Thursday, June 18, 2009

The GOP Keeps Trash Talking Health Care

Like when it rolled out its laughable 18-page “budget” five months ago that forgot to include any numbers, yesterday John “Man Tan” Boehner, Eric “Ralph Wiggums” Cantor and a handful of other Congressional Republicans unveiled a four page health care “plan” Wednesday that not only had no numbers, it had no substance, no ideas – good or bad – and the closest it came to being a plan was calling it one on the cover.

Not wanting to lose the spotlight to their colleagues in the House, three Republican Senators – John Kyl, Mitch McConnell and Pat Roberts – were busy introducing the Preserving Access to Targeted, Individualized and Effective New Treatments and Services (PATIENTS) Act of 2009. Their bill would prohibit Medicare or Medicaid from using “comparative effectiveness research to deny coverage.”

In layman’s language, this means Medicare would be compelled to pay for useless treatments. This comes from the same claque that prevented Medicare from negotiating drug prices when Republicans controlled Congress and the drug benefit was being introduced.

The trio actually launched this idiotic piece of legislation with a straight face, not noticing it is the silliest thing to come along since Nancy Reagan’s astrologer told Ronnie when to make policy speeches. As Paul Krugman points out Thursday morning, there are four insane components to the Republican’s latest piece of garbage:

1. Republicans who rail against wasteful government spending are taking action to prevent the government from … reining in wasteful spending.
2. Politicians who warn that the burden of entitlements is killing the federal budget are stepping in to block the single most painless route to reducing the growth of entitlements.
3. They’re doing it in the name of avoiding “rationing of health care” but they’re specifically addressing taxpayer-funded care. If you want to go out and buy a medically useless treatment, Medicare won’t stop you.
4. These same politicians are opposed to expanding coverage because it’s evil for government to “ration care” by only paying for things that work; it is, however, virtuous to ration care by refusing to pay for any care at all.

“You’re assuming people watching CNN are thinking,” a staff member to a Republican Senator tells me this morning. “We’re simply trying to make the point that government-sponsored health care is a terrible idea.”

Which Bureaucrat?

Trash talk was heard all over Capitol Hill Thursday and Friday.

Wednesday’s GOP talking point was warning about “inserting bureaucrats between you and your doctor,” and it was repeated at least a half-dozen times by interchangeable Republican faces popping up on cable news and C-SPAN.

Uhm, shouldn’t Republicans watch something besides Fox News occasionally? It is insurance company “bureaucrats” who keep inserting themselves between patients and doctors, denying coverage or treatment for people who are ill. Earlier this week Keith Olbermann treated us to the latest outrage: AIG, US Airways liability insurer, is telling a survivor of the airline’s Hudson River crash that she and her three year old daughter would not be covered for psychological counselling to deal with the on-going trauma of watching themselves almost die.

Yes, it’s that AIG. The one we own. One of us should tell AIG that even the Pentagon finally is treating Post-Traumatic Stress Disorder.

As for bureaucrats and medicine, I’ve had three grandparents and two parents covered by Medicare between the time they turned 65 and when they died – some in their late 80s and early 90s. Combined, they enjoyed 130+ years of Medicare and not once were any of them ever told by a “bureaucrat” they wouldn’t be covered for treating one ailment or another. They never waited to see a doctor nor did a “bureaucrat” dictate to their physicians which treatment to use or what medication to prescribe.

Oh, and by the way, dear Republicans: Not even the strongest proponents of a universal, single payer health care reform package is suggesting that doctors, nurses and other health professionals will work for the government. So why are you comparing them to postal workers and the Department of Motor Vehicles the way you did Thursday? Are you crazy, stupid or just plain liars trying to scare Harry and Louise into opposing health care reform one more time?

“OK, so likening a public plan to the DMV is an exaggeration. So what? The point is to stop this thing cold,” the Republican staffer admits reluctantly. “No one likes bureaucrats and everyone hates the Post Office and DMV. It’s a good ‘word picture’ that people who watch cable news can understand.”

So the answer to my question is: The GOP is happy lying to scare people while they try scoring a false point.

Paying Billions Already

What the viewers disparaged by the GOP don’t understand is they’re already paying for universal coverage, of sorts. An article published Thursday in The New England Journal of Medicine reports that we’re already spending $43-billion annually treating the 50-million uninsured Americans.

But care is an uneven hodgepodge of federal, state and local programmes, and much of the money is spent poorly or in the wrong place.

The report, co-authored by Linda Blumberg and John Holahan says, “Care provided in this way varies considerably by locale and does not amount to continuous, comprehensive care for the uninsured, nor do all the uninsured have access to such publicly subsidized services.

“Once everyone has health insurance coverage, either public or private, these funds can be redirected to help finance a new system that includes income-related subsidies for care provided in efficient health systems,” the article maintains.

