You're Making the Mothers In America Angry

I noticed another truck here in East Tennessee this past weekend with the bumper sticker which reads "TN is for Jesus Not Obama". Funny thing though - that's never been a choice anyone I know (or don't know) has ever been given. Ever.

The rising (and highly publicized) anger of some Americans about President Obama has been both shrill and more than a little manic - I'm sensing a lot of fear and paranoia but fear of what exactly? The dissent bellows back the reply: "EVERYTHING!!"

Here's one huge, giant change I've noticed since President Obama has taken office: people who voice loud and angry dissent are not silenced, are not forced to stay inside designated fenced-in "freedom zones", and are even allowed to carry guns to their protests. That's a massive change from the previous eight years, when even sporting a shirt or bumper sticker could get the Secret Service crawling all over you.

I'm betting that's what really has some people terrified - they are being given enormous opportunity to offer their viewpoints but very few Americans are buying it. It's being told you're obsolete and that's always a bitter slab of American pie to swallow.

The last week saw the hysteria emerge anew as Conservative leaders and others of dubious intent whipped up some media frenzy over a speech President Obama was offering to kids in school. That may have been a huge mistake because now the Mothers in America are questioning the source of such hysteria and they're pretty mad about what they have learned. Here's two from East Tennessee:

"Yep, according to Uncle C, all good Christian Americans will reject Obama’s attempt to indoctrinate America’s youth to socialist ideas (you know, ideas such as education is important, stay in school, be responsible, work hard and other pervasively evil, similarly socialist shit like that) by declaring Tuesday “National Keep Your Child Home from School Day.”

In Hawkins County, this will be followed by “Steve, the Republican Attendance Supervisor, Hauls Your Sorry Ass To Truancy Court Day.”

You know, America, I’ve been quiet about a great many things that have occurred in this country since Obama was elected. I guess I’ve been a little dumbstruck by this highly publicized war between the radical factions, by the polarization of the American people, by the resurgence of racism which is poorly disguised as political opposition, by the complete lack of intelligent discussion, mutual respect or common decency and the easy acceptance of the deceitful propaganda, which has taken it’s place – all things which should be insulting to any free-thinking intelligent person, regardless of party, but isn’t or doesn’t seem to be.

Literally. Dumbstruck.

I cannot count the number of times over the past few months that the behavior of the people around me or comments made by those closest to me have been so outrageously stupid, so painfully offensive or were delivered with such a wild-eyed fervor (the type which is normally reserved for snake handling or healing in the name of Jesus) that I cannot find the words to combat it.

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"But this controversy isn’t about Obama’s remarks or his method of delivery, is it? It’s about Obama, period – and the message you’re sending, I think, is quite simple: OH MY GOD, it’s a scary liberal BLACK guy with a foriegn-soundin’ name – RUN for your LIVES! BEFORE HE DEVOURS YOUR CHILDREN!”

Well, I’m tired of hearing that message. I’m tired of feeling defeated by dumbasses. I’m tired of remaining silent while radicals cry wolf. I’m tired of the media making those idiots spokespersons for us all – and I’m reeeaaallly tired of Republican leadership allowing the moderates, independents and people with half-a-brain to be shoved to the left of the center because that’s the only place where they feel safe from the crazies, the Klan and the state party chairpeople. Don’t believe me? Keep promoting yourself as the party of Grand Wizards and even grander fruitcakes, see how far it gets you."

That's from DeMarCaTionVille

And from Southern Female Lawyer:

"I am sorry, but there is NO WAY that this sort of crap is not at least partially race-based. Where was this fear and rage before? From now on I am calling it like I see it. Gloves off.

These are people who are afraid that they are losing their white christian hetero male advantage. They see a black President. They see hispanic folks at their grocery stores. They see gay couples on t.v. They see women in roles of power. In other words, they see change is coming and that there is NOTHING they can do to stop it. But that isn’t going to keep them from letting the wealthy and corporate interests use their fear and manipulate them. That won’t stop them screaming about ‘healthcare’ or ‘taxes’ or ‘constitution.’ Two of which have always favored the white and the wealthy. But you know what? The Constitution favors NO ONE above anyone else. We are ALL entitled to its protections. So suck it up people. You had your chance.

Change is here."

She also has another post you might like to read here.

Oh, and that speech which the President made today had some pretty basic and concrete typically Conservative components: Individual responsibility, setting goals, deciding to be your own boss.

"But at the end of the day, we can have the most dedicated teachers, the most supportive parents, and the best schools in the world and none of it will matter unless all of you fulfill your responsibilities. Unless you show up to those schools; pay attention to those teachers; listen to your parents, grandparents and other adults; and put in the hard work it takes to succeed.

And that's what I want to focus on today: the responsibility each of you has for your education. I want to start with the responsibility you have to yourself.

Every single one of you has something you're good at. Every single one of you has something to offer. And you have a responsibility to yourself to discover what that is. That's the opportunity an education can provide."

Full text here.

The Medical Industrial Complex

Journalist and Health Care Advocate Maggie Mahar has a new book and documentary out titled "Money-Driven Medicine: The Real Reason Health Care Costs So Much" and the documentary is starting to shake up some of the current debate about Health Care in America.

Here's some excerpts from the movie, which was featured on Bill Moyer's PBS show last week. She spends some of the film talking with doctors and others in Nashville, which is home to a large number of medical corporate headquarters. Here's some excerpts from Mahar's documentary:

"Maggie Mahar: One time Dr. Donald Berwick called a hospital in Texas and said, "We've heard you have a very good procedure for treating a particular disease. We'd like to learn more about your protocol so other hospitals can use it." And the hospital said, "We can't tell you that. It's a competitive advantage in our market that we're better at treating this disease and it is very lucrative. So this is proprietary information."

Dr. Donald Berwick: We believe in markets, right? Isn't that the American way? Well, markets mean competition. Isn't that the American way? Competition makes things come out right. Well, what does that mean in health care? More hospitals so they compete with each other. More doctors compete with each other. More pharmaceutical companies. We set up war. Wait a minute, let's talk about the patient. The patient doesn't need a war.

Maggie Mahar: The patient isn't the center of a collaboration. The patient is the victim of a competition. There's a saying in Swahili, "When…" I can't remember this one… "When the elephants fight the grass is trampled." The patient is essentially the grass.

Dr. Clifton Meador: Somebody says, "Nobody in Nashville makes anything. We just do stuff and people send us money." I've been told they never had a recession in the history of the place. This is music row. Every one of these houses is now a recording studio. There's Love Monkey Music, Flashville, Sharp Objects Music, Seasac, whatever that is. This is the heart of "music city" USA.

Here's what a nurse told me. "Tell patients to remove the foil from a suppository before insertion."

Maggie Mahar: Clifton Meador has had many careers. He's been an author, a family doctor, an epidemiologist, a health care administrator and the youngest ever Dean of the University of Alabama Medical School. Over the years, he's watched the business of health care turn into a driving force in the US economy. Much of it headquartered in Nashville.

Dr. Clifton Meador: This is Marilyn Way. Marilyn Way is a center road of Marilyn Farms. Marilyn Farms is a huge complex. The predominant business in here is health care corporations of one sort or another. This goes on and on for over a mile here and this is not called for-profit hospital row, or anything like that, but this, this is the equivalent of the music row that we went down for the recording industry.

Dr. Clifton Meador: This is titled "The Nashville Health Care Industry, The Family Tree 2006." Every little square here is a health care business industry or spin-off. We have 3 mother corporations here: HCA, which is the Hospital Corporation of America, spun off all of these. Hospital Affiliates, which is a spin-off of HCA, spun off all of these. And Health Trust, which is a spin of Hospital Affiliates and HCA, spun off all of these. So this is a massive, industrial health complex that's headquartered here in Nashville.

Maggie Mahar: After World War II, while other countries let their government begin to intervene in health care to make sure everyone got care, to regulate it to make sure it was good care, in this country doctors very, very strongly opposed any government involvement or anyone being involved in telling a doctor what to do. After Medicare was passed in 1965, elderly patients were getting far more care than they had been before then.

