Politics or Poppycock

A Look From the Left At Politics, Politicians, Policies and Issues of National Concern

Archive for August 26th, 2009

What a Pair–Fox News and RNC chairman Michael Steele

Posted by James O'Rourke on August 26, 2009

The Truth-O-Meter Says:
michael_steele_cropped.jpg
The Department of Veterans Affairs has “a manual out there telling our veterans stuff like, ‘Are you really of value to your community?’ You know, encouraging them to commit suicide.”
Michael Steele on Tuesday, August 25th, 2009 in a Fox News interview

RNC chairman Michael Steele says VA has a manual that encourages vets to commit suicide
tom-pantsonfire17.gif

Republican National Committee chairman Michael Steele jumped into the so-called VA “death book” debate, calling it just the kind of thing that makes people nervous about the Democrats’ health care reform plan

“If you want an example of bad public policy, just look at the situation with our veterans where you have a manual out there telling our veterans stuff like ‘Are you really of value to your community?’ You know, encouraging them to commit suicide,” Steele said in a Fox News interview on Aug. 25, 2009.

“I mean, this is crazy coming from the government. And this is exactly what concerns people and puts them in fear of what government-controlled health care will look like.”

But like the claim about “death panels” in the health care reform bill, we find this is another ridiculous falsehood about an important end-of-life issue.

At issue here is a 10-year-old VA-funded pamphlet on end-of-life issues called “Your Life, Your Choices: Planning for Future Medical Decisions.”

The pamphlet entered the national discussion on health care after President George W. Bush’s director of Faith-Based Initiatives, Jim Towey, wrote an op-ed piece for the Wall Street Journal on Aug. 18, 2009, in which he took issue with what he called the “hurry-up-and-die message” of the pamphlet. The issue takes on larger import, of course, due to the heated debate over funding for end-of-life counseling included in the Democrats’ health care reform bill.

In his op-ed piece, Towey zeroed in on an exercise in the manual designed to “help you think about and express what really matters to you.” The worksheet poses a number of scenarios and asks users to finish the phrase “Life like this would be…” by checking options that include “difficult, but acceptable,” “worth living, but just barely” and “not worth living.”

While the scenarios include such things as relying on a feeding tube or breathing machine to keep them alive, Towey notes that it also includes circumstances common among the elderly and disabled such as: living in a nursing home, being in a wheelchair and “cannot seem to shake the blues.”

“There are also guilt-inducing scenarios such as ‘I can no longer contribute to my family’s well-being,’ ‘I am a severe financial burden on my family’ and that the vet’s situation ’causes severe emotional burden for my family,’” Towey wrote.
“This hurry-up-and-die message is clear and unconscionable,” Towey concluded.

Worse, he said, is that after the Bush administration shelved the pamphlet in 2007 in order to make revisions, the Obama administration revived it in a July 2009 VA directive that “instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to ‘Your Life, Your Choices.’ Not just those of advanced age and debilitated condition—all patients. America’s 24 million veterans deserve better.”

We should note that Towey, president of Saint Vincent College and founder of the nonprofit Aging with Dignity, years ago created his own advance care planning document called “Five Wishes,” and he made an unsuccessful pitch to VA officials in 2007 to have the government buy and distribute his pamphlet. In his op-ed, Towey says that unlike the VA’s document, his “does not contain the standard bias to withdraw or withhold medical care.”

In response, the Obama administration’s veterans agency issued a fact sheet to the Plum Line’s Greg Sargent on Aug. 25 in which they state that the “Your Life, Your Choices” pamphlet, developed by the VA more than 10 years ago, “helps Veterans consider the types of health care they would want to receive if they were unable to make decisions for themselves, and encourages them to discuss their views with their loved ones and their health care providers, and, if they so desire, to complete an advance directive.”

The pamphlet, “does not promote limitation of life-sustaining treatment, assisted suicide, or euthanasia,” the fact-sheet states.

However, the VA did acknowledge in November 2007 that although “clear in its presentation,” it has been “interpreted by some to be too negative in tone and not sufficiently sensitive to the perspectives of veterans with pro-life perspectives and veterans living with life-long disabling conditions.” At that point, the VA officially suspended use of “Your Life, Your Choices”  pending review by an expert panel, including input from faith-based groups as well as disability experts. The pamphlet is currently undergoing final revisions before being posted online, which is set for the spring 2010.

