Obama Administration

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Health Care as a Subprime Mortgage

I have been staying out of the health care reform debate in part because I didn’t know how to say that one of the problems with cost is greedy doctors.  As the cliche goes, “some of my best friends are doctors” and I understand how costly thier education was and how far they are in debt.  I have also read that contrary to what we hear from doctor and hospital interest groups, the care one gets in Europe and Canada and many other places results in similar outcomes for the patient as we achieve but for a much lower cost.  We tend to talk aobut low cost health care as if cost were directly related to quality as in the higher cost the better the care.

Then I began reading the June 1 New Yorker on the train this week.  It has taken me all week to get through “The Cost Conundrm: What a Texas town can teach us about health care.”   (My summary is long also but I hope you will read it, even if you don’t read the whole article.)  Atul Gawande writes about the difference in the health care costs between McAllen, Texas and El Paso, Texas which are neighboring towns and wonders why the cost of care are so much more expensive in McAllen. 

And yet there’s no evidence that the treatments and technologies available at McAllen are better than those found elsewhere in the country. The annual reports that hospitals file with Medicare show that those in McAllen and El Paso offer comparable technologies—neonatal intensive-care units, advanced cardiac services, PET scans, and so on. Public statistics show no difference in the supply of doctors. Hidalgo County actually has fewer specialists than the national average.

Nor does the care given in McAllen stand out for its quality. Medicare ranks hospitals on twenty-five metrics of care. On all but two of these, McAllen’s five largest hospitals performed worse, on average, than El Paso’s. McAllen costs Medicare seven thousand dollars more per person each year than does the average city in America. But not, so far as one can tell, because it’s delivering better health care.

Gawande also looked other models like the Mayo Clinic “which is among the highest-quality, lowest-cast health-care systems in the country.”

The Mayo Clinic is not an aberration. One of the lowest-cost markets in the country is Grand Junction, Colorado, a community of a hundred and twenty thousand that nonetheless has achieved some of Medicare’s highest quality-of-care scores. Michael Pramenko is a family physician and a local medical leader there. Unlike doctors at the Mayo Clinic, he told me, those in Grand Junction get piecework fees from insurers. But years ago the doctors agreed among themselves to a system that paid them a similar fee whether they saw Medicare, Medicaid, or private-insurance patients, so that there would be little incentive to cherry-pick patients. They also agreed, at the behest of the main health plan in town, an H.M.O., to meet regularly on small peer-review committees to go over their patient charts together. They focussed on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates. Problems went down. Quality went up. Then, in 2004, the doctors’ group and the local H.M.O. jointly created a regional information network—a community-wide electronic-record system that shared office notes, test results, and hospital data for patients across the area. Again, problems went down. Quality went up. And costs ended up lower than just about anywhere else in the United States.

Grand Junction’s medical community was not following anyone else’s recipe. But, like Mayo, it created what Elliott Fisher, of Dartmouth, calls an accountable-care organization. The leading doctors and the hospital system adopted measures to blunt harmful financial incentives, and they took collective responsibility for improving the sum total of patient care.

This approach has been adopted in other places, too: the Geisinger Health System, in Danville, Pennsylvania; the Marshfield Clinic, in Marshfield, Wisconsin; Intermountain Healthcare, in Salt Lake City; Kaiser Permanente, in Northern California. All of them function on similar principles. All are not-for-profit institutions. And all have produced enviably higher quality and lower costs than the average American town enjoys.

So what happened in McAllen to make it so expensive?

About fifteen years ago, it seems, something began to change in McAllen. A few leaders of local institutions took profit growth to be a legitimate ethic in the practice of medicine. Not all the doctors accepted this. But they failed to discourage those who did. So here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers.

And we all know what happened to the subprime mortgage lenders. 

Gawande believes that the focus of the health care debate is misplaced.

As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.