Then that's when our industrial medical complex, I would say, took off. By the early 70s, there were so much money involved that suddenly people began to say, "You know what? Medicine is too important to be managed by doctors. We all know doctors are bad managers. What we need are businessmen managing health care." And that's when health care went from being physician centered and controlled, to a large degree, by doctors to being controlled by the corporation and the CEOs of those corporations.

And, over time, more and more the CEO of the Hospital would not even be somebody with a MD. He would be somebody with a MBA. And CEOs bent on growth, bent on higher quarterly earnings, quarter after quarter, and year after year, are always pushing for more sales, more revenues, more and more and more. It produces more. But more may not be better for our health."

You can see and read more about "Money-Driven Health Care" here.

And while there is an intense and rising anger among some about the evils of a government medical program like Medicare, surveys show patients are actually happy with the program (via Health Beat):

"Medicare is the second largest health care payer in America, trailing only Medicaid. The program is very popular with its enrollees, with polls showing a higher level of satisfaction than with private insurance.

Medicare is less popular with hospitals.

Opponents of health care reform in general and of a strong public option in particular often cite hospital dissatisfaction with Medicare as a reason why the reform programs won’t work. They report that evidence suggests that overall Medicare pays hospitals less than what it costs them to provide care. Private insurers pay more, and by “cost-shifting,” hospitals use these payments to make up the losses on Medicare. Opponents worry that if a public option linked to or modeled on Medicare becomes the dominant payer for people under 65, hospitals will go broke without the “subsidy” from private insurers, and the health system will be destroyed. Data collected by hospital groups and the insurance industry suggests that this is unlikely to happen.

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First, according to the American Hospital Association itself, 42% of hospitals make a profit on Medicare overall.

In the remaining hospitals, most Medicare patients are profitable. Losses on Medicare patients are related to a minority of patients who need much more care than average because of longer stays, more complications, and underlying health problems. Since the profits on most Medicare patients are small, large losses on this small number of outliers can drive overall payments below costs.In looking at any data on payments, it is very important to distinguish between Medicare and Medicaid. Payments by Medicaid – the government plan for the poor—are significantly lower. On average, Medicaid pays 72% of what Medicare pays for the same service. Those who oppose any government plan often lump Medicaid and Medicare reimbursements together to argue that Medicare grossly underpays providers. There is no question that Medicaid needs significant revision. Medicaid reimbursements should be hiked; payments to states should cover states’ costs. The House health care bill takes a step in that direction by mandating that Medicaid reimbursement for primary care must be raised to equal Medicare payments, and by providing direct funding to cover that raise and to cover new patients enrolled as a result of reform.

However, it is true that while many hospitals actually make an overall profit on Medicare patients, at the other end of the spectrum some hospitals lose more than average.One reason for some disparities is that Medicare payments to hospitals are not uniform throughout the country. In some areas, Medicare pays far more than in other areas. The differences can be quite large, with the highest paid hospitals collecting twice as much as the lowest paid. In some cases, this variation contributes to losses and has led to political controversy. “Blue Dog Democrats,” whose predominantly rural constituencies contain many of the low payment areas, are especially concerned.

As usual, this is more complicated than partisans would like us to think. Many rural hospitals in Blue Dog districts actually enjoy better than average Medicare margins, partly because of special adjustments to payments specifically for rural hospitals. Critics suggest that much of the focus on hospital payments was at least partially orchestrated by the Blue Cross plans to try to kill the public sector insurance option that progressive Democrats say we need to keep private insurers “honest”—and to give Americans choices.

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"The other big question regarding Medicare reimbursements to hospitals is whether hospitals are spending their money in appropriate ways. Everyone agrees that hospitals need to spend the money necessary to provide high quality care. However, many hospitals spend a great deal of money that is not directly related to patient care. More and more hospitals have invested large amounts in décor and esthetics, creating marble lobbies and hallways, building large patient rooms with features that mimic expensive hotel rooms, purchasing art installations, and so on. These amenities do not contribute to patient care. A visit to most European hospitals or to most VA hospitals illustrates that excellent care can be obtained in hospitals considerably less elaborate than many “flagship” hospitals. A few years ago I had the experience of visiting a friend who was a surgeon for Kaiser in the Bay Area. When I first saw his hospital, I was startled – it looked a lot more like a Motel 6 than a Four Seasons. Kaiser is a prospective payment system, so that when the money is gone there is no more. Kaiser also has to compete, at least partly on price, with other HMO’s and insurers in its market. That obviously results in closer attention to what is essential and what is not. However, the results attained at the hospital were excellent – according to the Dartmouth Data, better than at some of the “marble palaces” they compete with.

Salaries for hospital administrators have risen sharply in the last twenty years, with many hospital CEO’s now making seven figure salaries (and a few making eight figures,) and with lower ranked administrators paid proportional amounts. This makes its own contribution to costs.

Hospitals often invest large amounts of money in pleasing doctors who will bring them profitable patients. Many hospitals have overbuilt their angiography and OR capacity to make OR’s and angiography suites available at times when doctors prefer to operate, rather than distributing use through the day. OR’s are sometimes built to fit the personal demands of a surgeon, with side by side OR’s for other surgeons. An OR might be used only by a single surgery group or even a single surgeon and stand vacant when they are not operating. Angiography suites and their staffs might be jammed with work from eight AM to noon, but be shut down while the doctors tend their office practices, or take time off, in the afternoon.

Hospital units are customized to please doctors in other ways. Special parking garages for physicians, expensive meeting and dining facilities, and so on are all set up to attract the “right” doctors.

In the last few years, hospital advertising has exploded. In many cities you cannot drive very far, read the newspaper, or watch TV very long without seeing expensive ads for hospitals. Despite the recession, in 2008 total advertising spending by U.S. hospitals increased to more than two and one half times what hospitals paid for ads in 2001. The costs of these ads are added into hospital overhead—in other words, the charge for your appendectomy includes the cost for the ads. Ironically, this type of advertising is often the hallmark of “overbuilding.” When hospitals wind up with excess capacity, they are then forced to compete aggressively to fill the added beds. This gives costs a double whammy, first incorporating the costs of overbuilding, then absorbing the costs of advertising dictated by the overbuilding.
There is also a well documented hospital “arms race” going on in many markets. Hospitals vie to buy the latest and most impressive equipment, regardless of utilization or cost effectiveness. Relatively new and still useful equipment is discarded because of the perception that something is better. A two year old CT scanner may be replaced because a newer and shinier model is available. In a sense, this is a form of advertising aimed at both physicians and patients, trying to sell the notion that the hospital is the best and most modern.

All of this adds significantly to hospital costs without providing any real health benefit to patients."

And The Winners Are ....

As I posted previously, I've been running a contest in honor of this humble but lovable blog's birthday, and now I am happy to announce that two readers have each won a set of six movie posters from Turner Classic Movies -- I'm contacting them both and the winners are Michael Alvis and Ann Lloyd. Congratulations!!!

And my great thanks to all who entered, to TCM, and to each and every reader who takes the time to enjoy the rich, aromatic blend always offered in this Cup of Joe.

And here's to year number FIVE!!!

Local Blogger Says Health Care Is No Debate - It's A Matter of Life or Death

For a woman named Beth, a single mother of two, the so-called Health Care debate is not about politics of the Right or the Left, or the endless chatter on talk radio and television. For her, it is a matter of life and death.

Beth penned an letter to the East Tennessee blog OpenPen saluting them for their coverage of the debate and of her vital questions:

"Dear Editor,

I’m writing you, in part, to commend you for your fair and objective coverage of health care reform and town hall meetings. I’d also like to urge other media outlets and, more importantly, people to also be fair and objective in discussing health care reform. Though, for some people, especially pundits and politicians, health care reform is a vehicle for political posturing or personal bias. For millions of others it is a matter of personal health. And for far too many, like me, it is a matter of literal life or death.

My name is Beth. I am a divorced single mother of two wonderful children, ages 5 & 7. 3 ½ years ago I fell gravely ill to rare and potentially deadly, but treatable, disease called, Takayasu’s Arteritis. The rarity of my disease and severity of it’s debilitating symptoms led to me being misdiagnosed for the first 2 years of my illness. It is difficult to fully explain Takayasu’s Arteritis and its symptoms, in short form. But, in laymen’s terms, at 26 years old I have the vascular corrosion, bone density loss, joint inflammation and chronic fatigue of a person 60 years my senior.