But the pamphlet is still posted on the VA Web site, albeit with a disclaimer that it is undergoing revisions. And a July 2, 2009, memo on Advance Care Planning and Management of Advance Directives states that when patients request additional information about advance directives, “Patients may be directed to the exercises in ‘Your Life, Your Choices’ or other published resources.”

According to the White House fact sheet, the pamphlet is still officially suspended, but is available on the Website because, “it is the official policy of the Obama Administration not to suppress or alter information or products resulting from federal research grants.”
Whether the pamphlet should continue to be made available pending its revision is a matter for political debate. Here, however, we are focusing on Steele’s claim that the manual encourages veterans to commit suicide.

After reading the 51-page pamphlet, we conclude unequivocally that it does not. Rather, the pamphlet encourages vets to think about the kind of advanced care they’d like to receive in various situations, to communicate those wishes to loved ones, and to formally put them into writing (including steps on how to prepare a personalized living will).

Alongside positions such as “I believe there are some situations in which I would not want treatments to keep me alive” is the position, “My life should be prolonged as long as it can, no matter what its quality, and using any means possible.” The pamphlet also respects that some people may have religious beliefs that come into play. One position is described as “I’d want my religious advisors to be consulted about all medical decisions made on my behalf to make sure they are in keeping with my religious teachings.”

The document begins like this: “There’s only one person who is truly qualified to tell health care providers how you feel about different kinds of health care issues—and that’s you. But, what if you get sick, or injured so severely that you can’t communicate with your doctors or family members? Have you thought about what kinds of medical care you would want? Do your loved ones and health care providers know your wishes? Many people assume that close family members automatically know what they want. But studies have shown that spouses guess wrong over half the time about what kinds of treatment their husbands or wives would want. You can help assure that your wishes will direct future health care decisions through the process of advance care planning.”

With regard to the issue of suicide, the pamphlet is quite clear:
Q: Can I specify that I want assisted suicide in my directive?
A: No. Assisted suicide is currently illegal.

Advanced care scenarios are upseting to think about and discuss. And we certainly can see how some might think it’s insensitive to disabled or aged veterans to have a pamphlet with an exercise that poses scenarios such as being in a wheelchair or living in a nursing home, and then to even include the option to check a box saying that life like this would be “not worth living.”

But we think Steele goes way too far and sensationalizes an important issue when he says the pamphlet “encourages (vets) to commit suicide” – particularly when you consider the pamphlet in its entirety. This is a pamphlet intended to encourage vets to make choices about the kind of advanced care they want. And for the record, there is nothing in the manual that tells vets “Are you really of value to your community?” We rule Steele’s statement Pants on Fire.

Posted in Politics As Usual, Poppycock | Leave a Comment »

Some Thoughts on SEN. EDWARD KENNEDY

Posted by James O'Rourke on August 26, 2009

TERRANCE HEATH
Remembering a Fighter and a Friend
“If there is anyone whose career distills what being a progressive means to me – caring about and standing up for people and issues you don’t have to care about, that your circumstances don’t require you to care about – Ted Kennedy is such a person. His career in the Senate, and his political commitments are proof that one can be elite – born to privilege, wealth, and power – without being elitist. One simply has to care, as Ted Kennedy has and does. He could have spent most or all of his life coasting on the wealth, power, and influence of the Kennedy name. He chose not to do so.”
MIKE ELK
On the Death of My Older Brother, Jeremy, and Ted Kennedy
I have no great anecdotes or personal stories to tell about how Ted Kennedy directly touched my life. I meet the man once briefly in passing while walking in the U.S. Capitol. I did however lose an older brother, far too young, much as Senator Kennedy did. Anyone who has ever lost an older brother understands the intense pressure that the surviving younger brothers to live up to the legacies of their older brothers. Its an inescapable burden.
DAVE JOHNSON
The Bonuses and the Damage They Do
This is a story we are all too familiar with: Wall Street vs. Main Street. Irresponsible behavior leads to bonuses for Wall Street while working hard and playing by the rules leads to unemployment and foreclosure for Main Street.
BRIAN DOCKSTADER
Beware the Book of the Dead
Did you hear the latest ridiculous lie the right-wing is promoting against health insurance reform? You see, there is a book, an evil book, and if you read it, you get a phone call, and it tells you that in exactly seven days you are going to die. And then exactly seven days later…