Blumberg and Holahan call for a mandated public system, noting that research shows that without mandates, many people will remain uninsured because premiums will gobble up too much of their income – as much as 30%, according to the article, or about the same as rent or food.

Conceding that some federal subsidies will be needed, “most will go to the poorest and sickest – those who are most likely to enrol on a voluntary basis. Thus, a mandate will (also) bring healthier people and those with higher incomes into the system at a relatively low incremental cost, as compared with a voluntary approach with the added benefit of government financing redirected from the programs that currently cover uncompensated care.”

Whatever talking point the GOP rolls out today in its fight to keep America sick, remember that Republican staff people on the Hill admit all the party is trying to do is create scary “word pictures” to frighten the average cable news viewer. Republicans have always been good at twisting emotions and playing on fear. It’s past time for progressives to borrow a page from the Republican playbook and talk emotions, not just facts and figures.

The Curious Incident Of A US Extradition In The Night

Guest post by Denis Campbell, editor of The UK Progressive.

Gary McKinnon of Crouch End, North London, England was branded a ‘cyber-terrorist’ by the US government and, in 2002, was arrested for hacking into Pentagon and NASA computers.

The US Justice, Defence and Homeland Security Departments have been fighting a seven-year long battle to extradite McKinnon to the USA where he is charged under the 2003 UK Extradition Act. If convicted on terrorism charges, he could face up to 60 years locked-down, 23-hour per day, in a US SuperMax prison. While many differ on likely length of sentence, this is the same kind of prison convicted shoe-bomber Richard Reid sits on a hunger strike hoping to kill himself. Gary openly admits his guilt of computer mischief and he did hack into US government computers.

Now before jumping to the obvious conclusion thinking “a (then) 36-year old man should know the difference between right and wrong” and setting your “fry him” righteous jaw and mind firmly shut, you need to look, Paul Harvey-style, at “The Rest of the Story.”

At 43, Gary has lived with an until-recently undiagnosed case of high-functioning autism known as Asperger’s Syndrome. The disease was first discovered and labelled in the late 1990s and was made famous in the 2003 best-selling novel, The Curious Incident of the Dog in the Night-Time by Mark Haddon. Until the book, where a low functioning Asperger’s sufferer teenager sets off on a journey to find his dead mother, few ever heard of this syndrome. Famous Aspergers sufferers include American actor Dan Ackroyd and acclaimed Scottish artist Peter Howson – both of whom have spoken out on Gary ’s behalf.

Aspergers sufferers such as Gary make diagnosis more difficult because they often possess very high intelligence in specific areas such as math, computer science or physics. They are mostly reclusive and can become hyper-obsessive. One thinks of Dustin Hoffman’s character Raymond in Rain Man as an example.

Gary’s mother, Janis Sharp, spoke of a Christmas dinner where he put a large computer on the family dining table and could not understand why everyone was so upset. His logical but insensitive response was “well it’s my holiday party too isn’t it?” Indeed, it is the honesty of an Asperger’s sufferer – “often to a fault” Janis said – “that can be to their own detriment.”

When Gary spoke to UK computer crimes authorities in 2002, he could only speak truth. This is also why plea deals are abhorrent because it means admitting guilt to something he feels is untrue. Without a lawyer present, he freely admitted to UK police to looking around in government computers of all kinds because, “They were very nice to him.”

At the centre of the growing row between the UK and US is a demand to have Gary stand trial in the US despite his diminished capacity. Many in the UK want him to stand trial here. They launched a successful UK campaign that Kevin Anderson, blogs editor of The Guardian, took exception to the media blindly taking McKinnon’s side in their coverage of the case. He objected to the myths of imprisonment in Gitmo, portrayal of US anger at his extradition fight and widely reported belief that US authorities wanted McKinnon to “fry.”

Not Innocent

No one is suggesting he is innocent.

They are talking degrees of punishment and the curious use of the 2003 Extradition Act, which gives the Crown Court little leeway and they must extradite UK nationals on ‘suspicion’ of terrorism; anyone the UK seeks for extradition residing in the US requires probable cause. Too, cases involving extradition normally involve someone who has committed a crime and has fled that jurisdiction and must be forcibly brought back to stand trial. Gary McKinnon never left the UK.

The problem is the Act has been used in the non-terror cases of Alex Stone, an alleged child abuser whose charges were dropped after spending 6 months in a US jail; Ian Norris of Morgan Crucible, whose original price-fixing charges were dropped but still faces extradition on obstruction of justice charges; and The NatWest 3, bankers extradited and found guilty of wire fraud – the government’s old mafia conviction standby charge. They currently serve 37 month sentences in US prisons.

Even David Blunkett, UK Home Secretary when the Act was negotiated and passed, never foresaw this level of interpretation and believes it should not be used in Gary’s case because, after 9/11, the Bush Administration labelled everything they could terrorism. Politicians here and in the US were not keen to attack these cases for fear of looking soft on terrorism. Too, this issue grabbed its biggest headlines after the Spanish and 7/7 London Tube terrorist bombings, so the issue was high on everyone’s mind.