Likewise, I am also susceptible to heart attacks and strokes. It takes a daily regimen of highly toxic and very expensive prescriptions to regulate my disease. But even the treatment of my disease begets a series of daunting side-effects, including, but unfortunately not limited to, hypertension, extreme weight gain, skin thinning/bruising, hair loss, lymph node tumors, cataracts and skin cancer. The symptoms of my treatment are often as painful and debilitating as my disease itself. But, for (and with) the love of my beautiful daughter and son, I willingly submit myself to whatever it takes to be here for (and with) them.

It is in this spirit of self-sacrifice and survival that I have been rendered financially ruined, due to medical debt. I am stranded in an all too familiar conundrum for uninsured/underinsured patients: Either pay for prescriptions and treatment or living expenses, gas and food. I’ve always been a hard worker, averaging 70 hour weeks as a restaurant general manager. But maintaining the rigors of my job accelerated the symptoms of my sickness. My doctors notified me that continuing to work would jeopardize my chances of recovery and possibly lead to premature death.

Subsequently, I could no longer hold employment. Which meant I lost what health insurance I did have through my job. I initially qualified for TennCare; but was ultimately denied, due to a cluster of state guidelines and regulations. Moreover, because I have a pre-existing condition, no private insurance company will insure me. Effectively, I have been shut out of every feasible resource on a state and private level. Without a federal ‘public option‘, I will quickly descend from shut out to shut down, literally.

With a ‘public option’ I would be able to purchase an insurance plan that would not only provide adequate treatment, but allow me to purchase my prescriptions at a much more attainable cost than the current overwhelming prices (which I can no longer afford). It pains me to see the ‘public option’ be battered about in consideration of only the ‘option’ (resources) aspect of the term, but not the ‘public’ (people) part. And isn’t that what this whole debate is about? The people? Is the primary focus of health care reform to save money or save lives? I understand that it’s not a strictly either or proposition. There is a give and take. But ‘how much money are we willing to give’ seems a much more reasonable and humane question than ‘how many lives does it take before health care reform is a must‘.

Personally, I went form an upwardly mobile, gainfully employed, tax paying citizen to a patient who will likely never have good credit again, nor a bank account/savings, a house or any significant possessions or assets of worth to leave to my children… an especially heartbreaking dilemma considering my faltering health and uncertain treatment resources. I want to leave them something more than medical debt, antagonistic bill collectors and a jaded sense of being let down by a system I’d so willingly paid into when my health provided me the ability to do so.

This is no way for a young mother to live or die in America. This is no way for anyone to live or die in the richest country in the world and most successful democracy ever established. There is no shortage of hyperbole, partisan rhetoric and political propagandizing now polluting the health care reform discussions in the mainstream media, blogosphere and town halls. My plea will likely not influence those who most voraciously feed off cacophony to be more responsible or constructive in the dissent or support of health care reform. But to anyone who is willing to adhere to reason, I ask you, please stop shouting. Yelling a lie does not make it anymore truthful. And the truth is no less true in a whisper.

Blogger Southern Female Lawyer also posted a video on YouTube of her recent Town Hall conversation with 1st District Congressman Dr. Phil Roe:



Some background on what Rep. Roe referred to as an "Associated Health Plan":

"The big problem is that AHPs would be allowed to operate outside of the requirements of the state’s health insurance law and so create two separate and very different markets for health insurance. One would be made up of AHPs, each of which would be rated on its own experience and operate outside the requirements and protections of the current small employer health insurance law. The second would consist of all other small businesses and individuals, whose experience would continue to be merged. The effect will be to pull lower cost and better risk employers into AHPs, leaving higher cost and higher risk groups and all individuals in the merged market, with higher premiums.

Morristown City Admin Forgives and Other Stories Hiding Out

Here's a brief round-up of new and blog reports which stand out to me - some are stories which should get more attention, and perhaps some should grab your attention with some intensity:

MORRISTOWN FIRES CITY ADMINISTRATOR WHO OFFERS FORGIVENESS FOR BEING FIRED:


"City Administrator Jim Crumley was "honored" at a reception at the City Center on August 18. At the council meeting that followed, Mayor Barile, Crumley's most ardent supporter, gave him a plaque and Crumley then gave his farewell speech to the assembled council and public. It was a whopper! He thanked the council and the staff for accepting his leadership and then said that there are issues of leadership in the current council.

Crumley added: "I forgive you all for the mistakes in judgment that you have made."

ALSO at that meeting, the City Council said they had no idea the city was pushing forward with expansion plans for their Industrial Park with the response of "we had no idea", saying:

"Sublett added that the Industrial Board is interested in an Exit 6 as well. He mentioned that the city owns no property there. Why is an exit needed there? Most of the property being looked at is in Jefferson County. Sublett closed by saying that he'd like to know if the council "has a clue" about what is going on at the Industrial Board. No one responded, but after a long silence, Mayor Barile said: "The Industrial Board is always looking to bring in new jobs."

Sublett replied: "You already have 600 acres out there. The City is already 77 Million in debt. How are you going to buy more property? Who's going to fund that?"

No member of the council spoke. If they knew anything about discussions about purchasing property in Jefferson County and two next exits, councilmembers and the Mayor were not talking. Finally, Barile thanked Mr. Sublett and said: "I will talk with the Industrial Board and see what is happening."

She may do it, but I would suggest that no one holds his or her breath while waiting for Barile to find out and actually report to the council and to the public about what is going on at the Industrial Board in regard to purchasing property in Jefferson County or pushing for two new exits on I-81.

Hopefully, Mayor Barile has not signed any "confidentiality" agreement with the Industrial Board or others--like Jefferson County Mayor Alan Palmieri did--where she has agreed to keep public business a secret from the public. [Jefferson Countians found out that their Mayor, Alan Palmieri, and two county commissioners signed confidentiality agreements with Norfolk-Southern railroad and thus agreed to keep information about public business a secret. Word got out in Jefferson County, but only after word leaked out that discussion and conduct of public business was taking place behind closed doors. Someone needs to get an understanding of what the meaning of "public business" is and what the Tennessee Open Meetings Act is about. Of course, Hamblen County has its own problems abiding with the Open Meetings Act. Here and here.]


CHATTANOOGA SUSPECT SHOT 49 TIMES BY POLICE, FEDERAL SUIT FILED:

The police are calling it "suicide by cop" as a distraught and armed man stood on his porch at home in July. The Chattanooga Times Free reports there were 53 shots fired over the course of three full volley of shots:

"The family of a man shot multiple times by six Chattanooga police officers claims the officers were not adequately trained in use-of-force policy and created an "atmosphere of illegal and unconstitutional behavior" in "deliberate indifference and reckless disregard" for the public welfare, a federal court lawsuit states.

Alonzo Heyward, 32, died July 18 with 43 bullet wounds in his body.

Mr. Heyward's parents, James and Margie Marine, filed suit last week, seeking compensatory and punitive damages, attorney fees and a judgment that the police department's policies, practices and customs are illegal and unconstitutional, according to the suit.

The lawsuit is filed on behalf of Mr. Heyward's beneficiaries, including Neka Wells and Tanisha Johnson -- the mothers of his children.

It names as defendants the City of Chattanooga, the city police department and the six officers involved in the shooting: Lauren Bacha, Deborah Dennison, Zachery Moody, George Romero, William Salyers and Bryan Wood.

"The defendants have a policy, practice or custom of allowing its officers to use deadly, excessive and/or unreasonable force without fear of discipline creating an atmosphere where such behavior is accepted, condoned, tolerated, acquiesced, approved and ratified in reckless disregard and deliberate indifference to the welfare to the public at large, including Mr. Heyward," according to the suit."

