Oh, Those Tricky Massachusetts Democrats

When a political party stacks the deck in their favor, the cards they are dealt sometimes fall the wrong way. Such is the case of Sen. Edward Kennedy (D-Mass) who has sent a letter to Massachusetts elected leaders seeking a change in the 2004 state succession law and allow his Senate seat to be filled rapidly.

Kennedy, who liberals love and is affectionately called the Lion of the Senate, is suffering from brain cancer and has missed most of this year's Senate sessions. The 2004 law was enacted for fear then Gov. Mitt Romney would appoint a Republican if Massachusetts Democratic Sen. John Kerry won that year's presidential election. The new law required a special election called within 145 days of the vacancy.

"I strongly support that law and the principle that the people should elect their senator," Kennedy wrote in the letter, dated July 2 but only sent to state officials this week. "I also believe it is vital for this Commonwealth to have two voices speaking for the needs of its citizens and two votes in the Senate during the approximately five months between a vacancy and an election."

Kennedy, a champion of universal health care, suggested an interim replacement be named by the governor or state legislature on condition the person is not a candidate for the vacant seat in the special election.

Timing of Kennedy's letter does not reflect a worsening of his terminal brain cancer, his aids say. But it does reflect Kennedy's concerns for passage of a landmark health reform bill the Senate is expected to vote on this fall. The Senate has 60 elected Democrats which would assure passage if all were unanimous in their voting. However, Kennedy and Sen. Harry Byrd (D-West Virginia) have been chronically absent because of ill health. Democratic leaders fear the 40 Senate Republicans will vote a straight party line against any health reform legislation.

It seems to me Kennedy is asking his state to send a ringer to the Senate to be his stand-in surrogate vote. That's okay because most voters in Massachusetts would probably concur based on that state's track record.

But it sure smacks the democratic process with a black eye. It feels dirty. The person who is appointed as a lame duck would be a dupe for the Kennedy dynasty. Besides, during that 145-day interim the appointee would be voting on other critical legislation such as climate change. The appointee in effect would be doing what he is told by party leaders.

Just because Kennedy has served in the Senate for nearly a half century does not make him a god or kingmaker. But, don't blame good, old lovable Teddy.

Blame his state's Democratic leaders who changed the rules in their infinite wisdom to stick it to a rare Republican governor in that New England commonwealth. They changed the rules. Let them live by them.

Minnesota survived with only one senator for seven months.

(Author's Note: I was unable to find senate succession laws for West Virginia in the event Sen. Byrd dies in office. Sorry, mountaineers.

I Had A Dream

I had a dream. It took place in the White House. At the dining table was House Speaker Nancy Pelosi sipping a glass of California sherry and nibbling on one of those dainty sandwiches with the crusts cut off. Senate Minority Leader Harry Reid stared at his plate of fried zucinni and glass of iced tea. Vice President Joe Biden was telling stories of his youth in Scranton while talking with his mouth full of tuna salad. President Barack Obama was nursing a bottle of Perrier between bites of blueberry Yoplait yogurt.

Suddenly, the president slammed the dining table with his left fist and said "Screw it!" shaking the composure of the butler who had been standing at rigid attention.

"'Screw' what?" the vice president asked. "'Screw who?'" Pelosi asked with arched eyebrows. "'Screw' the pooch," Reid said. "Right, Mr. President?"

"Harry," the president said, "that's the first thing you got right in this whole process."

"What process?" Biden asked."

"This whole health reform debacle," Obama said. "Let's throw out everything and start from scratch." The president angrily tossed his copy of Newsweek onto the floor, the page open to Howard Fineman's column admonishing the administration for losing the health reform debate because they failed to make it simple.

"By God," the president said, raising his voice on one of those rare occasions. "We'll make it simple."

"What's your plan?" the vice president asked.

"Give something for everyone, including the Goddamn Republicans," Obama said in another rare occasion, this time taking the lord's name in vain.

President Obama laid out his plan -- in broad, sweeping parameters, of course.

"Extend Medicare to cover everyone," Obama said.

"Yippee!" shouted Pelosi.

"But make it voluntary," the president said.

"Brilliant!" Biden chirped.

"How do we pay for it?" the Senate leader asked.