This last point is vital. Activists and policymakers spend an inordinate amount of time arguing about whether the solution to high medical costs is to have government or private insurance companies write the checks. Here’s how this whole debate goes. Advocates of a public option say government financing would save the most money by having leaner administrative costs and forcing doctors and hospitals to take lower payments than they get from private insurance. Opponents say doctors would skimp, quit, or game the system, and make us wait in line for our care; they maintain that private insurers are better at policing doctors. No, the skeptics say: all insurance companies do is reject applicants who need health care and stall on paying their bills. Then we have the economists who say that the people who should pay the doctors are the ones who use them. Have consumers pay with their own dollars, make sure that they have some “skin in the game,” and then they’ll get the care they deserve. These arguments miss the main issue. When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care. Otherwise, you get a system that has no brakes. You get McAllen.

The conclusion to Gawande exploration:  We need to fundamentally change the culture of our health care system, to figure out what medical protocols are the most effective, to look at what makes the best health care delivery systems successful.  His final paragraphs are chilling.

Something even more worrisome is going on as well. In the war over the culture of medicine—the war over whether our country’s anchor model will be Mayo or McAllen—the Mayo model is losing. In the sharpest economic downturn that our health system has faced in half a century, many people in medicine don’t see why they should do the hard work of organizing themselves in ways that reduce waste and improve quality if it means sacrificing revenue.

In El Paso, the for-profit health-care executive told me, a few leading physicians recently followed McAllen’s lead and opened their own centers for surgery and imaging. When I was in Tulsa a few months ago, a fellow-surgeon explained how he had made up for lost revenue by shifting his operations for well-insured patients to a specialty hospital that he partially owned while keeping his poor and uninsured patients at a nonprofit hospital in town. Even in Grand Junction, Michael Pramenko told me, “some of the doctors are beginning to complain about ‘leaving money on the table.’ ”

As America struggles to extend health-care coverage while curbing health-care costs, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single-payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of Mayos and Grand Junctions. If we don’t, McAllen won’t be an outlier. It will be our future.

You may not agree with Dr. Gawande’s conclusion, but everyone who has a stake in the health care system should read his article and think about what he says.

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The Obama Date Nights

So what is the big flap about Michelle and Barack going out on dates?  My husband and I do it.  Maybe not flying to New York or to Paris but we try to go to concerts or for a walk at one of the local parks at least once a week.  It is fun and we try to make it stress free.  It gives one a new perspective on the relationship and on everything else going on in our lives and in the world.

The best take on the Obamas I’ve seen so far is Maureen Dowd’s Column today in the New York Times, “Can the One Have Fun?”

The fun police are patrolling Pennsylvania Avenue.

Given the serious times, the chatter goes, should Barack Obama be allowed to enjoy date night with Michelle in New York, sightseeing in Paris, golf outings in D.C., not to mention doing a promotion for Conan O’Brien and a video cameo for Stephen Colbert’s first comedy show from Iraq?

With two wars and G.M. in bankruptcy proceedings, shouldn’t the president be glued to the grindstone, emulating W.’s gravity when he sacrificed golf in 2003 as the Iraq insurgency spread?

So begins Dowd.

As a taxpayer, I am most happy to contribute to domestic and international date nights. As Arthur Schlesinger noted in his diaries, the White House tends to drive its occupants nuts. So some respite from the pressure is clearly a healthy thing. Not as much respite as W. took, bicycling and vacationing through all the disasters that President Obama is now stuck fixing — spending a total of 490 days in the tumbleweed isolation of Crawford and rarely deigning to sightsee as he traveled the world.

I agree.  Too much work is bad – and too much mindless brush cutting signaled inattention to the mess that was being created.  The Obamas are curious people and like to meet all kinds of people.  This can only be a good thing.

Interestingly, Dr. No, Dick Cheney, declined to tut-tut with other Republicans, saying “I don’t know why not,” when he was asked about the propriety of the president’s getaway to Broadway. A far more mature response than Senator Chuck Grassley’s nit-twit tweets grumbling about the president urging progress on health care “while u sightseeing in Paris.”

