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Carly Fiorina Exploits Recent Bout With Cancer To Fearmonger About Mammogram Recommendations

California Senatorial candidate Carly Fiorina is exploiting her recent bout with breast cancer to lie about the role of the U.S. Preventive Task Force and fearmonger about the consequences of health care reform. “This Task Force was explicitly asked to focus on costs, not just prevention. As it turned out, costs were a significant factor in this recommendation,” Fiorina says in this week’s Republican address. “Will a bureaucrat determine that my life isn’t worth saving?,” she asks before suggesting that the Senate health care bill would allow the Task Force to ration cancer treatments:

Do we really want government bureaucrats rather than doctors dictating how we treat things like breast cancer?…The health care bill now being debated in the Senate explicitly empowers this very Task Force to influence future coverage and preventive care. Section 4105, for example, authorizes the Secretary of Health and Human Services to deny payment for prevention services the Task Force recommends against. Another section requires every health insurer in America requires to cover Task Force recommended services….While some defend the idea of a government Task Force, my experience with cancer tells me it’s wrong.

Watch it:

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.”

“Our job is to review scientific evidence, politics play no role in our deliberative processes. Costs were never considered in our considerations,” Task Force Chairman Dr. Ned Calonge testified last week before the the House Subcommittee on Health.

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. “We expect clinicians to do what they’re trained to do in order to address the needs of the individual patient and his or her best interest,” Calonge said in his testimony. For the mammogram decision, which received a Grade of ‘C’ from the Task Force, “we recommend that the patient be informed of the potential benefits and harms and then be supported in making his or her informed choice about being tested.”

The Senate health care uses the recommendations of the Task Force to establish minimum requirements. Section 4105 gives the Secretary of Health and Human Services the authority, “if the Secretary determines appropriate,” to modify existing preventive care guidelines for Medicare and Medicaid only. If the Secretary chooses to modify the existing package of preventative services, the legislation instructs the Secretary to rely on scientific guidelines. The bill specifically contradicts Fiorina’s claim that care or treatment would be rationed in lines 6-9 on page 1190. “Nothing in the amendment made by paragraph (1) shall be construed to affect the coverage of diagnostic or treatment services,” the bill states.

If the Secretary were to adopt the Task Force’s grade ‘C’ mammogram decision — which Sen. David Vitter’s (R-LA) amendment already invalidated — the guideline would advise the doctor that the Task Force “recommends against routinely providing the service.” But, the recommendation stipulates that doctors should “offer or provide this service only if other considerations support the offering or providing the service in an individual patient.” Doctors could use the recommendations as a starting point to examine a patient’s particular needs; they would not replace professional clinical judgment.

On Thursday, the Senate also accepted an amendment from Sen. Barbara Mikulski (D-MD) that prevents private insurers from charging women for mammograms and specifically states that “nothing in this subsection shall be construed to prohibit a plan or issuer from providing coverage for services in addition to those recommended by United States Preventive Services Task Force or to deny coverage for services that are not recommended by such Task Force.’’

Yglesias

Mass vs. Elite Opinion on U.S. Role

A couple of days and one judicious Spencer Ackerman intervention later, it occurs to me that a clearly and less inflammatory way of making the point I was getting at here would be to simply reference the recent Pew survey comparing mass public opinion to the views of the foreign policy elite, defined as members of the Council on Foreign Relations.

569-6

Not too surprisingly, there are a lot of differences. Notably, the mass public is less enthusiastic about trade agreements and less enthusiastic about U.S. “global leadership” on geopolitical issues. The mass public is simultaneously more unilateralist as a matter of principle and also more interested in burden-sharing with other countries. Personally, I sympathize with the elite consensus about a lot of things (trade, a relatively benign view of China, a belief that climate change is an important issue) but I tend to be closer to the masses on the merits of an activist foreign policy.

Now you could ask yourself, do members of elite foreign policy institutions hold the views they hold because they’re somehow corrupt or on the take? I think that would be silly. What I think is true, however, is that one thing that makes those institutions elite is the fact that they have a relatively large amount of money behind them and formal and informal ties to U.S. government agencies. And it’s the very eliteness of elite views that makes them influential out of proportion to the actual number of people who hold them.