"First of all," Obama said, "we need to adjust the Medicare premiums in which seniors now pay $96 a month deducted from their Social Security checks. Rather, we will introduce a premium schedule based on income exactly patterned after the progressive income tax used by IRS but without the deductions and exemptions. Everyone pays into the pool except the unemployed and homeless."

Obama was on a roll. "We will increase payments to doctors to keep them happy but at the same time create a regional task force of doctors reviewing payments and procedures just as they do at the Mayo Clinic with the critical emphasis on patient care, not doctor and hospital profits."

"You said this is voluntary," Reid said. "What about those who want to keep their own workers insurance plans?"

"That's the beauty," Obama said. "As I said all along, if they like the insurance and doctors they now have, they can keep them."

"My Republican colleagues say the government will run the private carriers out of business," Reid said.

"My Blue Dogs echo the same thing," Pelosi said.

"Screw them," Biden said. "If they think the status quo is so great, let 'em keep it. Let 'em eat their cake. Let's have it out once and for all. Let the people decide what system they like best. Ain't America great!"

The president placed his long legs on the dining room table, folded his arms behind his neck, and smiled.

"I love it, man," Biden bellowed. "Everyone gets what they want."

"Excuse me, Mr. President, Mr. Vice President, madam Speaker," Reid said. "I must talk to chairman (Max) Baucus."

"Me, too," Pelosi said. "Can't wait to tell (Minority Leader) John Boehner. I can see him now, doing deep doo doo in his pants."

"More Perrier, Mr. President?" the butler asked.

One could hear fire engine sirens in the background. They weren't outside the White House I discovered sleepily. Just on the street outside my apartment.

I awakened from my dream.

Of Dr.E, Me And Dick Cheney (?)

We call her Dr.E, one of the most remarkable women I have had the privilege of knowing almost exclusively through TMV and one delightful hour-long telephone conversation on her nickle. We share numerous ailments brought about by the scavenging effects of diabetes but if you read her post today it dwarfs my ailments to a mere pittance.

Dr. Clarissa Piniloa Estes in simple terms argues for insurance carriers to drop their nasty policy of denying coverage to patients with pre-existing medical conditions. If nothing else comes out of our national debate on health care reform, this evil practice must be legislated against and banned forever.

Dr.E has a compassion for mankind way beyond my wildest dreams on a good day. I'm just a cynical, washed up old newspaperman. I do know my politics. Consider this prospect:

If all members of Congress only had the health care and insurance coverage Dr. E and I can afford, do you think for one minute this on-going debate -- started by President Truman -- would still be going? I don't think so. Consider this scenario:

Let's say Dick Cheney had his first heart attack as a Congressman under the coverage Dr.E and I now have. His coverage would have been dropped or his premium reset so high it would force him to bankruptcy. Instead, his coverage continued to pay for at three three more heart surgeries and an undisclosed number of relapses. Who knows? Without the health coverage the federal bureaucracy offers, would Cheney suddenly turn champion of -- oh, my god -- a single-payer system?

Preposterous, you say? Not so fast, my friends. Liberals and Cheney bashers suffered apoplexy when he said in interviews he supported same-sex marriage. And why did he buck his president and the conservatives who consider the issue as un-Christian, sinful and every other imagined dastardly deed?

Because one of his daughters is a lesbian. Give the man credit. He saw in his daughter the pains she was suffering as a subject of his peer's public disgrace. If it takes personal experience to enlighten one's view on a hot-button issue, terrific.

My goodness, folks. If Cheney -- the sultan of darkness -- can announce his views on same-sex marriage, why couldn't Congress come together on a reasonable health care plan if we had the power to jerk their current coverage as they have with ours?

Nothing like putting the shoe on the other's foot.

The thing is, Dr.E and I do the best we can coping with what we got. It could be so much better that I hazard to guess.

Undertow Of Today's News

I feel connected with Michael Corleone in Godfather III when he was on the brink of ridding himself from Mafia past, they pull him right back. Take today's news. Please.

Item: One of candidate Barack Obama's agent of change messages was to improve the professionalism of our diplomatic corps. So far, 38 of his first 65 ambassadorial appointments have been political. Among them, Charles H. Rivkin, a Hollywood mogul who contributed $500,000 to Obama's presidential campaign. Rivkin's credentials as Ambassador to France is he once pitted convicted felon Snoop Dog with Jim Henson's Muppets children's show.

