Via Felix Salmon, an eye-opening chart:

If you can’t think of a charitable institution that could use your money more than the already-richest university in the world—one that overwhelming educates the children of prosperous people—then you’re obviously not thinking very hard. If you want to support worthwhile education endeavors, find a charter school or an obscure local college that’s doing a good job with kids from underprivileged backgrounds. Or give money to improve public health in the third world, or to an effective politics/advocacy organization working to improve American public policy. Anything, really. Just not an outfit that’s already got way more money than every other nonprofit in the country.

The President, in an effort to demonstrate his desire for bipartisanship, has repeatedly tried to offer conservatives a deal on the issue of medical malpractice lawsuits since according to conservatives making malpractice litigation more favorable to defendants is key to reducing health care costs:

Politics is about the art of the deal, but it is worth looking at the actual policy issue and wondering if it’s true that malpractice lawsuits are actually driving health costs. As Igor Volsky says “the short answer is no”:

Malpractice costs represent less than half of 1% (0.46 percent of total health care expenditures) and malpractice settlements have grown modestly with inflation. In fact, in states that have adopted caps on jury awards, doctors are prescribing too many aggressive and intensive treatments that increase costs, but don’t improve outcomes.

When Texas capped non economic medical malpractice damages to $250,000 in 2003, most conservatives argued that the reform would free doctors from having to prescribe unnecessary treatment. It didn’t happen. According to the Dartmouth research on disparities in health care spending, many Texan doctors are still prescribing aggressive treatments that don’t improve outcomes. In fact, as of 2006, Texas was still at the top of the list of high-spending states.

There are certain perverse incentives inherent to fee-for-service medicine that can lead health providers to systematically err on the side of ordering tests and treatments whether or not there’s good reason to think they’ll be beneficial. Capping lawsuit awards doesn’t really change that.

To me the main point about malpractice lawsuits in health reform is that the prominence of this issue is one of the perverse consequences of our tattered social safety net. Medical treatment is complicated, and it’s inevitable that things will sometimes go wrong. Sometimes because of bad luck, sometimes because of an error in judgment, and sometimes because of a mistake that’s perhaps so bad as to truly constitute malpractice. But irrespective of the reason the treatment’s gone awry, what the patient needs is medical care to fix the problem and possibly financial support to cope with a disability. In a country where medical treatment is paid for by the state, then it doesn’t really matter why the additional treatment is necessary. If it’s necessary it will be done and paid for. Instead in our system, there needs to be a controversy over who will foot the bill for the extra treatment, and that requires the assigning of blame and culpability in a very specific kind of way and thus lots of essentially negative-sum litigation.

Changing the legal system while leaving the health care financing system intact is basically just a way of pushing costs around—onto the shoulders of patients—without really addressing the underlying topic of equitably financing health care and preventing medical errors.

Progressive Caucus Co-Chair Raul Grijalva

Ryan Grim reports on the effort to do a “whip count” around the number of left-wing members of congress who are going to refuse to vote for a health care bill that doesn’t include a public option:

The whip count will send a message to to the administration, said CPC co-chair Raul Grijalva (D-Ariz.): “Don’t cut deals with some elements of our party or with some elements of the Republican Party without including the progressives in that discussion,” he suggested. “So we’re going to count our votes, see how many we have and that’s the number we’re going to indicate to both the leadership and the administration.”

And:

A senior administration official said Wednesday that killing the bill for not including a public option would be “tragic.” Centrist and conservative Democrats have expressed frustration at the forcefulness of the support for the public option, arguing that it’s a distraction from the broader package.

I tend to agree with anyone who thinks it would be tragic to kill an otherwise good bill on the grounds that it doesn’t include a public option. That said, though I’m a bit frustrated at the forcefulness of the support for the public option, one should be equally frustrated at the forcefulness of the opposition for the public option. In essence, centrist and conservative Democrats are holding the entire population of uninsured and underinsured Americans hostage to the insurance industry’s desire to kill this one particular provision.

As far as whether or not this progressive block holds together, I assume the key thing will be the extent to which labor stands behind Richard Trumka’s pledge not to support a health care bill that doesn’t include a public option. If someone had told you two years ago “congress is going to pass a universal health care bill opposed by the AFL-CIO with no Republican votes” you would have said “no they’re not; that’s impossible” and it doesn’t seem any more possible to me today.