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"The lawsuit alleges that Mr. Heyward kept his rifle pointed at himself at all times and did not say or do anything that would have made the officers fear for their lives. The suit also says that the officers fired in three separate volleys totaling 59 shots and, after the initial barrage, fired again "suddenly and without warning." (report via the Chatanooga Times Free Press)

CUMBERLAND COUNTY RESIDENTS SUE TVA OVER COAL ASH DUMP, BUSINESS ADDS ANOTHER LAWSUIT:

Life On Swan Pond reports: "But now comes the news that the old coal mine at the top of the hill will become a mammoth dump site for TVA's enormous stockpiles of coal ash.

"Well, for what? TVA has 2,000 to 3,000 acres of their own," Brundage said.

Brundage and 16 other neighbors are suing the county mayor and county commission under the Jackson Law, a law that says elected bodies must consider eight things before making a decision including property values and safety.

The people who live on Smith Mountain Road said both of those will be ruined.

The lawsuit alleges Mayor Brock Hill told residents it was a done deal two full weeks before the first public hearing. The residents were also led to believe, they say, that the dumping would end after three years, but it's now open-ended.

ALSO the Knoxville News Sentinel notes more legal problems for TVA and their catastrophic coal ash spill:

"The lawsuit alleges that the spill caused elevated levels of lead, thallium, arsenic and other heavy metal toxins in the river water, affecting recreation on Watts Bar Lake and other areas downstream. It claims the situation has caused property values in the 90-acre Lakefront Estates to decrease and has diminished the appeal of water recreation at the development.

Because of the spill, TVA so far has been the target of seven federal lawsuits involving hundreds of property owners and four class action suits, but this appears to be the first lawsuit filed by a commercial operation claiming damages.

The lawsuit cites TVA reports as well as a review of the ash spill by TVA's Inspector General to claim that TVA did not take proper measures to prevent the spill.

"As a result of TVA's conduct described herein, Plaintiffs have lost the sale of multiple lots, the development has diminished in value, the recreational amenities afforded by the development have been substantially affected and the whole development and its purpose herein described, has been unreasonably interfered with by TVA as a result of the spill," according to the lawsuit.

REPUBLICANS TO GATHER AT ANGRY VOTER PROTEST AGAINST GOVERNMENT:

The event is scheduled for Labor Day - a holiday created by government - and will be attended by numerous elected Republican officer holders (and some currently not in office or seeking higher office. The KPT reports:

"Event organizers are billing the Tea Party-style rally as a “nonpartisan peaceful protest giving local citizens the opportunity to voice their anger over tax rates and deficit spending. This Rally, they say, will focus on “government excess” and two pieces of legislation being debated by Congress — the so-called cap-and-trade bill and health care reform.

“This is not an (President Barack) Obama bash. We want to protest anybody of any party who would dare to spend trillions of our dollars without even reading the bill,” rally organizer Brit Buehrig said in an e-mailed release.

Speakers at the event are expected to include U.S. Rep. Phil Roe, former U.S. Rep. David Davis, Lt. Gov. Ron Ramsey and state Reps. Tony Shipley, R-Kingsport, and Matthew Hill, R-Jonesborough. All are Republicans.

Buehrig said the event is “above party affiliation.”

Note that the U.S, Dept. of Labor terms the holiday as: "the first Monday in September, is a creation of the labor movement and is dedicated to the social and economic achievements of American workers. It constitutes a yearly national tribute to the contributions workers have made to the strength, prosperity, and well-being of our country."

Meanwhile, at KnoxViews, hysterics and rumors are reaching a full-blown crescendo of howls from the ill-informed and the downright lying prompters of The Dangerously Strange:

"A Republican candidate for Governor of Idaho joked about getting license to hunt President Obama. He later said everyone should have known he was joking because Idaho doesn't have jurisdiction over hunting in D.C.

A Baptist preacher in Arizona gave a sermon in which he prayed for the death of President Obama and his family. A member of his congregation showed up at an Obama health care rally toting an assault rifle and a handgun.

The Secret Service detained a man carrying a "Death to Obama" sign at a town hall meeting in Maryland.

The Black Hole of Health Care Fakery Sucks All Debate Into A Giant Anguished Cry

Separating fact from fiction when it comes to political debate is far more of a massive dredging operation than, say, merely sifting one from the other.

Enormous planet-sized heaps of information and dis-information blend so seamlessly together - and all is repeated and repeated via hard-core entertainer/rodeo clowns on radio and television and poster-carrying gatherings of the ill-informed and angry (it does not matter what they might be angry or ill-informed about, now that inertia's laws lend momentum to any scrap or bit circling around) and now, of course, in the "new media", aka the Internet - these planet-sized heaps form their own galactic expanse of factoids and gossip, mostly bereft of usefulness to any save those whose income requires a constant squeal for attention.

As someone who has worked in the news biz as both hard news and soft news correspondent, I knew long, long ago that all the scraps and bits of information soon merge together. Solemn stories become a pinnacle of the ridiculous and the ridiculous becomes solemn.

It is pretty easy to fool most of the people most of the time, after all.

The current so-called "debate" in America over health care and/or health insurance is a fine example of yet another giant, waffling, wheezing beast of unimaginable size, layered with confusion upon confusion upon confusion in a near-Book-of-Revelation vision of apocalyptic doom, complete with modern-day seers and prophets surrounding the thing and hurling their warnings and charms.

As I have observed both political and social "debates" for some decades, vast and immense emotions can be evoked by minor facts and fictions -- such as, for instance, a local government ordinance seeking to address something like "barking dogs" and "domestic tranquility". If months (or sometimes even years) of anguished public and governmental proclamations grow and grow around this kind of issue -- then just imagine (oh, wait, we don't have to, we can see it now all around us) what has been stitched together from parts far and wide when it comes to the issues of Health Care and Insurance.

Pretty much every president since the middle of the last century has tried to fashion new rules and regulations about Health Care and Government. The benefits and plans which all federal employees receive is by far one of the better plans available to Americans - no exclusions for pre-existing conditions, no reduction of services when ill, low co-pays, etc etc. Of course the tens of billions all that costs is subsidized by taxpayers.

They have all agreed, you see, and encourage "debate" among the rest of us.

When Congress returns to Washington and actually begins drafting and re-writing the rules and regulations which might (let me say that again) MIGHT actually become law, some will be helped and most will not.

I suppose (or perhaps hope) that the best that might happen is many Americans will be once again forced to do what they have always done - scour the marketplace and look for deals, look for ways they can survive and look out for Number One first, second and last. That's what millionaires like entertainer Rush Limbaugh call "American Exceptionalism", i.e. "I got mine, so you go get yours."

What's The Real Cost of a 'Shadow Army'?

While it might seem odd to some to follow-up this weekend's movie post about revisionist history with a story about our real political world -- they share a startling amount of fantasy and danger, but which is which and just what do these policies really cost our country?

For several years now, writer Jeremy Scahill has been tracking the Bush and now Obama administrative decisions to rely on private contractors to conduct warfare and operate spy missions, dodging the law and most every other normal convention of accountability. His most recent stories are even more grim.

I've written before about what Scahill has had to say -- here is a post about his testimony before Congress in May of 2007. Sad that very little has changed since then.

Scahill was on Bill Maher's HBO show this weekend talking about the continued madness and how the nation's media has ignored this story. WhitesCreek Journal has the video. I'd only watch it if you are ready to be stunned.

Meanwhile, Scahill has been writing about the current status of the usage of private contractors like Blackwater, Triple Canopy and others - soldiers paid more in a month than our own soldiers are paid in a year, soldiers who conduct interrogations, provide security to Cabinet officials, conduct secret renditions and aid secret prisons, who may or may not be part of the CIA and who are above the law or outside the law.

His reports are also being published via The Nation (an index is here). Most recently, he reported on J Cofer Black, who left the CIA's counter-terror operations to work for Blackwater and his instructions to a special squad sounds almost identical to the commands issued by one fictious Lt. Aldo Raine in the Tarantino movie "Inglourious Basterds". Raine was after "Nazi scalps" while Black was after Al Qaeda operatives:


"Before the CIA Jawbreaker team deployed on September 27, 2001, Black gave his men direct and macabre directions: "I don't want bin Laden and his thugs captured, I want them dead.... They must be killed. I want to see photos of their heads on pikes. I want bin Laden's head shipped back in a box filled with dry ice. I want to be able to show bin Laden's head to the president. I promised him I would do that." According to CIA operative Gary Schroen, a member of the Jawbreaker team, it was the first time in his thirty-year career he had been ordered to assassinate an adversary rather than attempt a capture.