Item: Vito Corleone, Michael's father, would roll over in his grave on reading today's news story that 90% of U.S. currency contains traces of cocaine. Study leader Yuegang Zuo of the University of Massachusetts in Dartmouth said scientists have known for years that paper money can become contaminated with cocaine during drug deals and directly through drug use, such as snorting cocaine through rolled bills. Contamination can also spread to banknotes not involved in the illicit drug culture, because bills are processed in banks' currency-counting machines. Zuo said the incident rate has increased 20% in the past two years. Not to worry, Zuo reports, there's not enough traces of cocaine remaining in the bills to sniff for a buzz.

Item: Tom DeLay, the former House Majority Whip known as "The Hammer," will join the cast of "Dancing With The Stars." DeLay's case for conspiring to violate campaign finance laws in Texas has yet gone to trial. His mug shot when jailed was a classic reversal of most: Hair combed, clean shaven and a smile that would wow the ladies. “This is going to be so much fun. I will need your support,” he announced on his Twitter account. Delay would be the highest profile politician booked by "Stars." No way to tell, but I doubt he could trip the light fantastic as well as the late California Sen. George Murphy who was a terrific dancer in his earlier career in the movies.

Item: This one is truly sad. It is an error repeated far too frequently in what in my childhood was the newspaper I grew up with. In its on-line edition today, The Los Angeles Times offered this teaser: "An occasional serious of editorials and Op-Eds on the crisis confronting California." Oh, for want of a copy editor in today's cutbacks of our declining, once proud newspapers.

Must be one of those days. Change you want doesn't happen. Change you don't expect, does.

At Least Hannity Got One Thing Right

Sean Hannity, one of the conservative commentators on Fox News I usually find repugnant, deserves credit for calling national attention to a tragic scenario that is playing out in California's fertile San Joaquin Valley. The nation's largest bread and fruit basket is experiencing a third year of drought made worse by severe cutbacks in imported water because of federal protection of an endangered species, a tiny minnow-sized fish critical in the ecological life-support system for orcas and several salmon families.

Of course, Hannity has a limited niche audience. At least he is trying to illuminate a severe problem effecting not only the lives of farmers and farm workers in central California but the cost of food for all Americans. It deserves a national debate but is drowned out by the national media's one-at-a-time focus on health care reform with the struggling economy and climate change legislation straggling behind in second and third place of attentive priorities.

But as his style, Hannity frames the issue as fish vs. people and the government is the villain. If only it were that simple the farmers would have received their allotment of water, the second (or eighth, depending whom you believe) highest unemployment rate among the state's 57 counties would drop and everyone would live happily ever after. Unfortunately, we don't live in Hannity's world.

The politics is relatively clear cut. California Gov. Arnold Schwarzenneger has declared the valley counties a disaster area and hopes for $3 million to $4 million a month in extended unemployment benefits and other aid to the targeted cities and counties. The Obama administration has yet to sign off on the request.

Interior Secretary Ken Salazar visited the stricken area and listened to the plight from county and city elected officials, state representatives, farmers and laborers. That was June 28. He promised nothing and no directives have been issued from his office on the subject since that time.

The delta smelt, the threatened minnow destined on the Endangered Species list, plug the drains releasing water to the farm lands. As a result, the Westlands Water District serving Mendota, a city in Fresno County, restricted the federal water allotment to farmlands to 10%. One result is planted fields going to rot and the other Mendota's unemployment rate reaching 41%.

But environmental groups involved in this battle hold the upper hand. Here is a sampling from one of the groups:

While falsely blaming modest regulatory protections for "fish populations to the north" for the Central Valley's problems, Representatives Jim Costa (D-Fresno) and Dennis Cardoza (D-Merced), neglected to mention the impacts that massive water exports out of the California Delta have had upon the thousands of people that have been employed in the commercial and recreational fishing industries and the coastal and Central Valley communities that depend upon healthy fisheries for their economic health. The closure of recreational and commercial salmon fishing season off California and Oregon this year and in 2008 has had a devastating impact upon coastal communities in both states.

"While they are bitching about fish protections robbing them of water (not true!), the Bureau of Reclamation is preparing now to ship 40,000 acre-feet of Central Valley Project water to Southern California – swimming pools and golf courses," noted Zeke Grader, executive director of the Pacific Coast Federation of Fisherman's Associations.