Media

Report: CNBC Was Considering Hiring Dobbs Until Latino Groups Pushed Back

lou_dobbs_huhThis past Wednesday, CNBC dispelled rumors that were circulating throughout the week that former CNN anchor Lou Dobbs would be joining the business network. Meanwhile, Dobbs affirmatively told Fox Business News shock jock Don Imus that he didn’t even talk with CNBC and that he had “no idea where they even got that.” However, National Hispanic Media President Alex Nogales told ThinkProgress today that CNBC was in fact talking with Dobbs and that his hiring was, at least in part, thwarted by the same coalition of Latino, civil rights, and media-watchdog groups that successfully campaigned to get Dobbs off CNN airwaves.

For the last several months, the Basta Dobbs and Drop Dobbs campaigns pushed CNN to sever ties with Lou Dobbs. CNN, while denying any connection to the intense pressure it felt, did end its long relationship with Dobbs. When the New York Times reported that CNBC was in negotiations with Dobbs, many of these same civil rights groups chose to similarly and quickly pressure CNBC. The groups, in a letter, warned CNBC that such a move “would be a clear demonstration that CNBC is willing to use its airwaves to promote hate.” They “respectfully” requested the network “refrain” from hiring Dobbs.

Nogales says he reached out with the groups’ concerns to Executive Vice President of Diversity for NBC Universal, Paula Madison, and informed her that his group had signed the letter and she should expect all the major Latino civil rights advocacy organizations and their allies to do the same. Nogales brought up the $30 billion pending deal between Comcast and General Electric on the acquisition of NBC Universal, pointing out that an ugly public battle would not be in NBC’s best interest. According to Nogales, he received a call one hour later from Mark Hoffman, President of CNBC, extending his sincere apologies and assuring Nogales that CNBC would not be offering Dobbs a job. Nogales says that CNBC was in fact talking with Dobbs, though it was unclear whether the two parties had reached an accord before Hoffman contacted him.

Nogales believes CNBC’s decision is yet another affirmation of the power of the Latino community and slams the new “immigrant-friendly” position that Dobbs adopted in his interview with Telemundo’s Maria Celeste last month:

This is a big win for the Latino community…we’re showing our power by collaborating with other groups and putting pressure on networks to do the right business thing. We’re ready to take on the antagonists.

Dobbs is opportunistic. For years he’s been hitting on us [Latinos] on every front — immigration, health care, the economy — and then all of a sudden he says he’s our champion. You’d have to be blind or stupid to believe that he’s our friend or that he’s going to help Latinos advance in society…as far as we are concerned, the damage is done.

On his radio show this week, Dobbs continued claiming that his Telemundo interview was not a flip-flop, but rather the reaffirmation of the same “humane” immigration views he has always held and expressed. The successful Comcast – General Electric agreement was announced yesterday.

Yglesias

Trapped in the Senate

The House of Representatives has already given us a good climate bill and a good universal health care bill. They seem poised to vote out a financial regulatory package quite soon. In the senate, none of those things have happened. They’re closest on health care, but instead of voting on a bill on Monday morning they’ll be doing . . . additional procedural antics more suitable to an elementary school student council goofing off than a crucial public institution of what’s still the world’s leading power.

Steven Hill has a nice op-ed in the FT on how ridiculous the whole thing is:

For a start, this “representative” body hardly looks or thinks like the rest of the nation. Only 17 senators are women, while the US as a whole has more women than men. Only five senators are Hispanic, black, or Asian-American, whereas one-third of Americans now belong to ethnic minorities.

A senator’s average age is an elderly 63 and most are wealthy millionaires. A famous 19th-century aphorism said: “It is harder for a poor man to enter the United States Senate than for a rich man to enter heaven,” and things are hardly different today. The senescent senators already have great healthcare benefits themselves, even while tens of millions of Americans do not. This powerful legislative body debating healthcare for the entire country is a patrician gerontocracy more closely resembling the ancient Roman Senate than a New England town meeting.

He also observes that not only is it ridiculous that 41 senators can block action, but the GOP 40 only represents about a third of the population!

At any rate, it’s hard not to sympathize with the Democrats as they struggle with Judd Gregg’s obstruction manual. But on an important level, you really shouldn’t. They’re all a part of the same absurd farce and until they come to recognize that’s what the senate is—not the “world’s greatest deliberative body,” but a bizarre anachronism—nothing will be done about it. When wild-eyed right-wingers wanted to deploy the “nuclear option” in 2005 the stage was set to at least attempt a broad structural reform and a return to majority rules. But instead the Democrats were so eager to preserve the right to filibuster that they agreed to surrender on the actual substantive point at issue—Bush’s crappy judicial nominees. And with the partial exception of Bernie Sanders, I never hear any of them talking about reform. Whining about obstruction, maybe. And, fine, whine away. But the question is what path will be taken to do something about it.