I loved the “Pretty Woman” romance of the New York tableau, the president, who had not lived an entitled life where he could afford such lavish gestures, throwing off his tie and whisking his wife, in a flirty black cocktail dress, to sip martinis in Manhattan, as Sasha hung over a White House balcony and called out goodbye.

When the president and first lady walked to their seats in the Belasco for “Joe Turner’s Come and Gone,” the theater-goers went nuts. And why not?

What a relief to have an urbane, cultivated, curious president who’s out and about, engaged in the world. Not dangerously detached, as W. was, or darkly stewing like Cheney. Not hanging with the Rat Pack like J.F.K. or getting bored and up to mischief like Bill Clinton.

What a relief change is.

Michelle and Barack Obama

The Obamas leaving for their date in New York.

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The Cairo Speech

I watched or listened to most of President Obama’s speech live risking being late for work and I have been pondering it ever since.  There is no doubt that the President gives great speeches and I believe that he laid out a foundation from which discussion can move forward.  He also tries to speak truth to power. Someone I heard, probably on public radio, said that he created the space for dialogue with the Arab world, within Israel as well as between the two.  People are saying that he didn’t say enough, that there was no new ground.  I don’t see how that claim can be made.

I noticed a few things about the speech that I thought were new.  First, he talked about the right of Iran to pursue a peaceful use of nuclear energy making a clear distinction between power and weapons.  Second, he never used the word “terrorism”.  He clearly stated that we were not at war with Islam. And, finally he talked about the suffering of the Palestinians – although he stopped short of calling what is going on in the camps and the recent Israeli offensive genocide.  That would have been even more explosive than demanding that Israel stop building settlements.  Here is some other reaction I found interesting.

The New York Times blog, The Lede, posted almost immediate reactions from some students in various parts of the Middle East.  These included a nineteen year-old, Sulafah Al Shami, a Joradanian who generally admired the tone of the speech but wrote

As the speech addressed many issues ranging from Iraq, Iran, Afghanistan, the Palestinian-Israeli issue and diplomacy in the Middle East to education and women’s rights, it was very general but it I find it a jump start and sent the right signals to the Arab world. It touched on many important issues in the Arab world that have always had big question marks on them such as the Palestinian-Israeli conflict and the American invasion of Iraq. Obama promised change and acknowledged the fact that many people in the Middle East view America with fear and mistrust and this acknowledgment establishes understanding. But what was surprising to me is that despite the fact that President Obama continued to make references to American and Israeli history, he overlooked the fact that Palestine does have a history which includes decades of Israeli occupation and terror. A two-state solution seems realistic and reasonable but I believe that saying Israel has “legitimate aspirations” isn’t really accurate.

Another Igny Hassieb, also nineteen, but Egptian wrote

I like his positivity — the way he addressed the pros of Islam instead of the cons was a great and very logical way to start off. The way Islam is portrayed in the media right now is very one-sided and President Obama managed to acknowledge the distinction between extremism and Islam.

Now, this is very important and is something that was not touched upon by the Bush administration. Ever since 9/11 Islam has been portrayed in a very negative light, as the religion of terrorism, and no one had managed to change or at least begin to work on changing that view, until today.

Other student comments are posted on the Lede.

As for reaction here in the United States, Robert Dreyfuss points out in a very interested piece in the Nation,

But the neocons and the right, including the Republicans, are already denouncing Obama for undermining Israel, abandoning the holy democracy mission, and ending the Global War on Terror (GWOT). (My favorite quote is from the always entertainingly stupid Michael Rubin, of the American Enterprise Institute, who foamed at the mouth over Obama’s de-emphasis of Project Impose Democracy. “Bush can look in the mirror and know that he liberated fifty million people,” wrote Rubin, neglecting to mention that Bush killed about a million of them in the process. “Obama will look in the mirror and admire how handsome he is.”