Little Green Men

Gary McKinnon is completely obsessed with the existence of UFOs and convinced the government covered them up.

He is a self-described “bumbling computer nerd” who wanted to know more about them in the Pentagon files he hacked. He was a big fan of the 1983 feature film War Games where a youthful Matthew Broderick accidentally breaks into a Pentagon computer and nearly converts a war simulator into a real global thermonuclear war.

As a 17-year old boy, Gary wondered, could that really be done? When he and many others proved it indeed could be, especially after 9/11, McKinnon became the poster child for lax DoD computer security.

Many DoD and NASA computer systems lack firewall protections an,d as Gary has said repeatedly,“one could easily see the IP addresses of other hackers from China , Russia and other places around the globe whilst in there.”

US Defence Secretary Robert Gates noted that the Pentagon has thousands of cyber attacks daily on its systems. Gary became upset when he could not find what he was looking for and started leaving notes and traces of his entry calling the US government “liars” for discrediting the existence of UFOs and lax 9/11 air security.

His original UK charge in 2002 was not an extraditable offence. After passage of the Extradition Act and showing an unwillingness to plea bargain to a lesser offence, then federal prosecutors Scott Christie and Ed Gibson upped the ante claiming McKinnon caused more than $700,000 in damages, deleted passwords and put a Naval defence system at risk, all denied by Gary and his defence lawyers.

He was re-charged as a cyber terrorist when extradition prospects were seemed automatic under this new treaty.

Appeals to The House of Lords and EU Court of Human Rights were denied or not heard. This left Gary’s defence team with very few options.

But the Asperger’s diagnosis did two things: It opened the door for a judicial review of both the Crown Prosecution Service’s handling of the case, which was heard last week, and the Home Office’s recommendation of accepting such an unbalanced treaty.

Karen Todner of lBritish law firm Kaim Todner serves as Gary ’s lawyer. Mrs. Todner was tenacious on Gary ’s behalf and hired leading human rights solicitor Edward Fitzgerald. In his brief Fitzgerald said, "the decision (to extradite) is procedurally flawed and unlawful for it wrongly fails to consider and analyse important expert medical evidence concerning the effects of extradition on the claimant and his mental health."

This is the real game changer.

In many ways, Gary’s disease reveals an intellectually and emotionally naïve child locked in a man’s body. His mind is both his biggest friend and greatest enemy. As Scottish artist Peter Hoswon said in a Scotsman interview with Gerri Peev, "Gary has the more anxiety-prone form of Asperger's, which I fear means he will not be able to survive life in an American prison. I have to be blunt: he will not be able to cope and will turn suicidal. He is not a terrorist, nor a threat to national security, but just a vulnerable Asperger's man whose complex mind caused him to make a mistake. Individuals like Gary should be protected by us and nurtured, not made a scapegoat for the sins of our police state society."

Gary’s curiosity took him to the place of trying to see if he could do it. Aspergers sufferers tend to believe what they read or hear and their desire for truth is so strong it overcomes all other rational thoughts and emotions. Indeed as he became more and more obsessed with the UFO conspiracy, his then girlfriend became very concerned for his well-being as Gary stopped caring for himself, even stopping eating and bathing – all hallmarks of Aspergers.

The legions of supporters for Gary include Peter Gabriel, Sting, US Shuttle Commander Clark McCleland, David Gilmour of Pink Floyd, former Iranian hostage Terry Waite, Peter Gabriel and Graham Nash of Crosby Stills and Nash, along with dozens of MPs and celebrities.

The US has a flawed history of understanding or even admitting mental illness in court. Because of this lack of understanding, prosecutors fight it tooth and nail. A defendant found not guilty by reason of insanity goes down in the loss column.

It taints a prosecutor’s record to have someone sent to an institution or psychiatric prison facility. A federal prosecutor speaking on condition of anonymity said, “Having a defendant found not guilty by reason of temporary or true insanity hurts the prosecutor. We need big winning records in high profile cases to move up the ladder politically or find top security positions when we leave …” (Indeed Gibson and Christie now run security across the UK for Microsoft Corporation).

“It’s tough to become a top paid white shoe firm white collar criminal defence attorney or be elected as a District Attorney or state Attorney General without a solid record of conviction in high profile cases,” this US prosecutor said.

As his mother, Janis, said, “People with Asperger’s are highly intelligent but cannot cross a busy road because it is so terrifying for them. Asperger’s is invisible in many ways and its sufferers can seem incredibly normal. The Pentagon had no firewalls or security, that’s an insult to the people who died on 9/11. How could the biggest superpower in the world not have firewalls? Gary was stupid, he left notes on the system but why extradite him because of a sense of embarrassment?”

If convictions are the yardstick upon which a prosecutor can strut, the question becomes should an impaired person be extradited to face horrific charges where a sentence in the UK would be more proportional?