Tag Archives: democrats

California & SF Voter Guide

Thoughtbasket readers, if you live in San Francisco, or in other parts of California, and haven’t had time to read up on all the initiatives and propositions on next month’s ballot, a friend of mine took the time to prepare a voter guide. I can’t vouch for his recommendations — I don’t agree with all of them — but his summaries are concise and amusing, which is a pretty good combo. Make up your own minds, of course, but this might be a useful tool.

Check out the quick voter guide at www.quickvoterguide.org

 

The Fakery of Paul Ryan

Like most (all?) Washington politicians, Paul Ryan is a liar and a hypocrite. Read about it here. Skip to page 6 for the ultimate example of Ryan’s nearly pathological fakery.

Democrats Need to Lead, or Lose

S&P downgraded US debt from AAA yesterday, knocking Treasuries from their perch as the safest debt on earth. We will see what happens to yields on Monday, but so far it’s not clear that the markets agree with S&P. After all, this is an agency that had AAA ratings on subprime mortgage-backed securities not that long ago.

But in the meantime, the GOP is using the downgrade to attack Obama, saying “look what happened on his watch.” The president doesn’t deserve all the blame, but I understand why the GOP has seized the downgrade as a bludgeon. And in the same way, democratic operatives are putting the blame on the tea party and its refusal to compromise on deficit cutting.

But you know who isn’t saying anything? Democratic leaders. The White House, Harry Reid, Nancy Pelosi — they are all keeping silent on this. They are trying to be the “adults” and not play the blame game. I appreciate that high-mindedness, but here’s the thing: the game is being played, with or without them. If they stay silent then they just let the GOP control the narrative. You know the Sunday talk shows will be full of Boehner and Cantor and Romney and the gang piling on Obama for the downgrade.

The Democrats have to realize that they are in the middle of a street fight and if they don’t fight back they will lose. And they’ll deserve to lose. If you are going to suck ass at politics, then you shouldn’t be a politician. Regular readers know that I mostly support Democratic policies (with some huge exceptions that I ought to detail one of these days), but I sure don’t support Democratic fecklessness. The Democrats got rolled on the debt ceiling negotiation, and now they are getting rolled on the downgrade. It’s pathetic. Or, to quote a senior democratic official: “if this White House showed a gram of leadership on the debt crisis we could have avoided this historic embarrassment.”

GOP vs. Democratic Messaging

E.J. Dionne recently wrote a piece about the open Supreme Court seat covering some of the same issues of Republican vs. Democratic messaging that I covered here and here. And a few weeks ago he wrote another article even more explicitly criticizing Democrats for continually losing the war of messages. Why are Democrats so terrible at this game? How is it possible for Frank Luntz to single-handedly kick Democratic ass time and again? I’d be willing to bet that the majority of folks at ad agencies are Democrats….so get them on the team.

You might think, and certainly we would all like to think, that policies and results are more important than messaging. Oh, how sweetly naive! If you lose the messaging battle, you never get to implement the policy and see the results. Messaging is how you get the support of the public, and since most people have very little time and/or attention for politics, your message has to be short and sweet.

Since Democrats can’t seem to get it together to develop appropriate messaging, I thought that I would take a crack at some of the key issues of the day. I don’t claim genius for any of these efforts – I’m a blogger, not a fighter – but maybe they will spark a little conversation and get some more talented folks to chip in.

Judges respecting individual rights
GOP

  • Judicial activism
  • Non-elected officials creating laws

Thoughtbasket

  • Understanding the meaning of the Constitution
  • Following in the Founding Fathers’ footsteps
  • Looking at the spirit of the law if the language is unclear