Well. Perhaps the pudgy Rubin can’t do the same when he gazes into his bathroom mirror. But the emerging apoplexy on Planet Neocon is a sign that Obama did something right in Cairo. Interesting, isn’t it, that with Hamas praising Obama, the only criticism of the Cairo speech is coming from (1) the neocons and their allies, and (2) Osama bin Laden, who is clearly panicking about Obama’s play for mainstream and conservative Muslim opinion. Strange bedfellows, indeed.

Strange bedfellows indeed.  And I say we need to build on the beginning made in the President’s speech by talking to each other.  Action hopefully will follow.  Richard Holbrooke is headed there soon.

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Some thoughts about Sonia Sotomayor and Race

Charles Blow has an interesting column in the New York Times about the Republican claims that Supreme Court nominee , Sonia Sotomayor would be a racist and rule consistently against anyone who isn’t a “minority”.   Those who call her racist generally only cite the New Haven firefighters case in which she joined the opinion of two other justices.  (No one ever talks about them, but given the composition of the judiciary, I presume both are probably white and at least one is male.)

Furthermore, the picture that those Republicans painted of Sotomayor doesn’t seem to be supported by her actions. The Scotusblog examined her court of appeals decisions in race-related cases and found that she rejected claims of discrimination 80 percent of the time.

Blow attached a nifty chart.  The chart shows that of the 96 cases involving discrimination she has heard on the Court of Appeals, in 78 she found no discrimination.  But, as Blow points out, the Republicans don’t want to apologize for calling her biased and racist.

Is such a stubborn stance good for the Republican Party?

No. Racial wounds are deeply felt and slowly healed. Having Hispanics feel racially slighted by the Republicans is suicidal. Hispanics are 15 percent of the nation’s population, and, unlike blacks, they’re not so monolithically democratic, at least not yet.

And here’s another take on the nonimation from Calvin Trillin.

The nominee’s Sotomayor,
Whom all good Latinos adore
But right-wingers tend to deplore.
They’d like to show Sonia the door.
Her record, they say, heretofore
Reveals that beliefs at her core
Would favor minorities more:
She’d hand them decisions galore,
Because of the racial rapport.

Whereas white male judges are, as everyone knows, totally neutral.

While I’m thrilled that President Obama has nominated a woman and a Latina, I worry that she is going to turn out to be more moderate than I would like.

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Dr. George Tiller

I haven’t posted for several weeks because of a problem with my arm that makes being at the keyboard painful, but I had to break by silence just to note with both sadness and outrage the shooting of Dr. Tiller in a church.

The religious right and the so-called pro-life movement is condemning the shooting, but they cannot deny their responsibility in stirring up hatred.  I am sure that the nomination of a new Supreme Court Justice by President Obama triggered something in the irrational brain of the shooter who realized that Roe v. Wade was not likely to be overturned.

This from the New York Times  story

Dr. Tiller, who had long been a lightning rod for controversy over the issue of abortion and had survived a shooting more than a decade ago, was shot inside his church here on Sunday morning, the authorities said. Dr. Tiller, 67, was shot with a handgun inside the lobby of his longtime church, Reformation Lutheran Church on the city’s East Side, just after 10 a.m. (Central Time). The service had started minutes earlier.

I was saddened when I first heard a snippet on the news, but then to realize that he was shot in church added outrage.  How can the religious right call themselves Christian?

The photograph from the New York Times story shows a man laying flowers at the church.

I sure we will learn more about the suspect who is under arrest in the days to come, but tonight we pray for Dr. Tiller and his family.

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Tar Heels Visit the White House

Anyone who reads this blog with any regularity has probably figured out I would write about the North Carolina Tar Heels visiting the White House yesterday.

President Obama welcomed Coach Roy Williams and the University of North Carolina Tar Heels to the White House.

Everyone who follows March Madnes(and many that don’t) knows that the President picked UNC to win it all.  Jeff Zelney writes  in the  New York Times

“Congratulations on bringing Carolina its fifth national championship,” Mr. Obama said. “And, more importantly, thanks for salvaging my bracket and vindicating me before the entire nation. That first round was rough on me.”