In September 2002, five months after Blackwater's first known contract with the CIA in Afghanistan, Black testified to Congress about the new "operational flexibility" employed in the "war on terror." "There was a before 9/11, and there was an after 9/11," Black said. "After 9/11 the gloves come off." Black outlined a "no-limits, aggressive, relentless, worldwide pursuit of any terrorist who threatens us," saying it "is the only way to go and is the bottom line." Black would later brag, in 2004, that "over 70 percent" of Al Qaeda's leadership had been arrested, detained or killed, and that "more than 3,400 of their operatives and supporters have also been detained and put out of an action." The Times reports that the Blackwater-CIA assassination program "did not successfully capture or kill any terrorist suspects."

It is simple to see comparisons between Nazi horrors and Al Qaeda - but what does it say about our own leadership, which seems to be content from the White House to Congress, to allow for a special type of private soldier in a shadow army to conduct our warfare?

And hundreds of millions continue to flow to Blackwater and other agencies even though no one is willing to confirm any success of their plans.

Just as all these reports are making the news, the Obama administration is sort of trying to approach the issue from another angle - a Justice Dept. investigation continues to examine the conduct of our own military and the private contractors to see if a criminal investigation is warranted.

This ugly story is just getting uglier, few changes are being demanded by Congress, and the real costs of these types of programs and polices remain unknown.

Scahill notes:

"In another development, [Blackwater founder Eric] Prince's lawyers have responded to explosive allegations made against Prince by two former employees. In sworn affidavits submitted by lawyers representing the Iraqis suing Blackwater, the two alleged that Prince may have murdered or facilitated the murder of individuals who were cooperating with federal authorities investigating the company. One of the former employees alleges that Prince "views himself as a Christian crusader tasked with eliminating Muslims and the Islamic faith from the globe," and that Prince's companies "encouraged and rewarded the destruction of Iraqi life." They also charge that Prince was profiting from illegal weapons smuggling. In a motion filed August 10, Prince's lawyers asked Judge Ellis to strike from the record the sworn statements of the two former employees, saying that "the conclusory allegations they contain are inadmissible on multiple grounds, including lack of foundation, hearsay, irrelevance, and unfair prejudice." They charge that the lawyers suing Blackwater are attempting to "use this litigation as a 'megaphone' to increase their ability to influence the public's perceptions regarding the use of contractors in military battlefield situations, the Iraq War, and most particularly about Erik Prince and the other defendants. Unsubstantiated statements made in filings in this Court become 'newsworthy' simply because they appear in those filings." The lawyers characterize the allegations as "scandalous, baseless, inadmissible, and highly prejudicial." Interestingly, nowhere do Prince's lawyers say flatly that the allegations are untrue.

As the cases against Prince move forward, the company continues to do a robust business with the federal government, particularly in Afghanistan. [Congresswoman Jan] Schakowsky has called for a review of all of the companies' current contracts, and she has called on Secretary of State Hillary Clinton and Defense Secretary Robert Gates to stop awarding the company contracts."

Camera Obscura: (Part 2) "Inglourious Basterds" and "District 9" Reviews

As Lt. Aldo Raine, Brad Pitt southern-drawls his commands, telling his squad he ain't very happy he had to leave his home in the Smoky Mountains to fight these dirty Nazis - and when directly questioned about where his home is , he proudly declares "Maynardville". As in East Tennessee. I'm certain this is the first ever film reference to the town of Maynardville - and it was director Quentin Tarantino's movie "Inglourious Basterds" that made it happen.

Tarantino's take on World War II is also part of his continuing love story with film itself - reels and reels of 35mm film burn up the screen in the movie and they sure burn up Tarantino's heart, and I just love how he tells his love of filmmaking and storytelling. There's likely far more film references here than actual scenes of violence, but you don't have to be a consummate film buff to like "Inglourious Basterds" -- you'll just like it even more if you are.

This is not a summer movie big blow-up crapfest tied into a toy line - see "G.I. Joe" for that, and note that any one of Lt. Raine's squad would beat the living daylights out of every character in "Joe". It's not a CGI Digital 3-D crapfest either -- this is a movie, dammit, for people who love movies and great storytelling. He even made sure the audience sees those so-called "cigarette burns", marks in the upper right corner of the screen which tell the projectionist to change reels. Yes, Tarantino re-writes the history of World War II here, and his version is spectacular, funny and startling - there are no giant military battles here. This is a battle between hearts that burn at 24 frames per second.

When most of Hollywood's mainstream efforts have nearly all turned into rapid-fire cuts and edits and flying cameras, all meant to imply action and violence, Tarantino plants his camera, carefully composes shots akin to John Ford or Jean Renoir, and his characters talk to each other. Some filmmakers would have taken the opening of "Inglourious Basterds" and made it a blitzkrieg of camera angles and rapid editing - but Tarantino's opening scene is about 15 minutes which are incredibly suspenseful, brilliantly acted and written, and sets up the riveting characters of Nazi Colonel Hans Landa, aka The Jew Hunter, and a young Jewish girl in hiding, named Shosanna, who barely escapes that first scene alive. As Landa, actor Christoph Waltz certainly earned this year's Best Actor Award at the Cannes Film Festival.

That first scene shows why Tarantino deserves the high praise he has received for the last 17 years: on the surface, it is a simple conversation between a French dairy farmer and a Nazi officer, but it has many more layers, right down to the life and death consequences fill every word and every gesture. Similar scenes of one-on-one conversation occur often in the movie, each one more suspenseful than the last.

Tarantino says in this interview with The Village Voice that Landa is best character he's ever written, and that's quite true. I was constantly fascinated and immensely entertained by the character and how vividly Waltz brought him to life. Shosanna, played by actress Melanie Laurent, also turns in a spectacular performance -- just as so many in this movie do, like Pitt and actor Michael Fassbender, as a British commando brought in to special mission to attack the Nazi high command officials -- what's more, he is recruited because he is a film critic, an expert in German cinema.

Music choices for the movie, as usual with Tarantino, are always unique, and his choices here are bold and brash - he repeats his usage of several Ennio Morricone soundtracks, and they underscore the scenes with wit and with pathos. He even works in one of my favorite songs ever created for a movie, David Bowie's blistering song "Putting Out Fire" from the remake of "Cat People" as Shoshna plots her ultimate revenge against the Nazis.

On a side note, in the VV interview mentioned above, Tarantino is asked again to name his favorite films, and he says that over the years, the movie that he likes best is Sergio Leone's "The Good, The Bad, and The Ugly" and I have to agree with him. Leone took one of American cinema's central genres, the Western, and turned it into something brand new. And Tarantino blends the Western and the War Film into something new, too, destined to be a masterpiece. Just like Lt. Raine wanted his work to be remembered.

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I asked my friend Matt McClane to write up a review of "District 9", a sci-fi tale from producer Peter Jackson and director Neill Blomkamp. I just didn't have time to see it for this weekend's post but Matt has the skinny on how just good this one is at his blog, The McClane Tirade --
"This week I took a trip through District 9 and somehow made it out of there unscathed.

You guys have heard of that place, right? For my non-African readers and friends, District 9 is a cozy little spot in Johannesburg, South Africa, where this relentless and carnivorous evil corporation, Multinational United (or MNU) is keeping more than 1 million homeless alien creatures in a busted slum.

Apparently these poor guys basically crash landed on Earth about 28 years ago and the kind people of Johannesburg have been cool enough to let them hang out in the neighborhood until they fix their ship (or pretty much indefinitely).

I wish it was as nice as it sounds, but it's not. These super tall, super intimidating and super scary bug-looking aliens—called "Prawns" as a bad derogatory racial slur—have been shoved into the most horrifying ghetto in the history of busted ghettos. MNU was assigned to govern the district, but now it's evolved into a rich white guy's worst nightmare.

Now you've got the happiest place on the planet: malnourished, ravenous and very pissed off ostracized aliens piled on top of endless garbage, dead animals, thousands of cat food cans and an entire mob of black-market-dealing Nigerian maniacs with stockpiles upon stockpiles of deadly weapons.

