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A Symbiotic Relationship – The AMA And The For-Profit Health Lobby

AMAThe New York Times is reporting that the American Medical Association will be lobbying Congress to oppose a public health insurance program, an integral part of health reform. In an attempt at damage control, the AMA has responded with a statement declaring it would support a public option if it operates like a for-profit insurance agency. In effect, the AMA still opposes reform. While Igor Volsky details the various reasons why the member physicians of the AMA should support a public health insurance program, it is important to consider that the AMA as an institution is not a neutral player simply representing doctors. Started in the mid 19th century as an accrediting organization, the AMA has morphed into a behemoth lobbying and member services entity that is deeply entwined with the for-profit health industry.

In the past century, the growth of AMA has been not only funded by health industry lobbies such as drug makers, but this relationship has tailored AMA’s anti-reform policy agenda. In reading the Huffington Post and the New America Foundation articles revealing AMA’s opposition to health reform during the New Deal, its efforts to block the passage of Medicare, and the AMA’s critical role in defeating health reform in 1993, questions arise over why the AMA has historically opposed any initiative to take health care out of the hands of the for-profit health industry.

In the first 50 years after its inception, the AMA struggled to fill its coffers. Because member dues were deemed insufficient to fund its various activities, the AMA eventually decided to sell advertising space for its medical journal JAMA to drug companies. Expanding on this business model, AMA President George Simmons decided to create the “AMA seal-of-approval” for favored drugs in 1899, resulting in a five-fold increase in advertising revenue by 1909. Simmons, it turned out, had no credible medical credentials and the AMA did no drug testing for the products given the seal-of-approval.

Simmons was later driven out of the AMA, but his model for extracting fees for branding medical practices and products persisted. Simmons’ focus on molding public opinion also became one of the greatest weapons of the AMA – his “Propaganda Department” would soon expand to communicate the AMA’s views through a column syndicated published in over 200 newspapers, a weekly radio program, and various books about how homeopathic practices and non-AMA approved drugs were “quackery.”

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Yglesias

Why Triangulation is Hard to Pull Off

John Side offers the following data (courtesy of Gallup) on who people think speaks for the two parties:

speaksforparties-thumb-1

Beyond the GOP leadership vacuum, I think the extent to which the Democratic Party is identified with Barack Obama highlights the difficulties in pursuing a strategy of “triangulation” over the long run. There’s enormous political upside to being seen as a moderate, independent-minded freethinker rather than a party hack, a dogmatist, or an ideologue. But for all Barack Obama’s efforts in that regard (he’s pragmatic!) the fact of the matter is that a party line Democrat is, to most people, now just someone who agrees with Barack Obama. And Obama agrees with Obama!

Politics

Megyn Kelly claims that the only reason people consider Fox News conservative is because of Sean Hannity.

Fox News anchor Megyn Kelly, who was hired because she believed there is “a left bias in the news,” tells Haute Living that she thinks the network’s conservative reputation is unfounded. Claiming that Bill O’Reilly is “all over the board” politically, Kelly claimed that people only think Fox is right-wing “because of Hannity”:

When asked about her employer’s reputation for being conservative, she attributed those perceptions to the network’s primetime host lineup, not its news coverage. “There is no question that Hannity is a conservative,” she says. “But I can tell you from personal experience after having worked with O’Reilly for years now, you never know where he is going to come out on an issue. He definitely leans right when it comes to certain social, traditional value issues, but he’s all over the board on certain other issues. And Greta-nobody knows exactly what her stripes are. I think [the conservative reputation is] really because of Hannity.”

Kelly is wrong. Fox is considered “the most biased name in news” for much more than just Sean Hannity. Not only does Fox regularly parrot right-wing talking points and promote right-wing events, but its executives want the network to be the “voice of opposition” to the Obama administration. Kelly also neglected to mention Fox’s rising star, Glenn Beck, who proudly calls himself a conservative.

Climate Progress

“We will have a bill,” Pelosi vows — several House Republicans agree

“We will have a bill,” the California Democrat said in a brief interview today after her weekly press conference.