As he stood on the South Portico of the White House, Mr. Obama played host to yet another group of collegiate champions. But this meeting was far more personal than previous teams that have visited the White House this year, largely because of Mr. Obama’s affinity to the Tar Heels and the amount of time he invested in North Carolina, where he won the statewide primary and general elections.

“Now, I did have a chance to play ball with this crew just over a year ago when I visited Chapel Hill. And I’m not sure whose luck rubbed off on who,” Mr. Obama said. “I think there was just a good vibe going on there, because they’re now national champions and I’m now president.”

A year ago, as his presidential campaign was beset with controversy over the incendiary comments of the Rev. Jeremiah A. Wright, Mr. Obama arrived on the Chapel Hill campus for an early-morning game of hoops and a tour of the Tar Heels’ locker room. (Mr. Obama followed tradition and stepped around the school logo in the center of the floor, a zone of respect where footsteps are not allowed.)

“When we played, everybody went out of their way to pass me the ball, set screens for me, let me take a shot,” the president said, recalling that 7 a.m. pickup game on April 29, 2008. “Tyler chose not to block my shot – of course, I was so intimidated by him being near me that I missed it.”

According to Politico , where you can also see video,

Obama — wearing a shade close to Tarheel blue — recounted a story about playing hoops with the team a year ago when he was a presidential candidate.

“There was a good vibe going on there because they’re now national champions and I’m president,” he said, teasing one player Jack Wooten for blocking his shot and fouling him during the game.

Obama joked that everyone at the White House was excited about the team’s visit “except my assistant Reggie Love,” who played basketball for Duke. The president congratulated the team and coach Roy Williams for “great character.”

Congratulations, Tar Heels.

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Banks and Our Money

Are the banks using TARP money to – successfully – lobby the Senate?  Sure looks that way.  I first heard this story on Keith Olbermann’s Countdown when he interviewed Arianna Huffington.  But the best story  is by Ryan Grim on the Huffington Post.

The Senate on Thursday rejected an effort to stave off home foreclosures by a vote of 51 to 45. It was an overwhelming defeat, with the bill’s backers falling 15 votes short — a quarter of the Democratic caucus — of the 60 needed to cut off debate and move to a final vote.

The death of the bankruptcy reform measure — which would have allowed a small number of homeowners who met strict conditions to renegotiate mortgages under bankruptcy protection — is a major tactical win for the banking industry. But allowing the foreclosure crisis to continue unabated may end up being a failed strategy for the financial sector.

A little background from the Washington Post.

The measure would have allowed bankruptcy judges to modify troubled mortgages, lowering the interest rate or principal balance, a process known as a cramdown. Bankruptcy courts can already make those changes for a second home or investment property, but not a primary residence.

This would impact owners who are seeing home values drop to the point that the mortgages are larger than what the home is worth.  Sentator Richard Durbin was the primary sponsor and the bill was back, a little tepidly, by the Obama Administration. So back to Ryan Grim.

The Chamber of Commerce has deemed the vote a crucial one that will be heavily counted in its annual scorecard, and those who voted yes will pay a financial price from the Chamber and the banking industry.

Other Democrats stuck with the banks against the homeowners. Sen. Robert Byrd (D-W.Va.) was wheeled into the chamber and pointed his finger in the air, signaling a yes vote, then dramatically swung it down, as if taunting the backers of the bill.

Sens. Jon Tester (Mont.), Mary Landrieu (La.) and Ben Nelson (Neb.) all voted with the banks, as they told the Huffington Post they would. Sen. Blanche Lincoln (D-Ark.) voted no, as did the new Democratic Sen. Arlen Specter of Pennsylvania.

Sen. Michael Bennett (D-Colo.), Sen. Tim Johnson (D-S.D.) and Max Baucus (D-Mont.) voted no as well.

Earlier this week, Durbin concluded that banks that “frankly own the place.”

How much did the Senate go for?