I say that I've been there because I feel that I've actually been there. What makes the film, District 9, so unbelievably original is the complete and absolute realism in every single frame. Director Neill Blomkamp (an actual native of Johannesburg) uses some of the most interesting film techniques that I've ever seen. Using a methodical combination of "mockumentary style" hand-held camera footage with the most realistic computer generated special effects ever, he pulls you straight into these slums, even when you're absolutely terrified of going in there.

Make no mistake, though, your ass is going in whether you like it or not. The film grabs your eyeballs, carefully unscrews them from your sockets and yanks you straight into the most hostile environment possible. (He's also going to come back for your ears, just as a warning.)

He completely immerses you into a powder keg of dynamite, as the friction between MNU and the aliens has come to its boiling point.

The corporation and normal folks of Johannesburg have gotten pretty sick of these weird aliens eating all the rubber off their tires, ferociously devouring their pets and making life pretty rough for humans in general. It's not really a fault of the aliens, though. They don't have any leadership. All their superiors have gone to Prawn heaven, and now a million worker aliens have taken a permanent day off.

What do you do on your day off? Do you sell your super-high-tech & highly destructive alien weapons to Nigerian mob bosses for large payments of cat food? (Aliens LOVE cat food.)

If you do choose to sell these weapons, the joke is totally on the mob guys. Turns out, alien weapons can only be fired by aliens. (The guns, etc. are only activated with synced up with Prawn DNA.) In other words, if you're not a 8' tall alien bug, you're not going to be able to do a damn thing with that massive gun, other than brandish it at old people to give them heart attacks or have some nice pretend games of G.I. Joe in your back yard with your closest friends or family.

Anyway, with all this chaos, MNU has finally decided to kick the Prawns out of District 9 and move them over to a new and special place, which is basically an even more busted concentration camp. This just doesn't go over well at all.

This is the part where we meet our main man of the tale, Mr. Wikus van der Merwe. (I know, kickass name, right? I wish I was named that. Can you imagine visiting the "Van Der Merwe Triade" every day? I certainly can.)

Anyway, MNU agent Wikus has been given the wonderful task of heading up the Eviction Task Force, making him the most unpopular man in the District. This guy is absolutely awesome. He's basically a fantastic mix of Borat, Mr. Incredible's tiny insurance company boss from The Incredibles, and every mindless corporate-loving idiot you've ever met. The man doesn't care about these aliens, in fact, he pretty much hates 'em. In a few quick scenes, you really see how much disdain he has for these guys. Basically, the poor guy has no soul. And an awesome corporate hair cut.

So in we go with Wikus to the depths of District 9.

I know it seems like I've given most of the entire movie away, but I haven't. No really, I haven't, readers. I know, you guys are still mad at me for giving away too much about some ballet movie in Morristown, TN, but you're going to have to trust me on this one. We're just getting started. What I've told you is only the set-up.

To keep things nice and vague to not spoil anything for you, let me throw out some of my favorite points here. Also, I'll say this: if somebody spoils this movie for you and gives away any more of the plot than I have, you totally have my permission to donkey punch them in the bread basket.

WHAT I OBSESSED OVER:

1. The realism of this movie will shock you. It just feels so incredibly real. From the special effect work on the aliens, their ship, their weapons, etc., it's literally like you're really in the middle of this place, experiencing these things right beside our characters. While the run-of-the-mill viewers may think it's sloppy, shaky and extreme, us true movie fans know better. Every shot in this piece was skillfully set up for the most unsettling and realistic sequences we've seen since our uncles video taped us walking across the stage at high school graduation.

2. The aliens. Perfectly designed to be completely original, every single one of these guys has its own look, its own mannerisms and its own fashion sense. (Literally.) The way they sound will freak you out in a really good way. Their voices are fascinating.

3. Wikus van der Merwe, played by this new guy named Sharlto Copley. Let me tell you right now: this guy is my favorite actor of the year thus far. I have to really fight my brain like a deadly alligator to remember seeing a character go through such an amazing journey of change like this man does in this film. His character arc is unbelievable, and his charisma is just out-of-control captivating. You'll hate the guy, you'll laugh at the guy, you'll be disgusted by the guy, you'll feel for the guy, you'll believe in the guy, you'll root for the guy and you'll cry for the guy in the same movie. The transformation his character goes through is the most grueling, graphic and emotionally painful performance of the year, by far.

4. The social impact. The themes this movie throws around aren't fun and games. Just try to watch this film without having questionable thoughts about everything from our cultural identity and racism to our God-given rights as not only citizens... but as human beings.

5. The action. Make no mistake, this movie does not mess around. Seriously guys, this movie is seriously hard-to-the-core. This is not the Transformers or G.I. Joe. This movie isn't even Jean Claude Van Damme in Lionheart. No, this movie is jammed packed full of highly, HIGHLY realistic violence, terror and complete carnage. I literally felt like I was watching a Faces of Death movie at some points. The nature of the film and its visual presentation excels every scene from level 5 ("Oh man, that was crazy!") straight to level 11 ("HOLY MOTHER OF GOD, DID I JUST SEE THAT? THAT COULDN'T HAVE JUST HAPPENED; I THINK I'M NEARLY HAVING A HEART ATTACK RIGHT NOW"). It reaches this point by using extremely intelligent special effects mixed with amazing gore, astounding music and hard-hitting sound effects that will leave you completely exhausted (in a terrific way).

To end, I have to make one final, important point: this movie is highly original and startlingly intelligent. It really is, by far, one of the greatest science fiction movies I've ever seen in my entire life. While it's a vicious ride, it's definitely one worth taking.

Take it readers. Take it hard."

Camera Obscura: (Part One) Still Time To Win Free Movie Posters

You still have time to enter to win a set of six great new movie posters from classic Hollywood courtesy of Turner Classic Movies -- I have two sets of the six posters to give away, and to win all you have to do is enter your name in the comments section of this post -- all part of my celebration of my blog birthday. (Entry is open until midnight Aug 31st and two winners will be then selected at random.)

Today, TCM's Summer Under The Stars event makes a day of the films of Gene Hackman - one of the finest actors working today. For many years, he was a solid supporting actor in wide range of roles and some of his best supporting and leading work is highlighted tonite. First, there's "Lilith", a moody tale from director Robert Rossen about a woman (Jean Seberg) being treated at a sanitarium for schizophrenia. While Warren Beatty has the lead role in the movie, Hackman nearly steals the movie in scenes where he plays the husband to one of Beatty's former girlfriends. Rossen's movies always play with intense realism, and that's the kind of movie where Hackman shines.

When Beatty began casting for "Bonnie and Clyde", also on TCM tonite, he put Hackman in as Clyde's brother, a performance which earned Hackman his first Oscar nomination. Also tonite, TCM airs "The Conversation" by director Francis Ford Coppola - a dazzling movie with Hackman playing the lead role of Harry Caul, a specialist in spying and surveillance. This excellent mystery allows Hackman to play a very dour and nerdy character, a man with so many layers - and his role as spy gets turned against him as we see unknown forces strip away each of those layers, all to a devastating effect on Hackman. (His character here was the basis of the one he played in the Will Smith thriller, "Enemy of the State", another tale of spying and surveillance).

Saturday, TCM features the work of another legend, Sterling Hayden. Hayden is likely best remembered for the hilarious lunacy of Colonel Jack D. Ripper in "Dr. Strangelove", but he was a menacing tough guy in some great crime films like "The Asphalt Jungle", "Manhandled" and more. TCM also airs "Johnny Guitar", one of the oddest Westerns ever made. Hayden plays the title character who joins forces with actress Joan Crawford as they fight off attempts to steal her property and chase her out of town. But that barely describes this entry from director Nicholas Ray -- best to describe it as a David Lynch-style warping of a Hollywood Western with psycho-sexual twists and turns. It's a strangely compelling movie, often hypnotic and garish all at once. It's a must-see movie.

So enter the contest and win some free movie swag!!

And check back later today for Part Two of Camera Obscura and I'll have reviews of two new movies for you - Quentin Tarantino's "Inglorious Basterds" and the new sci-fi film "District 9".

