate respect to those men while exerting the leadership that many are demanding.
"It's getting hotter, and there are bumps, but we are closer to health-care reform than ever before," Emanuel said.
Staff writer Alec MacGillis contributed to this report.
As Skepticism on Health Reform Mounts, He Will Intensify His Efforts
Washington Post By Michael D. Shear and Shailagh Murray
Six months into his presidency, Barack Obama may have no greater test of his ability to translate personal popularity into a successful legislative agenda than the upcoming two weeks.
With skepticism about the president's health-care reform effort mounting on Capitol Hill -- even within his own party -- the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time.
Senior White House aides promise "an aggressive public and private schedule" for Obama as he presses his case for reform, including a prime-time news conference on Wednesday, a trip to Cleveland, and heavy use of Internet video to broadcast his message beyond the reach of the traditional media.
"Our strategy has been to allow this process to advance to the point where it made sense for the president to take the baton. Now's that time," said senior adviser David Axelrod. "I don't know whether he will Twitter or tweet. But he's going to be very, very visible."
Another senior White House aide added: "It's time to raise the stakes on this."
But even as Obama returns to full-time campaign mode, he is facing increasing calls to show that his presidency can manage the tough, nitty-gritty of lawmaking by cutting deals with his allies to keep his health-care legislation moving in the House and Senate committees.
Conservative Democrats in the House are promising to vote against reform as it now stands, and are preparing two dozen amendments, including measures aimed at lowering the effort's long-term cost. In the Senate, members from both parties are urging the president to break his campaign promise to preserve the tax-free status of health benefits. And a chorus of weary voices from Capitol Hill is urging him to abandon his demand for passage of bills in the House and Senate by Aug. 7.
"I don't think we should be bound by a timetable that isn't realistic," Sen. Olympia J. Snowe (R-Maine), a key swing-vote on health care, told Obama last week as she reminded him that President Lyndon B. Johnson took 1 1/2 years to pass Medicare.
Obama has not officially budged on the timetable, although he and aides notably have not mentioned the August deadline in recent remarks. But he is quietly working with conservative, Blue Dog Democrats in the House on an amendment to create an independent panel to govern Medicare reimbursement rates that could help reverse crippling health-care inflation.
Most difficult for Obama is the pressure to accept a tax on health benefits as a way of financing the massive insurance reform he wants.
Speaking on "Fox News Sunday," White House budget director Peter Orszag would not rule out support for the benefits tax, but he continued to promote Obama's preference for limiting deductions for wealthy taxpayers.
Some Democrats close to the negotiations say they think it is only a matter of time before Obama backs off. One proposal that has emerged would tax insurance companies, as opposed to beneficiaries, and is considered a potential compromise approach that he may be able to embrace.
Aides said Obama and his team plan a rapid response to new developments, as they did Thursday with a quickly arranged conference call to rebut assertions by the Congressional Budget Office that health-care costs would go up, not down, if the Democratic bills pass.
The effort began Friday with impromptu remarks by Obama from the Diplomatic Room, even as groups allied with the White House launched political ad campaigns this weekend aimed at wavering lawmakers. On Monday, his advisers say, he will do a round of interviews to drive the narrative for the week. Private meetings with lawmakers will become more frequent and urgent.
The decision to vault Obama to the front carries huge risks.
The decades-long drive to reform the health-care system now rests largely on Obama's ability to quell revolts among Democratic allies, many of whom have spent the past several weeks picking at pieces of his proposals.
If conservative House Democrats succeed in sowing fear of rising deficits, it will be seen as Obama's fault that he could not rein them in. If Democrats in the Senate do not agree on financing, Obama must explain the failure despite his party's majorities in both chambers.
The health-care debate was at the center of private discussions at the annual summer meeting of the National Governors Association over the weekend. The health-care legislation under consideration in Congress envisions a significant expansion in eligibility for Medicaid, whose costs are shared by Washington and the states. Their budgets squeezed by the recession, governors fear a costly mandate to cover the newly eligible. The governors devoted most of a private lunch to the issue Saturday and earlier voiced objections to Senate Finance Committee Chairman Max Baucus (D-Mont.) over funding plans.
Obama's top strategists, including Axelrod and Chief of Staff Rahm Emanuel, have repeatedly defended the administration's ambitious agenda by saying that success breeds success -- each legislative victory makes the next one easier to accomplish, they insist. The flip side, then, is that a health-care failure could doom the rest of Obama's agenda.
Obama's advisers express confidence that the setbacks of the past week can be overcome, and they insist they have spent "no time" discussing the impact on his political fortunes if health-care reform does not pass this year.
"We don't do doom-and-gloom," Axelrod.
But the president's top advisers also recognize that the sense of optimism about health-care reform that existed in Washington several months ago has largely evaporated.
Cable news programs repeatedly declare the president's health care program is "teetering" or "embattled," despite a week in which Obama's proposals were endorsed by the doctor and nurses associations and committees in both legislative chambers passed major bills.
"We're swimming upstream against a culture of failure on health care in Washington," said one adviser, who spoke on the condition of anonymity to discuss the administration's strategy.
The White House decided early in the year on a hands-off approach to health-care legislating.
"Had we put a plan out, the entire debate would have been changes to the plan," said Emanuel, a veteran of the failed Clinton health battle. "It would have been how the president is failing or succeeding."
But even as he shifts into a more active role, Obama must be mindful of his legislative allies. Rather than strong-arming these old bulls, the White House must tiptoe around them.
Baucus was a veteran lawmaker in 1994 when the Clinton plan ran aground. House Energy and Commerce Chairman Henry A. Waxman (D-Calif.) is a leading health-care expert. Senate health committee Chairman Edward M. Kennedy (D-Mass.), who is battling brain cancer, voted to create Medicare in 1965.
For health-care reform to succeed, Obama will have to carefully navigate between paying the appropriate respect to those men while exerting the leadership that many are demanding.
"It's getting hotter, and there are bumps, but we are closer to health-care reform than ever before," Emanuel said.
Staff writer Alec MacGillis contributed to this report.
Subscribe to:
Posts (Atom)