Climate Progress

Pre-Copenhagen Climate Progress updates plus top ten players in green energy

Anyone want to blog from the AGU meeting?

First, the number of daily posts is going to jump 50% to 100% for the next two weeks.  I want to give full coverage to Copenhagen with lots of interviews, while still reporting on the other major issues, including hackergate and the bipartisan climate and clean energy bill.  I’ll be in Copenhagen myself the final week.  So you’re just going to have to come back more than once a day to catch all the news.

Second, that kind of coverage means a lot of guest posts — the best from the web plus daily reporting from the CAP team at Copenhagen, which includes Wonk Room’s Brad Johnson and international climate expert Andrew Light, both already frequent guest bloggers.  CAP’s IT wizards have been migrating CP to a better server this weekend to handle the traffic — apologies for any inconvenience that has caused.  As an aside, CP should be able to handle “Opera” now.

Third, we’ve finally added a subhead feature, so my main headlines won’t have to be so long!  I do welcome any other suggestions for improving the blog.

Fourth, the American Geophysical Union cleverly scheduled its important annual conference to overlap with the crucial final days of Copenhagen.  I ran a number of stories on major new research presented at last year’s meeting, plus some blogging from a roving reporter on site, Jeff Goodell, author of the terrific book, Big Coal (see “Report from AGU meeting: One meter sea level rise by 2100 “very likely” even if warming stops?” and “How desperate are climate scientists? Desperate enough to contemplate geo-engineering“).  But Goodell can’t make it this year and frankly pretty much every major climate reporter will be a third of the way around the globe.

So if you are going to the AGU meeting and want to report/blog daily (or more) on the latest climate science presented (and more), send me an email — click here.

Read more

Politics

Watergate redux: Break-ins reported at another climate research center.

WatergateBurglars and hackers have attacked the Canadian Centre for Climate Modelling and Analysis at the University of Victoria in British Columbia, apparently in an attempt to further the “Climategate” intimidation of global warming researchers. The Climategate smear campaign rests on the release of thousands of emails illegally hacked last month from the British Climatic Research Unit (CRU). The National Post reports that the Centre for Climate Modelling, a government institution, is also the victim of repeated criminal attacks:

Andrew Weaver, a University of Victoria scientist and key contributor to the Nobel prize-winning work of the Intergovernmental Panel on Climate Change, says there have been a number of attempted breaches in recent months, including two successful break-ins at his campus office in which a dead computer was stolen and papers were rummaged through.

As the United States — led by President Barack Obama — prepares to join the world in the fight against global warming, the opponents of reform are resorting to criminal desperation, harkening back to the amoral extremes of Richard Nixon. The release of the hacked emails from CRU was praised as the act of a “whistleblower” by conservatives. “The timing couldn’t be better,” chortled Sen. Jim Inhofe (R-OK). The original Watergate scandal began when right-wing operatives burglarized the offices of their political opponents during a presidential election. “Climategate” is turning out to be worse — now the criminals are turning on scientists as the world burns.

Update

A retired ExxonMobil executive, Roger Cohen, is attempting to convince the American Physical Society to retract its 2007 statement affirming the reality of manmade global warming and the immediate need to reduce greenhouse pollution. Cohen and four other denier physicists (none of whom are climate scientists) claim the hacked emails are proof of “admittedly corrupted science.” These same physicists led a failed attempt this summer to get APS to overturn its statement.


Update

,Achim Steiner, director of the UN Environment Programme, said the theft of e-mails had echoes of the Watergate scandal:

This is not ‘climategate’ it’s ‘hackergate’. Let’s not forget the word ‘gate’ refers to a place [Watergate] where data was stolen by people who were paid to do so. So the media should direct its investigations into that.