The banking and real estate industry has funneled roughly $2,000,000 into Landrieu’s campaign coffers over her 12-year career, according to data from the Center for Responsive Politics. The financial sector is Nelson’s biggest backer; he’s taken $1.4 million from banks and real estate interests and another $1.2 million from insurance firms. Tester has fielded roughly half a million in his two years in office. Lincoln has taken $1.3 million from banking and real estate interests.
Carper has raked in more than $1.5 million. Baucus, chair of the finance committee, has been on the receiving end of $3.5 million over his career. Specter has hauled in more than $4.5 million and Johnson has gotten some $2.5 million.

So don’t these Senators realize how we got into this mortgage mess to begin with?  I see crazy loans made way above a homes value even in good times whose owners are now in trouble.  Where are the mortgage bankers getting the money to lobby?  I thought they were in trouble and needed taxpayer help.  I say, no more bailout for any mortgage bank which lobbied against this bill.

By the way, there is also a list of Senators who voted their consciences:  Evan Bayh, Mark Warner, Jim Webb, and Ted Kaufman (who is not running for re-election).  We need to thank them for their votes.

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The Slow Drip of Torture Revelations

Sometimes it feels like torture.  Everyday it feels as if there are new revelations.  Everyday there is more speculation about why President Obama doesn’t come out and say he will or will not support prosecution of Bush administration officials.  I have said before that I think he is waiting to see what Congress does and what the Justice Department finds in various investigations.  I think he doesn’t want to be seen as too eager and too partisan.  I understand why many are frustrated.  After all, the Republicans brought impeachment procedings and had a multi-year investigation by a special prosecutor about what was essentially a personal crime by President Clinton.  The whole thing sapped energy from things that Clinton could have been doing and I can understand that Obama wants to pass some of his real agenda first.  I want to see criminal prosecutions in the courts, although Judge Jay Bybee is an exception who needs to be impeached.

John Nichols writing in the Nation says

And President Obama, who erred on the side of the transparency demanded by the American Civil Liberties Union in its long campaign to obtain the memos, gets points for ordering an end to the use of the torture techniques they outlined and for expressing at least a measure of openness to a “further accounting” and perhaps prosecution of wrongdoers. But Obama’s fretting about inquiries “getting so politicized” and suggesting a preference for shifting responsibility to a bipartisan independent commission are unsettling.As a former constitutional law lecturer, Obama should have a firmer grasp of the point of executive accountability. It is not merely to “lay blame,” as he suggests; it is to set boundaries on presidential behavior and to clarify where wrongdoing will be challenged. Presidents, even those who profess honorable intentions, do not get to write their own rules. Congress must set and enforce those boundaries. When Obama suggested that CIA personnel who acted on the legal advice of the Bush administration would not face “retribution,” Illinois’s Jan Schakowsky, chair of the House Permanent Select Committee on Intelligence’s subcommittee on oversight and investigations, offered the only appropriate response. “I don’t want to compare this to Nazi Germany, but we’ve come to almost ridicule the notion that when horrific acts have been committed that people can use the excuse that, Well, I was just following orders,” explained Schakowsky, who has instructed aides to prepare for a torture inquiry. “There should be an open mind of what to do with information that we get from thorough investigations,” she added.

There must also be a proper framework for investigations. Gathering information for the purpose of creating a permanent record is only slightly superior to Obama’s banalities about wanting to “move forward.” Truth commissions that grant immunity to wrongdoers and bipartisan commissions that negotiate their way to redacted reports do not check and balance the executive branch any more than “warnings” punish speeding motorists.

Impeaching Bybee, as recommended by Nadler and Common Cause, would send the right signal. But it cannot be the only one. The House Judiciary Committee should examine all available avenues for achieving accountability–including the prospect of formal action against former officeholders, up to and including the sort of impeachments imagined by Mansfield and his compatriots in 1974. And Nadler and Feingold should use their subcommittees to begin outlining statutory constraints on the executive branch. The point, again, is not merely to address Bush/Cheney-era crimes but also to dial down the imperial presidency that has evolved under the unwatchful eye of successive Congresses.