Estate taxes
GOP

  • Death taxes

Thoughtbasket

  • Monarchy prevention policy
  • Asset transfer payment

Regulation
GOP

  • Government control
  • Business killer
  • Job destroyer

Thoughtbasket

  • Public safety measure
  • Children’s health initiative

Aid to Poor
GOP

  • Socialism
  • Promoting dependency

Thoughtbasket

  • Safety net
  • Short-term help for the most vulnerable citizens

Economic Equality
GOP

  • Threat to liberty

Thoughtbasket

  • Promoting American capitalism

Questioning Security Policies
GOP

  • Unpatriotic

Thoughtbasket

  • Keeping America safe
  • Developing the best security system in the world

Healthcare Reform
GOP

  • Government takeover

Thoughtbasket

  • Preventing the deaths of innocent citizens

Finance Reform
GOP

  • Enabling taxpayer bailouts

Thoughtbasket

  • Stopping taxpayer bailouts

Raising Tax Rates
GOP

  • Destroying individual initiative

Thoughtbasket

  • Fiscal responsibility

Reaching Out to Non-allied States
GOP

  • Appeasement

Thoughtbasket

  • Realpolitik

Cap & Trade
GOP

  • Energy tax

Thoughtbasket

  • Grandchild Safety Act

Immigration Reform
GOP

  • Amnesty

Thoughtbasket

  • Continuing the American melting pot tradition

Nuclear Arms Treaties
GOP

  • Weakening America’s defense

Thoughtbasket

  • Making America safer by reducing nuclear proliferation

The Role of the Supreme Court

Following up on last week’s post regarding the new opening on the Supreme Court, Dahlia Lithwick at Slate wrote a piece more up to her normal standards, discussing how a court that “shows restraint” essentially just perpetuates the political power dynamic currently in force, enabling tyranny of the majority, which is exactly what the founding fathers wanted the judicial branch to be a bulwark against.

Lithwick’s article draws heavily on this awesome NY Times op-ed by Geoffrey Stone, a law professor at University of Chicago. His money quote is here:

Although the framers thought democracy to be the best system of government, they recognized that it was imperfect. One flaw that troubled them was the risk that prejudice or intolerance on the part of the majority might threaten the liberties of a minority. As James Madison observed, in a democratic society “the real power lies in the majority of the community, and the invasion of private rights is chiefly to be apprehended … from acts in which the government is the mere instrument of the major number of the constituents.” It was therefore essential, Madison concluded, for judges, whose life tenure insulates them from the demands of the majority, to serve as the guardians of our liberties and as “an impenetrable bulwark” against every encroachment upon our most cherished freedoms.

Lithwick also refers to this Huffington Post piece discussing how the Democrats have greatly improved their messaging on this matter, linking economic populism with the role of the Court, as in this quote by Vermont senator and Judiciary Committee chairman Pat Leahy:

“Congress has passed laws to protect Americans in these areas, but in many cases, the Supreme Court has ignored the intent of Congress in passing these measures, oftentimes turning these laws on their heads, and making them protections for big business rather than for ordinary citizens.”

Politicians Should Start Their Careers Outside Politics

I was reading recently about Senator Byron Dorgan’s retirement, and the article claimed that he had been in politics for 40 years. I looked up his biography on his official site and on Wikipedia, and both confirmed the 40 year figure. Dorgan worked in business for 2-3 years, and then became State Tax Commissioner at age 26, and has been an elected official ever since.

Then this weekend’s NY Times magazine had a long piece on the GOP’s moderate vs. Tea Party battle, as personified by the race in Florida between Charlie Crist and Marco Rubio. It turns out that Rubio has never done anything but hold elective office, serving as a West Miami city commissioner right out of law school.

Dorgan and Rubio might be great legislators — I don’t know enough about either of them to judge — but doesn’t it seem like we should want our politicians to have lived in the real world? Think of all the things we regular folks have to do: hunt for jobs, worry about insurance, cooperate with coworkers we hate, shop for cars, get things done at work, etc. Career politicians don’t have to do any of that stuff. They never need to execute and accomplish, and they get rewarded for being obstinate. They stop worrying about money, since they get to pay their family as “consultants” out of campaign funds. And they have staff to take care of life’s little details.

I’m not expecting our politicians to follow the lead of Cincinnatus, who left his farm to run Rome, and then returned to his farm. But maybe some experience in the real world, not the political world, would get our legislators to work — WORK — on policy, instead of spending all their time posturing and campaigning.

