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Politics

Former Insurance Company Executive: Health Insurers Stand Between Patients And Their Doctors

ellenhayden3 One of the most common right-wing memes used by opponents of health care reform is that progressive solutions to America’s health care problems place “Washington bureaucrats firmly between you and your doctor.” Again and again, conservatives have deployed this meme to demagogue the health care debate.

However, the reality is there already is someone standing between you and your doctor: health insurance companies. Single mother Ellen Hayden knows this from experience. After losing her mother at the age of 7 from breast cancer, Hayden has done everything she can to get regular mammograms. Following an abnormal mammogram, her doctor recommended that she have an MRI. After the scan, her insurer, Blue Cross Blue Shield, refused to pay for the procedure and is also refusing to pay for a follow-up second MRI her doctor has suggested.

Ned Helms, a former health insurance industry executive who now works at the University of New Hampshire, told Sea Coast Online that this is Hayden’s case is an example of “insurance people” getting between patients and their doctors:

“It’s understandable that this is an emotional issue because most patients believe that ‘nothing is going to stand between me and what I want to get done,’” said Ned Helms, a former health insurance industry executive and director of the N.H. Institute of Health Policy and Practice at the University of New Hampshire. [...]

“We have this notion in our political debate and popular culture that we can’t have reform because that means that government bureaucrats will make decisions but we already have insurance people playing that role,” said Helms

Helms went on to say that one of the major obstacles to attaining proper reform is the way insurance companies often “write their own rules for the road.” Late last year, former Cigna executive Wendell Potter left his 15-year career at the major health insurer and joined the fight for universal health care. He told Bill Moyers last July that politicians who warn about the government getting between patients and their doctors are “ideologically aligned with the [health insurance] industry.”

Security

Consequences Of An Israeli Strike On Iran: Still Very Bad

081112-F-7823A-160A new memo from Steve Simon of the Council on Foreign Relations looks at the possibility of an Israeli strike on Iran’s nuclear facilities. “In assessing the likelihood of an attack,” Simon writes, “it is useful to look back on the origins of the Six Day War in 1967 and the raid on the Osirak reactor in Iraq.”

In each case, Israel attacked only after a long period of procrastination. In 1967, Washington’s hands-off posture tipped the balance in the cabinet in favor of preemption. In the case of Osirak, the Carter and Reagan administrations’ unwillingness or incapacity to intervene left Israel feeling cornered and compelled to act unilaterally. One lesson to be learned from this is that Israel is more likely to use force if it perceives Washington to be disengaged.

I’m not sure what lesson this has for Obama. No one can say that he’s been “disengaged” in the Middle East. Clearly, Obama hasn’t been “engaged” in precisely the manner that Netanyahu would probably prefer — i.e. taking a harder line on Iran while ignoring Israel’s settlement building — but he has repeatedly stressed both the U.S. commitment to Israel’s security and that he recognizes Iran’s nuclear program as a threat to that security. So I suppose the question is whether, or at what point, Netanyahu will decide to interpret Obama’s pursuit of engagement with Iran as “disengagement” from Israel.

Simon concludes that, while Israel could carry out such a strike, the margin of error for a successful strike — that is, one that destroys or at least seriously incapacitates Iran’s known nuclear facilities — is razor thin.

And then there are the consequences of such a strike. Here’s a summary:

First, regardless of perceptions of U.S. complicity in the attack, the United States would probably become embroiled militarily in any Iranian retaliation against Israel or other countries in the region. [...]

Second, an Israeli strike would cause oil prices to spike and heighten concerns that energy supplies through the Persian Gulf may become disrupted. [...]

Third, since the United States would be viewed as having assisted Israel, U.S. efforts to foster better relations with the Muslim world would almost certainly suffer. [...]

Fourth, the United States has a strong interest in domestically generated regime change in Iran. Although some argue that the popular anger aroused in Iran by a strike would be turned against a discredited clerical regime that seemed to invite foreign attack after its bloody post-election repression of nonviolent opposition, it is more likely that Iranians of all stripes would rally around the flag. [...]

Fifth, an Israeli attack might guarantee an overtly nuclear weapons capable Iran in the medium term.

Sixth, although progress toward an Israeli-Palestinian final status accord remains elusive, an Israeli strike, especially one that overflew Jordan or Saudi Arabia, would delay fruitful renewed negotiation indefinitely. [...]

Finally, the United States has an abiding interest in the safety and security of Israel. Depending on the circumstances surrounding an Israeli attack, the political-military relationship between Jerusalem and Washington could fray, which could erode unity among Democrats and embolden Republicans, thereby complicating the administration’s political situation, and weaken Israel’s deterrent. Even if an Israeli move on Iran did not dislocate the bilateral relationship, it could instead produce diplomatic rifts between the United States and its European and regional allies, reminiscent of tensions over the Iraq war.