“Congress…must be vigilant to the perils of the subversive notion that any public official, the president or a policeman, possesses a kind of inherent power to set the Constitution aside whenever he thinks the public interest or ‘national security’ warrants it. That notion is the essential postulate of tyranny,” California Congressman Don Edwards warned thirty-five years ago, when too many of his colleagues thought Nixon’s resignation had caged the beast of executive aggrandizement. That vigilance, too long delayed, is the essential duty of every member of Congress who swears an oath to support and defend the Constitution.

Here’s most recent example of the drip of revelations.  It appears that former Secretary of State Condi Rice might also be implicated in a conspiracy.  Keith Olbermann ran this tape  of her trying to defend torture.

So I say the Congress should begin impeaching Jay Bybee and we should let the relevatiions continue.  I’m not sure when enough will be enough to begin criminal proceedings but I’m sure Eric Holder will figure that out.

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Specter Jumps Ship

I don’t share a lot of political views with Arlen Specter, but I have to admit that on occassion he has said things and voted in a way that delighted me.  Like his vote against Robert Bork for the Supreme Court and some of his civil libertarian stances.  So I was like D.D. Gutterplan (biographer of I. F. Stone) who wrote in the Nation

…I’m trying to figure out why the news that he’d crossed the aisle made me smile this morning. I don’t think I have a sentimental take on how rapidly, even with 60 Democrats, the U.S. Senate is likely to bring about the blessed community.

I read about it at lunch and immediately thought to myself, now isn’t that wonderful.  But why exactly?  If Specter were to lose the Republican nomination, it is likely that one of several really progressive Democrats would win the general election, giving the Democrats another seat.  So why did the President welcome him to the party and say he would campaign for him instead of a real Democrat?  While Specter has made it clear he is not an automatic vote on anything (his first vote was against the Democratic budget resolution), he also made it clear that, according to the New York Times, he thought he could help President Obama.

Mr. Specter said he was “comfortable” with how Mr. Obama has conducted his presidency, which is 100 days old today, and that his own “centrist” approach on governance would help reach solutions on matters like health care, climate change, immigration, and the fiscal balancing act during a time of economic strain.

 

But let’s face it:  Specter knew he was going to lose in the Republican primary and he wants to be re-elected.  It is also true to some extent that, as he said, the Republican Party had left him.  This was echoed by Olympia Snowe quoted here in the New York Times

But Senator Olympia J. Snowe of Maine, a Republican who also supported the administration’s economic stimulus plan, said Mr. Specter’s view that the party had shifted too far to the right reflected the increasingly inhospitable climate for moderates in the Republican Party.

Ms. Snowe said national Republican leaders were not grasping that “political diversity makes a party stronger, and ultimately we are heading to having the smallest political tent in history.”

I think that the President has embraced Specter and is dissing a sure Democratic vote later because he sees Specter as a 60th vote for health care and education reform now and he wants to pass both before the 2010 elections.   And in the meanwhile it is lovely to watch the Republicans have fits.

Politico.com has a lovely article – quite long – about the finger pointing going on among Republicans. 

Faced with a high-profile defection and the prospect of political irrelevance in the Senate, Republicans took off the gloves Wednesday for a ferocious game of finger-pointing.

Republican Sens. Orrin Hatch and George Voinovich blamed the Club for Growth for imposing a right-wing litmus test that chased Arlen Specter out of the Republican Party. The Club for Growth blamed Specter — first for helping to ruin the GOP and then for leaving it. A leading Republican strategist blamed the party for turning its back on moderates. Sen. Lindsey Graham sniped at Republican National Committee Chairman Michael Steele. Specter’s pollster blamed the stimulus bill. Karl Rove blamed Specter himself. 

The Club for Growth President defended himself

But Andy Roth, the Club for Growth’s vice president for government affairs, said the Republican Party is at its nadir precisely because it has tolerated the likes of Specter.

“Let’s look at what a big-tent Republican Party gets you,” said Roth. “Over the last eight years, we had Big Government with a party that had no identity. People like Specter destroyed the Republican brand.”