Greedy Doctors Are The Same As Wall Street Bankers

Given the current legislative efforts to reform health care, it’s not surprising that there are plenty of articles being written on the subject. But I was surprised that in just one day last weekend I managed to read three articles that blamed doctors for a decent chunk of our out of control health care costs. More interesting, not one of these articles was talking about defensive medicine or a focus on high tech care; no, they were all basically saying that too many doctors are greedy for money.

First there was this article in the NY Times, which discussed how the AMA has since 1929 (yes, 80 years ago) fought against systems (such as cooperatives) that would potentially limit doctor incomes by creating a salary structure rather than a fee for service structure. Although some cooperatives were formed, it was over the objections of the AMA. Not coincidentally, the two medical groups that are continually held up as paragons of cost-effective and world-class care, the Mayo Clinic and the Cleveland Clinic, are both cooperatives. At a recent conference on cost-effective care, most doctors and hospital executives agreed that the fee for service system is “archaic and fundamentally at odds” with good practice.

Next was this article by Dr. Atul Gawande in The New Yorker, in which he investigates why health care in McAllen, Texas is so much higher than the national average. In fact, he notes, McAllen’s health expenses are twice as high as El Paso, Texas, which has the exact same demographics. Gawande explores a number of reasons – service quality, technology, legal environment – but ultimately concludes that it comes down to massive overuse of medical care. Doctors in McAllen do far more tests and scans and procedures than average.

But Gawande goes even further. He blames this overuse not on a surfeit of caution, or desire to better treat patients, but on doctor greed. Doctors make more money when they do more procedures, and if they have ownership stake or revenue sharing agreements with imaging centers or labs or hospitals (and many of them do), then they have financial incentive to send patients to those facilities. Interviewing doctors in McAllen, Gawande uncovers a culture of greed, where doctors are in it for the money. Or, as a McAllen cardiac surgeon says, “Medicine has become a pig trough here.”

I sent Gawande’s article to a friend of mine, who is a doctor in a family practice, but who also has a Master’s in Public Health and did a fellowship in preventative medicine. My friend agreed with Gawande’s conclusions, noting that “nobody wants to give up that $500k+ salary, and the AMA is a huge lobby.”

Finally, The New Republic had a piece that sort of summed it all up, noting:

“Given how much of the game of reining in costs hinges on doctors–whether they see themselves as profit-maximizing small businessmen (or, for that matter, large businessmen), or as fundamentally involved in healing patients and receiving fair compensation for that service–I think we have to think about the kinds of people who go into the profession.”

And this is where I get to have my say. Because if someone is going into medicine because they want to make a million dollars, I say they should go to Wall Street instead. As this chart shows, it isn’t exactly like doctors are hurting for money. Practicing medicine isn’t a license to print money, and when a doctor orders an extra $1,000 procedure, while he gets to keep that $1,000, we all have to pay for it through higher insurance premiums. At which point he is no better than the greedy mortgage-backed security trader whose huge bonus ended up being subsidized by taxpayers.

This just in: right before posting, I read this article in the Wall Street Journal about how the AMA and the American College of Surgeons both came out against the idea of a commission setting Medicare payments to doctors. These groups continually lobby against reductions in Medicare payments.

Added bonus links:

  • Slate article describing how a Supreme Court anti-trust decision gave rise to doctor-owned hospitals and other greedy doctor abominations.
  • Denver Post article about a woman who died when a doctor-owned specialty hospital that didn’t have the resources necessary to handle her post-surgery complications.
  • Book review by Harvard Medical School professor Arnold Relman, who attacks the “medical-industrial complex” and the whole concept of profit-driven medicine: “in no other country is medical care marketed and advertised so aggressively, as if it were just another commodity in trade.”
  • New York Times article describing how the greediest hospital in Gawande’s article is one of the largest contributors to Democrats this year as it lobbies “to soften measures that could choke its rapid growth.” This lobbying has been successful, as language limiting physician ownership of hospitals has been stripped out of bills. According to Democrat Pete Stark, the physicians “just thought they could buy their way out of it, and it’s a sad commentary on the Congress.”