That’s a lot of downsides. One that I have yet to see discussed, however, is the potential effect on U.S. public support for Israel of attacks by Iran on American troops in retaliation for an Israeli strike. As retired General Anthony Zinni put it back in September, “Eventually, if you follow this [a strike on Iran] all the way down, eventually I’m putting boots on the ground somewhere. And like I tell my friends, if you like Iraq and Afghanistan, you’ll love Iran.” A solid majority of Americans support the U.S. Israel relationship, but I’m not sure Netanyahu really wants to test the depth of that support once America starts taking casualties as a direct result of precipitous Israeli military action. And no one wants Israel to be put into a position where he has to do that.

Politics

Barrasso politicizes breast cancer: The Preventive Services Task Force would pull the plug on my wife.

Yesterday, Rep. Debbie Wasserman Schultz (D-FL), a breast cancer survivor, accused Republicans of politicizing breast cancer. This afternoon, Sen. John Barrasso (R-WY) — a doctor who runs a private orthopedic practice and serves as Chief of Staff of the Wyoming Medical Center — proved her point. Barrasso called Fox News to register his opposition to the Senate health care bill and argue that the new mammogram guidelines would have pulled the plug on his wife:

And we just saw this past week the first step in rationing of health care in the country with this panel that they have, this preventive panel. A government panel that says women between 40 and 50 shouldn’t have mammograms. You know, my wife Bobbi is a breast cancer survivor. She was diagnosed by a mammogram, went for an operation, the cancer had already spread. The mammogram has saved her life, but yet this preventive panel that the bill says, this health care bill says, ‘oh no, they’re the ones who get to decide what preventive measures are paid for or not.’ That panel would have not allowed her to have this care.

Watch it:

Rather than mandating “what preventive measures are paid for or not,” the task force issues recommendations that help doctors decide on a course of treatment. Providers can use the recommendations as a starting point to examine a patient’s particular needs, but the task force has no authority over coverage or treatment decisions. Barrasso’s wife Bobbi Brown would have received a mammogram regardless of any recommendation. Wyoming, along with 48 other states, requires insurers to cover mammograms and if the Senate bill were to become law all insurers would be required to pay for the procedure. The Wonk Room has more.

Yglesias

Endgame

Now I’m just crazy:

— Stick to Christian side hugs.

— The suburbanization and reurbanization of Mt Vernon Square in DC.

Sarah Palin parking lot.

— Earth heading for six degrees of warming.

— The walking paths of Brasilia.

— I think it probably is too late to pull the plug on Ben Bernanke’s renomination but it’s not at all too late for Senators to give him a hard time about why the Fed isn’t doing more to bring unemployment down.

— Will India be the world’s largest economy by 2109.

I don’t know what made Girls think it would be a good idea to poach the title “Lust for Life” from Iggy Pop but it’s a good song.

Climate Progress

Breaking: US will announce target for cutting carbon emissions before Copenhagen

White House hits back on climate critics

That’s the banner headline at the Politico, which reports:

“It would be a mistake to conclude that the international community’s failure to reach a final treaty in Copenhagen is due to a lack of domestic legislation in the United States,” said a senior White House official, who briefed reporters on the condition of anonymity.

The United States, said officials, plans to propose a near-term emissions reduction target as part of a “meaningful submission” the country will present at the talks.

The BBC’s story is even more specific on the proposed target (though I think a little off):

Read more

Health

Sen. John Barrasso: Preventive Services Task Force Would Have Pulled The Plug On My Wife

Yesterday, Rep. Debbie Wasserman Schultz (D-FL), a breast cancer survivor, accused Republicans of politicizing breast cancer. This afternoon, Sen. John Barrasso (R-WY) — a doctor who runs a private orthopedic practice and serves as Chief of Staff of the Wyoming Medical Center — proved her point. Barrasso called Fox News to register his opposition to the Senate health care bill and argue that the new mammogram guidelines would have pulled the plug on his wife:

And we just saw this past week the first step in rationing of health care in the country with this panel that they have, this preventive panel. A government panel that says women between 40 and 50 shouldn’t have mammograms. You know, my wife Bobbi is a breast cancer survivor. She was diagnosed by a mammogram, went for an operation, the cancer had already spread. The mammogram has saved her life, but yet this preventive panel that the bill says, this health care bill says, ‘oh no, they’re the ones who get to decide what preventive measures are paid for or not.’ That panel would have not allowed her to have this care.

Watch it:

Given Barrasso’s medical background and personal experience with breast cancer, his claim is especially irresponsible. It’s also completely inaccurate. The U.S. Preventive Services Task Force is an independent panel of experts first convened by the U.S. Public Health Service during the administration of President Ronald Reagan. The panel “is financed by the Department of Health and Human Services but works at arms length from it, making its decisions without consulting the agency.” Panelists are prohibited from “considering costs when they make guidelines.”