Ridiculous Health Reform Fear Number 10,432

Just when I thought I had all I could stomach from the deeply ill-informed lunacy from folks who think changing the way health insurance operates is Eeeeeevil Incarnate --- I finally found something that made me laugh out loud.

More Conservative Lies about Health Care In The U.K.

Via The Week magazine, this article by Robert Shrum:

"Opening an Atlantic front in their summer campaign of lies, conservative opponents of health-care reform have targeted the British National Health Service as a care-denying, euthanizing, broken-down caricature of "socialized medicine"—a portrait that bears no resemblance to reality or to President Obama’s far more limited proposal for reform."

---

"For unadulterated obscenity, however, it’s tough to beat the suggestion of Iowa Sen. Chuck Grassley—one of the "reasonable" Republicans allegedly negotiating reform in good faith—that due to his colleague Ted Kennedy’s age, Kennedy would not be given treatment for his brain tumor in countries with "government-run health" like the U.K. It’s bad enough to exploit the illness of the leading champion of health reform to assail that cause. It’s even worse when, as Kennedy has said, the purpose of his—and Obama’s—reform is not to ration care, but "to ensure that someday, when there is a cure for the disease I now have, no American who needs it will be denied it."

Undeterred by facts, the disinformers have taken their fraudulent assault to the airwaves. The oxymoronic Conservatives for Patients' Rights, working with the PR firm that marketed the Swift Boat libels against John Kerry in 2004, have produced a series of fear-mongering TV ads about the British health system. One of them asserts: "If you have cancer in the U.K. you are going to die quicker than in any other country in Europe." The claim is based on flawed data; international trials show British cancer patients do just as well as those in other countries. A British woman who appears in the ads says she was duped into participating. She’s not in favor of dismantling the NHS, she says, but of providing it with more resources.

The deception shouldn’t be surprising. The founder of Conservatives for Patients' Rights is Rick Scott, a man the media too often fails to identify as the former CEO of Columbia Hospital Corporation, a giant HMO. He was forced to resign after FBI agents raided the company, which subsequently paid a $1.7 billion fine—the highest in history— for Medicare fraud. Rick Scott is for patients’ rights like Dick Cheney is for open government.

The mounting falsehoods have annoyed the British. When they launched a "We love the NHS" campaign on Twitter on Aug. 12, it was the most talked about topic on the service and has stayed near the top ever since. What had finally set the British tweeting were attacks on the NHS from one of their own, Daniel Hannan, a Conservative elected to the European Parliament who’s become something of a fixture on (surprise!) Fox News, where he toes the network’s anti-health-reform line.

Hannan was rebuked as "eccentric" by the embarrassed Conservative Leader, David Cameron, who insisted that he himself was "100 percent behind the NHS." The last thing Cameron wants is to revive the impression that Conservatives are hostile to the NHS, an attitude that has doomed the party in past elections.

The British aren’t indignantly championing a system that neglects their needs. As their Department of Health noted, life expectancy in England is a year longer than in the United States and mortality among children from birth to age five is a third lower. In a 2007 survey of health care in five advanced nations—Australia, Canada, Germany, New Zealand, Britain, and the United States—the U.S. ranked last. Yet every one of the other countries spends less than we do per capita on health care—in Britain about half as much.

The British would never willingly surrender their NHS. Nor will Americans retreat on health care once reform survives the current perils and passes into law. When families see that their care isn’t rationed and that their coverage can’t be canceled; when costs are brought down; when seniors find that their Medicare is not only safe but strengthened, then the fear-mongers will be punished at the polls. By 2016 at the latest, Republican candidates will be pledging, much like their conservative counterparts in the U.K., not to undermine national health coverage.

Of course, we won’t have a system like the NHS, no matter how relentlessly conservative critics may invoke it. We won’t even get the system Obama first proposed. Instead, we’ll likely end up with a compromise—provided it’s not defeated by a self-righteous reaction from the Left. In the end, I don’t believe it will be. As Sen. Kennedy has argued, the plan can be improved in the years ahead. Bill Clinton agrees: "We need to pass a bill and move this thing forward," he said.

Amid the torrent of falsehoods and the tumult of town halls, there came a twittering of truth from across the Atlantic. The Brits fought back over there. Once Barack Obama and the Democrats win their fight over here—and they will have to fight very hard—our system will still be different from Britain’s. But finally, Americans, too, will have a health-care system we can be proud of."

Thought For The Day

“Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did.”

Mark Twain

Health Care In America - A Reality Check

Please read through the two following blog posts on the debate (or lack of it via Our Modern Media, which instead aims their cameras at train wrecks rather than dig into the facts and figures of a handful of proposed bills -- and recall that None Yet Have Been Voted On By Congress) --

First, some Facts:

"Pathetically but predictably, the health care reform debate is not focused on health care or reform, but rather on imagery meant to trigger our reptilian responses. In another article, I shall address what the "debate" should really be about (hint: improved health!), but in the public interest, in the hopes of lassoing crocodile frenzy before it totally consumes its young, I offer help for those struggling with friends and family who may be shaken by what has occurred during our own August recess.

"This is not to suggest that those who already believe that health reform is designed to kill Granny, or that the government just wants to "take over" Medicare are salvageable. Rather, that there may be increasing numbers of people who do not buy the inflammatory rhetoric, but do not know how to respond (to themselves) otherwise.

Here's a little primer on addressing some of the most absurd claims:

1. The government -- i.e., not private enterprise -- wants to kill Granny. Let us get this straight. The government wants to kill Granny and, by implied contrast, private enterprise, that we all learned in Economics 101 exist for the sole purpose of caring for each and every citizen, will look out for Granny's well-being.

Is this the same private enterprise that sells death (cigarettes), needing to addict 15,000 new children per month just to maintain revenues? Or, is it the same private enterprise that resisted selling safe cars? Or, perhaps it is the same private enterprise that would never pollute our air or water, or, if they did, rush to clean it up before they hurt anyone? Or, maybe they mean the private enterprise that imported toxic toys for children? Or, the private enterprise that so generously donates candy and soda pop machines to public schools?

We actually do know the private enterprise they mean -- it is the private insurers who try not to insure people who are or may get sick, try to drop them from their rolls when they do, and deny every claim they can when they cannot drop you from their policies. That's the private enterprise that has been caring for you for years.

And what about the government? Perhaps the evil government they refer to is the one that determined cigarette smoking caused lung cancer in the first place; or the one that established pollution controls and standards for clean air and clean water; or, perhaps it is the evil government, out to kill Granny, that administers Medicare with less than a 5 percent administrative cost compared to 25-30 percent for private enterprise; or, the evil people at the Food and Drug Administration that ensure the integrity of the food supply and the safety (and potency) of drugs people take to combat illness?

Let us concede, however, that the government does deliberately kill people. It is called the death penalty. And, although the goal is not to have our own people killed, war usually does a pretty good job of ensuring people die. So, if Granny refrains from committing a capital offense, and does not -- like the Limbaughs and O'Reillys and Bushes and Cheneys and Kristols and Lowrys and Buchanans and Chamblisses who love war so long as they do not get called to fight it -- volunteer for the armed forces, it is not the government she needs to fear for her life.

2. We cannot afford it. Here's a shocker--we are affording it today, paying for it now. Hospitals, doctors, pharmaceutical companies are not giving away treatment and medicine for free. They are not printing their own money (although the word "scrip" is indeed in prescription). They are getting paid.

Now, how can that be? Well, if you are among the 260 million Americans who have health insurance, you are already paying for the 47 million who do not. Health care providers overcharge you assuming a predictable percentage of bills will go uncollected. You see, along with your insurance exec's Gulfstream, you pay for the uninsured with your premiums for those higher charges.

But, you don't mind, do you? Because they never called it a "tax."

If we get universal coverage, there will be no unpaid charges. Charges per item or service could come down and, therefore, insurance premiums could come down -- unless of course the insurance execs wants a company yacht along with the Gulfstream, or just to report higher profits, then they won't. Wonder what a competing public option would do? Hmmm....

And, by the way, there are huge savings to be had just from improved efficiencies of a system in which total costs count more than the cost of one procedure or drug or intervention.