So Greenwire (subs. req’d) reports this afternoon, for those who had any remaining doubts about whether the Waxman-Markey clean energy and climate bill would pass the House (see also Boucher predicts “I think we’ll do far better than” the 218 votes needed to pass Waxman-Markey, GOP’s Walden agrees passage likely).

House Democrats are expected to close ranks within days on a major energy-and-climate proposal, leading to floor debate and final passage before the July 4th recess, according to key lawmakers and sources tracking the debate.

Behind-the-scenes talks on the comprehensive bill have left only a few critical sticking points, but those issues are expected to be resolved soon as House Speaker Nancy Pelosi weighs in on an issue at the top of her legislative agenda.

What about the push-back from the aggies that seems to be flooding the media in the last couple of day?

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Climate Progress

House GOP Energy Bill Mentions Oil Three Times More Often Than It Mentions Renewable Energy

Yesterday, House Republicans, led by Rep. Mike Pence (R-IN), introduced the “American Energy Act,” an energy bill that shares not just the title but most of its content with the “American Energy Act” of 2008, the Republican energy bill that died in the House last year.

House Republicans are quick to try to call the new American Energy Act a “substitute” and an “alternative” to the Waxman-Markey American Clean Energy and Security Act (H.R. 2454). Yet, like the 2008 version, the 2009 “American Energy Act” is heavy on dirty energy and light on the clean energy that generates American jobs.

Like its predecessor, Pence’s bill would continue the Bush/Cheney tactic of giveaways to oil companies. The GOP bill also makes a point of denying global warming — just as in 2008. This new bill merely restates the wrong-headed priorities of the past, mentioning “oil” three times more often that it mentions “renewable” energy and barely mentioning “climate change” at all.

This word frequency chart is a quick way to visualize the differences in priorities between the GOP energy plan and the Waxman-Markey clean energy economy bill:

gop-plan-mentions-oil-three-times-more-than-it-mentions-renewable-energy1

The word “oil” appears 93 times in Pence’s legislation — much as it made 95 appearances in the 2008 bill — while there are just 29 mentions of renewable energy, only a few more than in the 2008 version. In the Waxman-Markey legislation, which would make historic investments in clean and renewable energy and create millions jobs, there are 141 references to renewable energy. The Pence “substitute” claims that it will “encourage greater efficiency and conversation,” but mentions “efficiency” only seven times. Waxman-Markey brings up “efficiency” more than 240 times.

Even the updated portions of the bill are just warmed-over, previously rejected Republican ideas: one of the biggest (and only) changes to the bill is the new emphasis on nuclear energy, but it’s just more of the same out-of-touch rhetoric on nuclear power that Sen. John McCain tried to push during the 2008 presidential election. As Joe Romm points out, this risky nuclear scheme could actually amount to an energy tax on American families.

Politico reports, “Republicans have proposed most of these ideas in the past.” A Media Matters fact-check exposes the similarities between Pence’s legislation and President Bush’s failed plans.

We’ve seen where this obsession has gotten us: the Bush energy system made us more dependent than ever on oil and increased annual energy costs for American families by $1,100. The House GOP just hasn’t gotten the message that we can’t afford more of the same.

Yglesias

The GOP’s 100 New Nukes

nuclear-power-costs

If it turns out to be the case that appropriately pricing greenhouse emissions makes nuclear energy price-competitive again, then I wouldn’t have a problem with that leading to the construction of some new nuclear reactors in the United States. But it’s worth noting that the right’s monomania about boosting nuclear power is really bizarre. In the latest iteration of same-old, same-old conservative energy policy they want to build 100 new nuclear reactors by 2029, seemingly because 100 is a number that is both large and round. No sense of where those are going to go, or what will happen to the waste.