SEN. EDWARD KENNEDY
“The Cause of My Life”
truthout.org - Last year, I was diagnosed with a malignant brain tumor. I’ve undergone many rounds of chemotherapy and continue to receive treatment. I have enjoyed the best medical care money (and a good insurance policy) can buy. Quality care shouldn’t depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to. This is the cause of my life.
ROBERT CREAMER
Greatest Tribute to Kennedy: Pass Health Care for All
huffingtonpost.com - The decision facing America is whether – at long last – we will inscribe into our law the principle that health care is a human right – that everyone among us deserves health care simply because we are all human beings. Ted Kennedy believed that to his core. It was his life’s passion. It would be fitting if his passing itself served to refocus the health care debate on the moral principle that lies at its center. It would be his last great contribution to the struggle that more than any other defined his 47-year career in the Senate – the battle to make health care for all a reality in America.
ROBERT B. REICH
Ted Kennedy
robertreich.blogspot.com - America has had a few precious individuals who are both passionate about social justice and also understand deep in their bones its practical meaning. And we have had a few who possess great political shrewdness and can make the clunky machinery of democratic governance actually work. But I have known but one person who combined all these traits and abilities. His passing is an inestimable loss.
EZRA KLEIN
The Cause of Ted Kennedy’s Life
voices.washingtonpost.com - “This is the cause of my life,” Ted Kennedy wrote. “For four decades I have carried this cause – from the floor of the United States Senate to every part of this country. It has never been merely a question of policy; it goes to the heart of my belief in a just society.” Kennedy was talking about health care. But then, Kennedy was always talking about health care.
ROBERT SCHEER
Remembering the Real Deal
thenation.com - Born of privilege, and yet absorbed with the fate of those in need, Sen. Ted Kennedy’s intense commitment to progressive ideals represented the best of the Kennedys.
HAROLD MEYERSON
Ted Kennedy: Keeper of the Liberal Flame
prospect.org - Kennedy was the champion of the uninsured, the undocumented, and the forgotten.
HOWARD DEAN
Three Myths About Healthcare Reform
tpmcafe.talkingpointsmemo.com - Since Congress began considering health care reform, conservatives and their industry allies – so-called opponents of health care reform – have embarked on a shameless misinformation campaign about the consequences and implications of expanding access to affordable coverage. Here, debunked, are three of the right wing’s most widely circulated myths about reform.
SIMON JOHNSON AND JAMES KWAK
Don’t Want a Public Plan? Well, What Do You Think of Medicare?
washingtonpost.com - Plan designed by the government? Check. Government bureaucracy? Check. Subsidized? Check. Able to drive private insurers out of business? Check. Medicare dominates the over-65 market. If you are against the public option, you should be deeply, fundamentally, bitterly against Medicare.

Posted in Issues | Leave a Comment »

The Lion Sleeps

Posted by James O'Rourke on August 26, 2009

Progressive Breakfast: The Lion Sleeps

By Bill Scher

August 26, 2009

Sen. Ted Kennedy, The Liberal Lion, Dies At 77

NYT obituary: “Senator Edward M. Kennedy of Massachusetts, a son of one of the most storied families in American politics, a man who knew triumph and tragedy in near-equal measure and who will be remembered as one of the most effective lawmakers in the history of the Senate, died late Tuesday night. He was 77. … While Mr. Kennedy was physically absent from the capital in recent months, his presence was deeply felt as Congress weighed the most sweeping revisions to America’s health care system in decades, an effort Mr. Kennedy called ‘the cause of my life.’”

Robert Borosage on HuffPost: “the great cause of his career — health care for all — will pass the Congress as his final triumph.”



Baucus Caucus Member Raises Prospect of Health Care Bill Without GOP TPMDC’s Brian Buetler reports Sen. Bingaman OK with using Senate budget rules to pass health care on simple majority vote: [3]“[Bingaman] says that if bipartisan negotiations go nowhere, he’d support an effort to circumvent a filibuster and pass legislation without any Republicans. ‘If we are unable to do it any other way, that is an option. It is a very difficult option,’ Bingaman told a crowd of about 200 at a town hall event in Albuquerque yesterday. He was referring to the possibility that Democrats will pass health care reform through the so-called budget reconciliation process.”