Yglesias

Obama’s Dismissal of Drug Legalization

(cc photo by Wili Hybrid)

(cc photo by Wili Hybrid)

Peter Suderman highlights a disappointing moment from the president’s generally excellent Allentown Q&A:

Prompted by a rather bizarre question from a Sophomore at Lehigh Carbon Community College who wanted to know – based on his criminology course studies – if the President has considered legalizing prostitution, some drugs, and releasing non-violent offenders to stimulate the economy, the President answered with an unequivocal no.

“I appreciate the boldness of your question,” Mr. Obama said during his Allentown, PA jobs town hall, “That will not be my job strategy.”

Obama delivered the line well and got a good laugh out of everyone. But this is a serious proposal—more serious, I dare say, than Evan Bayh’s threat to default on the national debt unless he gets a pointless commission appointed—that deserves a somewhat serious answer. I think it’s obvious you can’t end the recession by legalizing prostitution and drugs. But at the same time, it should also be obvious that there are real economic costs associated with the prohibition of these activities and politicians ought to actually justify asking people to bare those costs. This is particularly pressing because the laws in question are so selectively enforced. Elliot Spitzer had his political career derailed by prostitution, but he’s not in jail. Does Obama think the world would be a better place if Spitzer were serving hard time? What about Senator David Vitter, Republican of Louisiana? For that matter, does Obama think the world would be a better place if he’d been caught using drugs back in the day and sent to jail?

Presumably not. But to have laws on the books that the national elite fully intends never to apply to themselves or their families is ridiculous. I don’t want to see hookers and blow available for sale at the corner store, but there’s enormous scope for the reform of our policy in this area.

Health

FLASHBACK — McCain: ‘I Say God Bless The AARP For Everything They’re Doing’

Sen. John McCain (R-AZ) has responded to the AARP’s endorsement of the Senate health care bill and its $436 billion of cuts to Medicare and Medicaid by encouraging senior citizens to rip-up their AARP cards and send them back to the AARP.

Today, McCain argued that if the government limited the over-payments to private insurers participating in Medicare Advantage programs, more seniors would be forced to buy Medi-gap policies, which the AARP endorses. AARP would “generate $414 billion” under the provisions of the Senate health care bill, McCaing argued, and asked for unanimous consent to restrict the amount AARP leaders could deduct from their compensation packages.

But McCain wasn’t always so hostile to the AARP. During the 2008 Presidential campaign, McCain appeared at AARP’s Live @ 50 event (the organization’s birthday party) to highlight his close relationship with the president of AARP and the organization:

MCCAIN IN 2008: I say God bless the AARP for everything they’re doing. Not only for the present generation of Americans but for future generations. That’s your duty. That’s your strength. And that’s why I love to see you at every town hall meeting, and I always try to let you talk.

MCCAIN IN 2009: I say shame on the AARP. I say to my friends, especially those who are under the Medicare Advantage program, the 300,030 in my state who admittedly they are going to cut their Medicare Advantage benefits. Take your AARP card, cut it in half. And send it back. They’ve betrayed you.

Watch a compilation:

During the campaign, McCain announced that he would pay for his health plan “with major reductions to Medicare and Medicaid…in a move that independent analysts estimate could result in cuts of $1.3 trillion over 10 years to the government programs.” In fact, the campaign specifically endorsed competitive bidding for Medicare Advantage. “We see no reason why the Medicare Advantage plans should continue to get a $15-billion-a-year subsidy,” McCain campaign adviser Douglas Holtz-Eakin said, “we’ll put them on a level playing field and save some money there.”

At the AARP appearance McCain endorsed Medicare payment reforms and improving reimbursements to “doctors, hospitals, and others.” “I’ll fight the Medicare fraud that’s estimated to take $60 billion each year.”"And AARP has led as usual in this effort,” he said.

Yglesias

Cobra’s Anger

The administration’s Afghanistan surge strategy strikes me as a questionable allocation of national resources. But the strategy-qua-strategy has sounded perfectly reasonable to me, and I think there’s reason to believe that an adequately resourced population-centric strategy can be made to work. And given that the decision has been made to allocate vast resources to this endeavor, I’m certainly hoping it works even though if it were up to me we wouldn’t be going down this road.