What’s more, while it’s genuinely true that coal-fired plants produce cheap electricity and thus are appealing if you ignore the environmental devastation, nuclear plants just aren’t very economical:

The cornerstone of the GOP plan — whose acronym just happens to be nearly identical to that of the IAEA (International Atomic Energy Agency) — is an $800 billion plan to build 100 nukes (see “Areva has acknowledged that the cost of a new reactor today would be as much as 6 billion euros, or $8 billion, double the price offered to the Finns”). Taxpayers will assume the full liability for any default on those nuclear plants. The Congressional Budget Office estimates the likely default rate of these loans at over 50% — so that’s $400 billion down the toilet right there. And of course taxpayers already assume the liability for any catastrophic meltdown.

I don’t see any reason to think that would be a good idea. A reasonable approach to nuclear power would, I think, just start with the reality that the waste problem is both serious and also potentially solvable. Put a solution in place, and then the country could accommodate more nuclear power. Then put a carbon price in place, and more nuclear power could provide to be part of the solution. But if you’re going to pour billions in subsidies toward something, you should focus it on truly clean sources of energy.

Politics

Liz Cheney falsely claims Obama hasn’t said ‘I believe in American exceptionalism.’

Liz Cheney continued her seemingly unending campaign to flood the American media, and once again, she said something that isn’t true. This time, on CNN last night, she criticized the Obama administration for being “focused on the president’s popularity overseas.” “We’ve now seen several different occasions when he’s been on the international trips, where he’s not willing to say, flat out, ‘I believe in American exceptionalism,’” Cheney complained. But of course, Obama has said this. Last April during a press conference at the NATO summit in Strasbourg, France, Obama was asked if he “subscribe[s]…to the school of American exceptionalism.” Obama replied:

OBAMA: I believe in American exceptionalism, just as I suspect that the Brits believe in British exceptionalism and the Greeks believe in Greek exceptionalism. I’m enormously proud of my country and its role and history in the world. … And I think that we have a core set of values that are enshrined in our Constitution, in our body of law, in our democratic practices, in our belief in free speech and equality, that, though imperfect, are exceptional.

Watch the compilation:

No, Obama did not say “America is the best nation that ever existed in history, and clearly that exists today,” as Cheney wishes. But she essentially wants him to stand in front of a room full of foreigners and say, “We’re better than you.” This is exactly the kind of cowboy diplomacy that has hurt America’s relationship with its allies over the last eight years and ultimately its standing in the world.

Climate Progress

Cash for Clunkers becomes Handouts for Hummers

As a means of reducing greenhouse gas emissions, the “cash for clunkers” deal Congress appears to be on the verge of embracing is probably among the least cost-effective uses of federal dollars one could imagine (see here).  That doesn’t mean it won’t have benefits to the auto industry, but nobody should sell it as a GHG reducer. Today’s “guest bloggers” are Senators Dianne Feinstein (D-CA) and Susan Collins (R-ME), whose piece, “Handouts for Hummers,” was first published in today’s Wall Street Journal.

http://www.rogerwendell.com/images/fueleconomy/no_hummers.gifIt’s amazing how quickly a good idea can go bad in Washington. In January, we joined with Sen. Charles Schumer to introduce a bill that would allow Americans to trade in gas-guzzling cars in exchange for vouchers worth up to $4,500 toward the purchase of vehicles with greatly improved fuel economy. This legislation was modeled after programs in California and Texas that improved fuel efficiency, reduced pollution, and stimulated auto sales.

Our “Cash for Clunkers” proposal was a win-win for the environment and the economy. Then Detroit auto industry lobbyists got involved. Soon a rival bill emerged in the House, tailored perfectly to the auto industry’s specifications.

The House bill was written so quickly that one of its main components — a provision that would have excluded any vehicle manufactured overseas — had to be removed because it violated trade laws. But the worst item on the auto industry’s wish list is still at the heart of the bill — a provision that undermines fuel-efficiency standards.

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Security

Surveying The Terrain Of Iran’s Elections

Our guest blogger is Peter Juul, Research Associate at the Center for American Progress Action Fund.

PD*29370358Tomorrow, Iranians will go to the polls to choose their next president. This election (and the possible run-off) will be far from free and fair – who can and cannot run for president is determined by the Guardian Council, the unelected theocratic body that approves all candidates for elected office. Despite this circumscribed choice, Iranians do have options in these elections.