Buetler also tries to figure out Sen. Grassley’s comments: [4] “Are the Senate Finance Committee’s bipartisan health care negotiations getting anywhere? According to the panel’s lead Republican, Chuck Grassley, the answer is no. And yes! … What we may be witnessing, more than any problem with the White House, is Grassley’s tendency to say one thing to people in Washington and another to people back home.”

The Hill reports from several town halls. In VA with Howard Dean and Rep. Jim Moran: [5] “Though the crowd was overwhelmingly supportive of the [public option] plan, Moran used a loud amplifier to speak over near-constant heckling from opponents, generally ignoring them.” With Rep. Donna Edwards in MD: [6]“…attracted only a single protester outside a D.C.-area recreation center on Tuesday night — and fairly minimal opposition inside.” With Rep. Gerry Connolly in VA: [7] “In general, Connolly received a warm reaction to his argument that a healthcare reform bill is necessary to keep healthcare spending down and to keep Medicare afloat.”

Media Matters dares cable nets to air clip of participant from Dean town hall: [8] “the press really doesn’t seem to want to cover policy. You know, they want to cover gossip, and I’m very disappointed, and I would like all of you press to start covering the policy.”

US News reports on Organizing for America bus tour for health care: [9] “…kicks off [today] in Phoenix. The ‘Health Insurance Reform Now’ bus will make 11 stops between tomorrow and when members of Congress return to Washington, hitting up Albuquerque, N.M., Denver, Raleigh, N.C., and Pittsburgh … [today's AZ stop is] conveniently scheduled around the same time and down the street from Sen. John McCain’s healthcare town hall meeting.”

The Treatment’s Harold Pollack rips right-wing fundraising email claiming reform will kill women with breast cancer: [10] “IWF’s materials are outstanding in their deep foray into the territory of the untrue … Women in other industrial democracies do not go bankrupt because they have breast cancer. That’s an everyday occurrence across America–among both insured and uninsured citizens. Democratic health reform bills … would provide every woman the opportunity to buy affordable and decent insurance that covers diagnosis and treatment of breast cancer.”

TPMDC reports insurance lobby angry at Sen. Rockefeller for looking at insurance company books: [11]“Sen. Jay Rockefeller (D-WV) has a proposition: If the government is going to mandate that Americans buy health insurance from private companies, they should know how much of that money actually goes to paying health insurance costs. And insurers aren’t happy about it.”

The Health Care Blog’s Matthew Holt on new evidence debunking drug lobby’s claims: [12] “[Health Affairs' Donald] Light shows that the added R&D spent in the US compared to Europe doesn’t give much bang for the buck, and that not many breakthrough drugs have been created anyway-something that PhRMA knows all to well as it looks at its shrinking pipelines.”

Posted in *Healthcare Issues | Leave a Comment »

Conservatives Try To Pare Down Reform

Posted by James O'Rourke on August 26, 2009

HEALTH CARE

Statement from Center for American Progress President and CEO John Podesta on the passing of Sen. Ted Kennedy: “The progressive movement lost a hero today, and the Center for American Progress lost a dear friend. Senator Ted Kennedy served tirelessly in the Senate for the state of Massachusetts and the nation for over four decades, putting his efforts toward critical progressive issues such as education and immigration reform, fighting poverty, expanding civil rights and working to ensure health care for every American. When it came to reaching across the aisle and forging compromise and getting something done — Senator Kennedy was simply in a league of his own. This great man bridged the idealism and purpose of an earlier generation and helped usher its revival today. His memory will live on in the generation of progressives that he has inspired through the change he has brought to America.  Our thoughts and prayers are with his family. We will miss the Senator, as will our nation.”


Conservatives have used the August recess to mount an organized opposition to President Obama’s health care reform efforts. Even as 14,000 Americans lose their health insurance coverage every single day — half a million will become uninsured while Congress is on vacation — Republicans are insisting that Democrats pare down existing reform legislation. “We need to slow down and do a little less,” Sen. Chuck Grassley (R-IA), the ranking member on the Senate Finance Committee and member of the “Gang of Six” tasked with producing bipartisan health care legislation, told a town hall gathering in Pocahontas, IA, on Monday. Similarly, during an appearance on CBS’s Face the Nation, Sen. Kent Conrad (D-ND) predicted that the bill out of the Senate Finance Committee is “going to have to be significantly less than what we’ve heard talked about.” Yesterday’s revised deficit projections have given conservatives an additional argument for paring down existing legislation. Sen. Lamar Alexander (R-TN) issued a statement arguing that the higher projections were “a flashing red light for any health care proposal that doesn’t reduce the cost of health care for Americans and their government,” and Rep. Dave Camp (R-MI), the ranking Republican on the Ways and Means Committee, declared that “if the House Democrats’ unaffordable $1 trillion health care bill wasn’t dead before, it should be now.”