Republicans also wanted to know why the party let someone run against Spector in the first place which is an excellent question. 

While acknowledging that Specter’s defection was “about political survival,” veteran GOP strategist John Weaver said the party must be concerned about its “political relevance.”

“If [President Barack] Obama and the Democrats control not just the left side of the playing field but also the broad middle, then we are in for generations of irrelevancy,” Weaver said. “Yes, our party principles are important. But we better be more pragmatic in how we advance our cause. There can be a center-right governing party. There cannot be one only from the right.”

Weaver said there’s “plenty of blame to go around,” and that Specter himself should receive his fair share. But he also pointed a finger at Steele, the RNC chairman, who undercut Specter by suggesting, in a recent TV interview, that he could be open to supporting primary challenges to Specter and the other GOP senators who supported Obama’s stimulus plan.

“I would remind Mr. Steele and some of our party leaders: Theirs is a job of winning elections, of increasing party strength, not of forming some sort of party purity police so this grand experiment to shrink the base to its purest form finds us confined to a phone booth,” Weaver said.

What a delicious image! 

by

The Republicans at 100 Days

I’ve lived in the political wilderness so I have some idea of what the Republicans must be feeling.  I mean, who is this  guy anyway?  And how come the American people were so silly and stupid as to elect him?  I thought that about RR, George HW, George W and, when I was living in Virginia, George Allen.  But, I sat in my corner and groused.  I worked for candidates, I wrote letters, and I bought funny books about the right wing.  I bought a W countdown calendar. I didn’t go out and buy a gun to protect a woman’s right to choose. I tried to tell myself that it will all end and the good guys will win again and I was right.  The country, by a still surprising to me margin, elected a black man who has a great wife, kids, mother-in-law and now, dog.  Suddenly a family kinda like the Cosbys, but for real, is living in the White House and he is leading people like me out of the wilderness. 

It has been 100 days and President Obama is not going away.  If anything, he is getting higher approval ratings and popularity than when he began.  So what is it with the Republicans?  Bill Maher has written a great piece for the LA Times. His analogy:  “The G.O.P is acting like a Guy Who Got Dumped.”

The conservative base is absolutely apoplectic because, because … well, nobody knows. They’re mad as hell, and they’re not going to take it anymore. Even though they’re not quite sure what “it” is. But they know they’re fed up with “it,” and that “it” has got to stop.

Here are the big issues for normal people: the war, the economy, the environment, mending fences with our enemies and allies, and the rule of law.

And here’s the list of Republican obsessions since President Obama took office: that his birth certificate is supposedly fake, he uses a teleprompter too much, he bowed to a Saudi guy, Europeans like him, he gives inappropriate gifts, his wife shamelessly flaunts her upper arms, and he shook hands with Hugo Chavez and slipped him the nuclear launch codes.

Do these sound like the concerns of a healthy, vibrant political party?

It’s sad what’s happened to the Republicans. They used to be the party of the big tent; now they’re the party of the sideshow attraction, a socially awkward group of mostly white people who speak a language only they understand. Like Trekkies, but paranoid.

Maher continues

Look, I get it, “real America.” After an eight-year run of controlling the White House, Congress and the Supreme Court, this latest election has you feeling like a rejected husband. You’ve come home to find your things out on the front lawn — or at least more things than you usually keep out on the front lawn. You’re not ready to let go, but the country you love is moving on. And now you want to call it a whore and key its car.

That’s what you are, the bitter divorced guy whose country has left him — obsessing over it, haranguing it, blubbering one minute about how much you love it and vowing the next that if you cannot have it, nobody will.

But it’s been almost 100 days, and your country is not coming back to you. She’s found somebody new. And it’s a black guy.

And there, to end on an unfunny note, you have it:  The Republican Party is in real danger of becoming the irrelevant party of white people in a world that is changing.  Janet Napolitano had it right.  We need to worry about the next Timothy McVeigh who is influenced by Representative Michelle Bachman and Governor Rick Perry.