Current President Mahmoud Ahmadinejad, well-known as a radical conservative to the outside world for his inflammatory rhetoric, faces the internal opposition of reformists and pragmatic conservatives in his quest for a second term. These groups believe Ahmadinejad’s outlandish behavior on the international stage and economic mismanagement are driving Iran to ruin. They include people like former president and 2005 Ahmadinejad opponent Hashemi Rafsanjani, who recently accused Ahmadinejad of lying about his [Rafsanjani’s] public service record in a letter to Supreme Leader Ayatollah Ali Khamenei.

Ahmadinejad faces three challengers, two relative reformists and one moderate conservative. Of these, the challenger perceived to have the greatest support is the moderate reformist Mir Hussein Mousavi. A former conservative and prime minister during the Iran-Iraq war, Mousavi has cultivated the support of students and women. In a recent televised debate, Mousavi accused Ahmadinejad’s foreign policy of “adventurism, illusionism, exhibitionism, extremism, and superficiality.” Other opponents include Mehdi Karroubi, another reformist who promises to appoint a female minister if elected, and Mohsen Rezai, a pragmatic conservative and former Revolutionary Guard head who warns Ahmadinejad is leading the country to a “precipice.”

The biggest issue facing Iranian voters, like those in much of the rest of the world, is the economy. Ahmadinejad’s economic policies have bought him the political goodwill of the rural poor at the cost of rampant inflation – 23.6 percent according to Iran’s own central bank. The IMF estimates that Iran’s economic growth has slowed from 8 percent in 2007 to 4.5 percent in 2008, and projects that it will further decrease to 3.2 percent this year. All three alternatives are promising to end the current president’s economic mismanagement and take a less confrontational approach to foreign affairs.

But will it really matter who wins? As Laura Secor observes in The New Republic, all four presidential candidates are playing on essentially the same rural, conservative political terrain. Urban Iranians with more liberal attitudes “are so disenchanted with the Islamic Republic that they are as a whole increasingly disinclined to vote.” And even if one of the alternatives to Ahmadinejad wins in the end, he will not be the most powerful person in Iran’s convoluted political system. That honor goes to the Supreme Leader, to whom all roads of political power ultimately run in the Islamic Republic.

To be sure, an Ahmadinejad defeat would be a good thing. Replacing an ideological blowhard with a more pragmatic or even reformist figure will certainly make it politically easier for the United States and Iran to engage one another after 30 some years of estrangement. But the United States can’t bank its Iran policy on who occupies an office with powers that ebb and flow on the whim of an unelected senior cleric. We must deal with the byzantine Iranian political structure as it is, not place unfounded hope in individual changes in positions with fluctuating status and power.

Yglesias

Debating Regulatory Consolidation

bank-cracked-11

For a while, it looked inevitable that as a result of the financial crisis we were going to consolidate our patchwork system of financial regulators. Nowadays not so much. Tyler Cowen tries to offer four reasons not to money:

1. Getting current regulators to do a better job may be a better goal.

2. The consolidation behind the Department of Homeland Security has not been a smashing success. It’s too easy for regulators to focus on formal goals of consolidation at the expense of substantive goals of mission.

3. The major overseer probably would have to be the Federal Reserve and that would mean the long-run chances for restoring an independent central bank would be slim. The Fed as super-regulator would be more accountable to Congress than is desirable.

4. Many of the real regulatory problems are due to the preferences of Congressional committees and it is high time we admitted this. How about reforming them?

Points two and three I’m on board for. I’m not so sure about the others. Point one is definitely true, but my understanding of the dynamics is that consolidation would help do this. Right now, institutions can forum shop and basically pick their own regulator. Meanwhile, many regulators’ budgets come out of fees from regulated entities. So basically you have regulators competing against each other for the “business” of regulated entities. It’s an inherently problematic situation. Similarly on point four, the easiest way to consolidate the congressional oversight of financial regulation would be to consolidate the agencies to be overseen. More broadly, congress is depressingly dysfunctional.

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