Rather than mandating “what preventive measures are paid for or not,” the task force issues recommendations that help doctors decide on a course of treatment. Providers can use the recommendations as a starting point to examine a patient’s particular needs, but the task force has no authority over coverage or treatment decisions.

Barrasso’s wife Bobbi Brown would have received a mammogram regardless of any recommendation. Wyoming, along with 48 other states, requires insurers to cover mammograms and if the Senate bill were to become law all insurers would be required to pay for the procedure.

Under the bill, health insurance issuers would offer “services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force” without “any cost sharing requirements.” Last week’s guideline was rated ‘C,’ meaning that the panel “recommends against routinely providing the service” but stipulates that doctors should “offer or provide this service only if other considerations support the offering or providing the service in an individual patient.”

Ultimately, the Panel’s recommendations are just guidelines, not mandates. They have no authority to “decide what preventive measures are paid for or not.”

Media

Fox’s Fuzzy Math: 193 Percent Of The Public Support Palin, Huckabee, And Romney

Reporting on the latest Fox News/Opinion Dynamics poll last night on Fox News’ local Chicago affiliate, anchor Byron Harlan employed some funny math in asserting that Sarah Palin is leading the pack for the GOP nomination in 2012:

HARLAN: It looks as if the rogue route is helping Sarah Palin. Her book tour has meant new support. A new Opinion Dynamics poll for 2012 shows her on top when it comes to landing the nomination. Palin is at 70 percent, about a third higher than this past July. Mike Huckabee stands at 63 percent. Mitt Romney’s 60.

Those figures add up to 193 percent. An accompanying graphic tried to squeeze the numbers into one pie chart:

FoxChicagoPoll

In fact, the poll Harlan referred to did not ask Republican respondents to pick their favorite candidate. The numbers he cited merely represent favorable ratings among Republicans surveyed for each individual. Watch Harlan’s report:

(HT: Twitter user Kevinthepang)

Yglesias

Obama to Outlines Emissions Cut Target

Good news of a sort:

The US will announce a target for reducing greenhouse gas emissions before next month’s UN climate summit, according to a White House official.

The target is expected to be in line with figures contained in legislation before the Senate – a reduction of about 17-20% from 2005 levels by 2020.

This is a reminder of two sobering realities about climate change. One is that this kind of target is, by most accounts, pretty grossly inadequate. The other is that by all accounts it will be extremely difficult to get the United States Senate to agree to even doing this much.

Climate Progress

Satellite data stunner: “Our data suggest that EAST Antarctica is losing mass…. Antarctica may soon be contributing significantly more to global sea-level rise.”

The East Antarctic ice sheet has been losing mass for the last three years, according to an analysis of data from a gravity-measuring satellite mission.

That’s from the BBC storyNature Geoscience just published the study online, “Accelerated Antarctic ice loss from satellite gravity measurements.”  It begins, “Accurate quantification of Antarctic ice-sheet mass balance and its contribution to global sea-level rise remains challenging, because in situ measurements over both space and time are sparse,” and it concludes:

Our results suggest that over the WAIS [West Antarctic ice sheet] (especially the ASE [Amundsen Sea Embayment]) there is accelerated ice loss since around 2005 and/or 2006, with the EAIS showing correlated changes of the same sign in this period, attributed to increased ice loss over EAIS coastal regions in recent years. Using a simple linear projection for the period 2006-2009, Antarctic ice loss rate can be as large as -220plusminus89 Gt yr-1. These new GRACE estimates, on average, are consistent with recent InSAR fluxes4 but, in contrast to previous estimates, they indicate that as a whole, Antarctica may soon be contributing significantly more to global sea-level rise.

East Antarctic ice - graphicThe accelerated ice loss in WAIS is not a surprise to CP readers — see Nature: “Dynamic thinning of Greenland and Antarctic ice-sheet ocean margins is more sensitive, pervasive, enduring and important than previously realized.” Nor is the rapid loss at the ASE — the big blue blot in the figure [click to enlarge] — see Large Antarctic glacier thinning 4 times faster than it was 10 years ago: “Nothing in the natural world is lost at an accelerating exponential rate like this glacier.”

But ice loss in the East Antarctic ice sheet is definitely unexpected — the study leader Jianli Chen from the Centre for Space Research at the University of Texas in Austin told the BBC, “We felt surprised to see this change in East Antarctica.”