But the new operation currently underway—dubbed “Cobra’s Anger”—an offensive in Helmand Province seems to have a somewhat problematic relationship to the overall strategic concept. We’re attacking a sparsely-populated area (NYT: “an effort to finally secure what was once a bustling village but what years of fighting have turned into a ghost town”) where public opinion is more hostile to us than is the case in most parts of the country. The strategic objective sounds enemy-centric (to re-occupy “Helmand, a Taliban stronghold whose huge opium crop provides a large portion of the insurgency’s financing”) as do the tactics (“assault Taliban sanctuaries in Helmand”). And as Mike Crowley wrote yesterday a wide range of people, from COIN guru John Nagl to Senator Carl Levin, are on record as thinking this Helmand focus is misplaced.

One assumes that part of the background here is simply that there was an unsuccessful campaign in Helmand earlier this year. If a renewed assault can be made to work, that will help vindicate the earlier effort, whereas if Helmand is abandoned in favor of some more promising area that might be seen by some as conveying the idea that those who lost their lives earlier this year died in vain. I don’t think that’s the right way to think about the situation, but you can see how it would exert a powerful pull over people in the field.

Strategically, the risk is that by focusing on places where the Taliban is well-entrenched rather than places where its gains are recent and tenuous, you ultimately undermine the objective of producing a short-term change in momentum that alters the political calculus.

Economy

Blue Cross Blue Shield Lobbyists Quietly Helping Extreme Effort To Declare Health Reform Unconstitutional

ThinkProgess has documented how the private health insurance industry is waging a duplicitous, “two-faced” campaign to kill health reform. Because the industry understands that the public views it in a largely negative light, the industry presents itself as proactively working hand-in-hand with legislators to produce reform. However, behind the scenes, the industry is coordinating a massive effort to kill all reform — employing attacks from front groups, allied politicians, think tanks, lobbyists, and right-wing media.

The Blue Cross Blue Shield Association, which is a lobbying group representing 39 independent Blue Cross and Blue Shield Plans, is also engaged in this two-faced campaign. Like most of industry, the BCBS Association says it fully supports the concept of health reform, but continually demands drastic changes to the bills in Congress. Some have begun to question the BCBS Association’s claim of support given its new study attacking reform legislation in the Senate. The criticism of BCBS is bolstered by a new revelation that BCBS Association lobbyists are helping to orchestrate a right-wing movement to invalidate all of health reform.

Yesterday, the BCBS Association released yet another industry-sponsored study to distort health reform and falsely claim that premiums will skyrocket because of the legislation. However, the nonpartisan CBO reported earlier this week that under the Senate health reform bill, “most Americans would pay the same or less in premiums.” A New York Times editorial yesterday criticized BCBS Association’s study, and noted correctly that it is yet another example of the private insurance industry doing whatever it can to frighten Americans.

But while the study certainly damages BCBS’ credibility, BCBS is involved in another anti-health reform ploy that they do not bother to promote on the BCBS website. The American Legislative Exchange Council (ALEC), founded in 1973 by conservative activist Paul Weyrich, is a DC-based front group which helps state lawmakers craft corporate-friendly legislation. As the Atlantic has noted, ALEC developed template health care “states’ rights,” legislation to declare aspects of health reform unconstitutional. ALEC has promoted this “tenther” legislation using its network of mostly far right Republican state lawmakers. The bills, which have been adopted in some form in 24 states so far, aim to invalidate federal regulations of health insurance, the public option and the individual mandate using the Tenther Amendment.

According to the ALEC website, the resolution was developed by a three member task force of industry representatives. One of the of the members is Joan Gardner, who is executive director of state services with the BCBS Association’s Office of Policy and Representation. In an interview with ThinkProgress, Christie Herrera, the director of ALEC’s health task force, confirmed that Gardner played a pivotal role in crafting this anti-health reform states’ rights initiative. Herrera told us that Gardner’s unique position at the BCBS Association brought “great knowledge” to the issue, and that Gardner voted to press forward with the campaign.

Part of the reason the BCBS Association has claimed that it opposes the reform bill in its current form is because of what it perceives as a weak individual mandate. However, the BCBS Association-supported ALEC campaign depicts the very notion of an individual mandate as “anti-freedom.” So either way the Senate acts, BCBS will be able to trash the bill and try to kill reform.

Private insurers have already been caught using a stealth lobbying firm to send employees to rowdy town halls (and radical tea party events), sharing lobbyists with slash-and-burn anti-health reform attack groups, and paying a number of conservative pundits who regularly appear in major media outlets to slam health reform. Now that it is clear that BCBS helped write the script for the radical tenther movement, any claim that the industry supports reform must be viewed with heightened skepticism.

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