SMALLER IS NOT BETTER: A smaller health reform package would do little to reduce health care costs and increase access to affordable health care. As National Institutes of Health bioethicist Ezekiel Emanuel points out, “[H]ealth care costs are the long-term driving force in federal and state budgets.” Health care spending makes up “$1 out of every $6 in the economy, dwarfing automobiles and all other economic segments” and represents the “single most important factor influencing the Federal Government’s long-term fiscal balance.” Health care growth rates are “simply unsustainable and are why slowing the growth in health care costs is the single most important step we can take to put the Nation on firm fiscal footing.” Scaling down legislation, however, “basically means gutting the benefits that would go to the working and middle class,” the New Republic’s Jonathan Cohn points out. “In other words,” Cohn says, “it would help fulfill the fear many of these voters already have and that opponents of reform have tried hard to stoke: That reform doesn’t have much to offer the typical middle-income American.”

STEELE SCARES SENIORS: Despite the consequences of skyrocketing health care costs, Republicans continue to fearmonger about reform. On Monday, Republican National Committee (RNC) Chairman Michael Steele wrote an op-ed in the Washington Post saying that Obama “and congressional Democrats are planning to raid, not aid, Medicare by cutting $500 billion from the program to fund his health-care experiment.” “These types of ‘reforms’ don’t make sense for the future of an already troubled federal program or for the services it provides that millions of Americans count on,” wrote Steele. To perpetuate the fear of Medicare cuts, the RNC released a “Seniors’ Health Care Bill of Rights” declaring that Medicare should not be “cut.” “We want to make sure that we are not cutting the Medicare program,” said Steele on ABC’s Good Morning America. But the $500 billion in cuts the Democrats are proposing would eliminate inefficiencies, reduce insurance company subsidies, unnecessary hospital readmissions, and lower payments that encourage overtreatment. None of the $500 billion is coming out of benefits. In fact, some of the cuts have been endorsed by the health industry and supported by Republicans — including Steele. All of the latest Republican health care planscall for eliminating Medicare “waste, fraud and abuse,” for instance, and a good number of Republicans voted for Medicare payment cuts as part of the Balanced Budget Act of 1997. Yesterday, Steele further undermined his own argument that Medicare is a sacrosanct program that must be protected by calling it “a very good example of what we should not have happen with all of our health care.” Asked to respond to Rep. Anthony Weiner’s (D-NY)argument that “if you like Medicare and you don’t want to make any cuts to it, then you’re basically defending a single payer system,” Steele launched into an attack on the program, implying that it would be better if it were privatized.

REPUBLICANS REFUSE TO VOTE FOR REFORM: Senate Republicans who had previously indicated that they would be open to compromising on health care reform, are now suggesting they have closed the book on negotiations. Back in March, Grassley characterized himself as an honest negotiator, telling the Kaiser Family Foundation that “everything is on the table. … You don’t negotiate when everything is not on the table…everything’s got to be on the table if you’re negotiating in good faith.” Since then, Grassley has adopted the rhetoric of the far right, routinely referring to health care reform as a government takeover, disingenuously misrepresenting reform legislation, and even going so far as to endorse the “death panels” myth. Yesterday, the Wall Street Journal reported that Grassley “vowed not to vote for an ‘imperfect‘” health care bill. “Now is the time to do this right or not do it,” Grassley said. Similarly, Sen. Mike Enzi (R-WY), who is supposedly negotiating a health care bill in the Senate Finance Committee with Grassley and Sen. Max Baucus (D-MT), has indicated that he disagrees with “the entire approach the Finance Committee is taking.”"We do need to have health care reform,” Enzi said. “We do need to get it right. We need take the time to do it. I think the only way it will happen is we need to break it down into smaller parts than we have now and put it through one at a time.”

Posted in *Healthcare Issues | Tagged: , | Leave a Comment »