And it’s especially worrisome because EAIS contains vastly more ice than Greenland or WAIS:

Read more

Climate Progress

ClimateGate: Vitter Staffer Accuses Researchers Of ‘Greatest Act Of Scientific Fraud In History’

David VitterEmbracing the fevered speculations of right-wing bloggers, a top Republican Senate staffer has accused climate scientists of orchestrating a planetwide conspiracy to convince the public that global warming is real. In an error-ridden email acquired by the Wonk Room, Bryan Zumwalt, legislative counsel for Sen. David Vitter (R-LA), claims hacked emails from the University of East Anglia Climatic Research Unit (CRU) are evidence for what “could well be the greatest act of scientific fraud in history.” Zumwalt’s attacks are part of a global right-wing effort — from Rush Limbaugh to right-wing members of the British House of Lords — to Swiftboat climate scientists on the eve of international climate treaty negotiations. He argues that the “theory of global warming” is now tainted with “data corruption and fraud“:

Much of what is being said is speculation at this juncture, as a great many folk are working to mine through the emails. However, the CRU has made public that they were indeed hacked and much of the information appears to already be confirmed as legitimate. If so, this could well be the greatest act of scientific fraud in history (it will take a while to calculate the total amount of grant money achieved by fraud and the cost of climate change legislation “Cap-and-Trade” could have been in the $ trillions). Accordingly, nearly all of the international data and models supporting the theory of global warming would have been influenced by data corruption and fraud…with the blatant attempt to perpetuate the political agenda of global warming supporters and the UN IPCC.

It is, of course, the likes of Zumwalt and other right-wing defenders of a pollution-based economy that are the actual “global warming supporters.” Sen. Vitter, whose career was tarnished by the revelation he used prostitutes, is one of several Republican senators who deny the reality of manmade climate change, despite the devastation of Hurricane Katrina. Coincidentally, Vitter is a strong ally of Lousiana’s oil and gas industry, which faces regulation under climate legislation.

Zumwalt’s conspiracy theory, sent this morning and addressed to “friends,” includes the Fourth Estate. He writes that the New York Times’ Andrew Revkin — who wrote a front page story sympathetic to the rabid claims of conspiracy — “was mentioned in some of these emails as one of the people in the press they use, so his motives are questionable.”

Zumwalt even offers a top-ten list of the climate scientists’ supposed crimes:

1. Suppression of Data

2. Destruction of data subject to FOIA requests

3. Organized subversion of the peer-review process

4. Coordinated efforts with media outlets

5. Blacklisting of scientific journals for political reasons

6. Blatant scientific fraud and misrepresentation of data

7. Manipulation of data for the UN/WTO’s political agenda

8. Strategies for tax evasion

9. Deceit of International and U.S. agencies for funding and grants

10. And much more…

Zumwalt recommends recipients learn more about the “coordinated effort to achieve the IPCC agenda” by searching for blogs using the keywords “Hadley, hacked, global warming, email, fraud.”

As a side note, Zumwalt’s email contains several basic errors of fact, evidently copied from right-wing blogs. He incorrectly calls the University of East Anglia’s Climatic Research Unit the “UN IPCC’s Climate Research Unit,” “also known as Hadley.” Similarly, he incorrectly says the “I” in IPCC stands for “International,” not “Intergovernmental.” These errors, while minor, are consistent with the disdain the Climategate conspiracy theorists have for reality.

Download the Vitter staffer’s “ClimateGate” email here.

Update

The Union of Concerned Scientists‘ Dr. Peter Frumhoff, an IPCC lead author, criticizes credulous coverage of “Climategate”:

Climate science contrarians are using the release of e-mails from several top scientists to attack climate science. Unfortunately for these conspiracy theorists, what the e-mails show are simply scientists at work, grappling with key issues, and displaying the full range of emotions and motivations characteristic of any urgent endeavor. Any suggestions that these e-mails will affect public and policymakers’ understanding of climate science give far too much credence to blog chatter and boastful spin from groups opposed to addressing climate change.


Update

,E&E News reports that Sen. Jim Inhofe (R-OK) announced today that he would call for an investigation into “the way that they cooked the science to make this thing look as if the science was settled, when all the time of course we knew it was not.”

“In addition to Inhofe, Republicans on the House Oversight Committee are also looking into the e-mails, according to an aide for the committee’s ranking member, Rep. Darrell Issa (R-Calif.).”


Update

,Issa is going after White House science advisor Dr. John Holdren, the Wall Street Journal reports. Keith Johnson — who absurdly describes Dr. Michael Mann as “a scientist who believes global warming is man-made” — mentions that Holdren defended Mann in one of the emails.

Dr. Holdren told WSJ:

I’m happy to stand by my contribution to this exchange. I think anybody who reads what I wrote in its entirety will find it a serious and balanced treatment of the question of ‘burden of proof’ in situations where science germane to public policy is in dispute.

In fact, in the 2003 email, Holdren notes “it is sometimes a mistake to get into these exchanges (one’s interlocutor
turns out to be ineducable and/or just looking for a quote to reproduce out of context in an attempt to embarrass you).”

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