The secret reason they never called part of your premiums a "tax" is that if we ever got health care reform, and premiums declined, or at least did not increase more rapidly than other parts of the economy, then we might have called it a "tax cut." And one of the "Old Rules" is the only the right wing gets to say the word, "tax cut." (Are you listening, Bill Maher?).

But, they are correct that health care costs are spinning out of control and that one of the purposes of reforming the system is to reduce those costs. One of the best ways of reducing costs is improving outcomes. More on that in another article.

3. Let private competition solve everything: Imagining a world without Medicare

Ok, to test that hypothesis, let us examine what our world would be like without Medicare. One possibility would be that the elderly would be insured privately and randomly in the same plans as the rest of us. Care to guess how high your premiums would be if your plan carried those higher risk seniors?

Or, suppose no insurance company really wanted to insure the elderly and they were without insurance. Then Granny gets sick. Who pays? Do you let Granny go untreated? Does Granny "allow" you go bankrupt, and deprive your kids, her grandchildren(!), of their college funds, to pay for her care?

Or, suppose there are insurance companies only covering the elderly? Their insurance premiums would be ... oh, doesn't seem to work does it? Very few would be covered since it would be unaffordable, so we are back to no coverage.

How about this? Your children can be covered to the age of 18 under your policy. What about your parents getting covered under your policy once they hit 65? Think we are back to sky-high premiums with that one.

I know, I know, I know (says Newtie), let's give each Medicare recipient a lump sum, and let them go out and buy private insurance with it. For starters, about 20-30 percent of that is no longer going into actual care, but into "administrative" costs, so their coverage would decline.. Then again, if a person is ill, the insurer may not wish to cover him; if there were a law against such discrimination, we are back to both skyhigh premiums few could afford and the contribution coming from Medicare being insufficient.

Now, for the most likely scenario without Medicare. Granny is covered, premiums are higher but not outrageously. Why? Because when Granny does get ill, the insurance companies will deny coverage, or drop her. So, you can have the wonderful experience of paying higher premiums and then going bankrupt a bit sooner, all while Granny is wondering how she could allow herself to do this to you, and her grandchildren. Now that would really kill her.

4. The free market can solve everything, and at lower cost. No, it cannot. First, and most convincingly, it has not. Since most systems tend toward equilibrium, it might have been surmised that, after all these years, everything would have already been solved. The purists would say that there are government programs around (like Medicare) that have distorted the system so that free markets cannot reach an equilibrium solution. But, that is nonsense. See # 3 above.

Secondly, though, free markets are genetically incapable of providing high-quality, low-cost, health care for all. Why? Because most people incur most of their health care costs when they are old. By the time they are old, health care prices have risen (even if at a normal rate), whereas their incomes were earned way-back-when wages and salaries were not nearly as high. Hence, even if they had saved prudently for the inevitable rainy day, it is unlikely most people would have enough saved from wages during their youth and middle age to cover the costs that they are now charged in their old age.

In addition, the costs of an illness can be, and often are, catastrophic to individuals, and only the very wealthy would have the money to pay for the total costs of care.

Ok, the free-market-solve-everything crowd would say, they would all purchase insurance. But, that is today's system, not everyone purchases it, not everyone can afford it, and private markets in search of profits do what would be expected: they weed out those most likely to add costs.

5. Your health care will be rationed. Don't know how to break this to you, except to say it in a whisper -- your health care is rationed today. Insurance companies do not cover everything, and, when they do, it is often just up to a point. Medicare likewise has certain rules about the level of nursing care required to qualify for reimbursement.

For example, we now know that highly intensive, properly guided physical therapy can restore motor function in people after strokes. A different part of the brain is trained to take over motor control. Here is a real-life case: A professor had a stroke. He is otherwise young and vigorous, formerly a champion-level athlete. But, his insurance will not cover the costs of 12-16 weeks of the highly intensive physical rehabilitation required to recover motor function. He gets just 3 weeks, only one hour on alternate days, but not even at the facility closest to his home, he has to go to one the insurance company approved.

One of the benefits of a comprehensive system is that treating this man for 12-16 weeks so that he can recover his motor function is not only better for the patient but, in the long run, is also much less expensive than forcing him, because of lack of coverage, to remain partially paralyzed. For any given insurance company, however, it is not less expensive, because he is likely to get passed into a different company. Thus, outcomes are worse and costs are higher.

6. Medicare is bankrupt ... or will be in 2042.

Name the private insurance company who is funded for all the healthcare expenses it will have to pay for the next 33 years, and I'll buy you 3 cheeseburgers, freedom fries deep-fried in beef fat with all you can drink Mountain Dew."

Meanwhile, Vibinc voices a more urgent reality:

"I know this whole “death panel” thing has been going on for weeks now, but I’ve gotten to the point where I want to slap someone every time I hear them talk about Government pulling the plug on granny because she’s too expensive. What bullshit.

We already have death panels you douchenozzle, they’re called INSURANCE COMPANIES.

As The Memphis Liberal points out the Supreme Court has ruled that

Inducement to ration care is the very point of any HMO scheme.

The argument on the right is that you can sue an insurance company. Perhaps, but you’re still dead if you don’t get the treatment you need because some corporation hedged their bets.

It’s not like it’s ever happened before or anything.

Oh, and how does a lawsuit play with conservative notions that tort reform will magically fix what’s driving up the cost of healthcare. Come on people be consistent.

Nope, the reality is we’re talking about two different cultures. One that believes corporations are going to do what’s right for people and that the government can’t do ANYTHING right, and one that believes government’s role is to provide an equitable foundation for all Americans and that corporations are more interested in protecting shareholders than doing right by regular folks.

Which one sounds more realistic?

Seriously, conservatives have been working for 30 years to protect shareholders and corporations far more than help regular Americans. Their perspective is that if the corporation benefits, somehow so does everyone else. From the union busting that the Reagan Admin. engaged in, to trade deals that have sent American jobs hither and fro, with the help of conservative and largely southern Democrats that have served as compliant enablers, the conservative ideology has destroyed America’s manufacturing base and left us in a position where good jobs for regular people are going the way of the dodo. All the while this same “Conservative ideology” is largely responsible for a tenfold increase in the national debt over the past 28 years.

Somehow, this is supposed to provide a better quality of life for all us little people. But aside from making really affordable “cheap plastic crap” made in places most people couldn’t find on a map, the only real benefit has been the availability of second rate goods to people who used to make a first rate version of the same damn thing.

So when we apply this ideological difference to the healthcare “debate”, if that’s what you want to call it, you have some people talking about healthcare, and others talking about something else entirely. Sobeale hit on this back in June when talking about the difference between the left and the right on the healthcare debate.

Progressives want to give everyone healthcare. The other side wants to give everyone health insurance.

Healthcare. That’s what I’m talking about, not insurance. Insurance is the ONLY thing in the world you buy and pray you don’t have to use. Healthcare is something EVERYONE NEEDS, but that a growing minority of working Americans DON’T HAVE ACCESS TO. Sure, they can go to the doctor or the hospital, but if it’s something serious, they’ll likely go bankrupt. That’s the reality, and 50% of the people who go bankrupt every year are in that situation.

So now that the Healthcare industry has dumped some $130m since April into putting the kibosh on any plan that includes a “public option” by stirring irrational fears and mobilizing a vocal but largely uninformed group of people to disrupt anything and everything that might further the “public option”. The debate has shifted from providing healthcare to all Americans to providing Americans with insurance, something they don’t want to have to use.

This is just plain madness.

The right wing reactionaries that show up in force at Town Hall meetings across this nation are grounded in the same ideology that has helped bankrupt this county and millions of it’s citizens. They are not there to debate, they are there to debase the process, to incite fear, and ultimately, deny you a right to affordable treatment when you need it most.

This is not the huge movement that the media would play it up to be. They are not taking to the streets demanding that things stay the same. They are a couple of hundred people per district, out of some 600,000+ constituents, mobilized to make a good show of strength for a very short period of time. It’s media manipulation at it’s worst, and the media is playing the role of compliant enabler, just like those conservative Democrats who are paralyzed with fear anytime someone proposes a change that they might have to defend.