One analyst for an environmental group may have cherry-picked the data and came up with these numbers:

Fresno County had 15.4% unemployment in May with a 9-year average of 10.5%. The average unemployment for all 18 primarily agriculture dependent counties in May was 15.6% which placed Fresno eighth and Imperial County first at 26.8%.

"What this data clearly shows is that unemployment is chronic in Mendota (28.1% average), worsened by the drought, as with all other agriculture dependent counties," the analyst reported.

"The owners of the big farms there are certainly not sharing their profits well with the labor community that serves them. There is much to be done to improve their plight, and it should not include disaster relief from the taxpayers (as requested by the Governor and our Senators)."

For more complete details on this story, try this link to the Fresno Bee, and this one and a third which presents the environmentalists opposition.

Forgive me for stealing a motto from Hannity's network.

I report. You decide.

Myths And Facts About Illegal Worker Health Costs

My friend Maurice and me were talking about the high cost of health care and ways Congress is searching to reduce the inflationary spiral dealing in the trillions of dollars neither one of us could truly comprehend.

"How about hospitals refusing treatment for illegal Mexican workers?" Maurice asked.

"No," I opined. "The courts have ruled everyone is entitled to emergency trauma services."

"Okay," Maurice replied. "Deny them all those other freebies. You know, they're using the hospital emergency wards for hang nails, runny noses and minor stuff like that. Plus free drugs."

"You're onto something there," I said. "But what about those illegals who receive pay checks and pay their taxes like the rest of us?" I asked. "Seems to me there's a difference between them and those illegals who form our shadow economy and are paid in cash."

"Don't care," Maurice said. "You think for one minute you or me will get free medical service if we landed in a Mexican hospital? I don't think so."

We drove in silence until he dropped me off at my apartment. "Let me look into it," I said instead of thanking him for the ride.

----------------

What I learned shatters the myth Maurice and me presumed. According to the Pew Hispanic Research Center and other sources listed below:

Illegal immigrants can get emergency care through Medicaid, the federal-state program for the poor and people with disabilities. But they can't get non-emergency care unless they pay. They are ineligible for most other public benefits.

Data on health care costs for illegal immigrants are sketchy because hospitals and community health centers don't ask about patients' legal status. In California, a 2004 study by the Federation for American Immigration Reform put the state's annual cost at $1.4 billion. Similar studies in Colorado and Minnesota in 2005 came up with much smaller estimates: $31 million and $17 million, respectively.

One thing is clear: Undocumented immigrants are driving up the number of people without health insurance. The Pew Hispanic Center estimates that 59% of the nation's illegal immigrants are uninsured, compared with 25% of legal immigrants and 14% of U.S. citizens. Illegal immigrants represent about 15% of the nation's 47 million uninsured people.

But these statistics scratch only the surface. Because of state budget cuts:

The University of Texas Medical Branch in Galveston plans to deny cancer care to illegal immigrants whose hospital costs estimated by the state comptroller is $1.3 billion.

Oklahoma lawmakers in May restricted illegal immigrants from most public benefits, including health care and education.

Nationally, the cost of health services for illegal immigrants is 2% but in counties with high density illegal immigrants, the cost is as high as 10%.

Steven Camarota of the conservative Center for Immigration Studies says offering non-emergency Medicaid to illegal immigrants would be more expensive than leaving them uninsured and in need of occasional hospital care. In those cases, hospitals lose money, and taxpayers pick up the tab.

"Either you enforce the law and don't have so many illegals, or you shut up about the cost," he says.

At the state and local level, illegal immigrants already cost more in public services such as education and health care than they pay in taxes, the Congressional Budget Office reported recently. In 2000, counties along the Mexican border lost more than $800 million in health care services for which they were not paid; about 25% of that went to care for illegal immigrants, according to a report by the United States/Mexico Border Counties Coalition.

Since 2003, California's San Mateo County has used local tax dollars as well as money from hospitals and non-profit groups to provide health insurance to all low-income children, regardless of immigration status. "These children are in our schools. They're part of our community," says Beverly Thames, spokeswoman for the county health department. "It's just important that they have access to health care."

San Francisco goes further, adding adults at local expense. Some cities, including New York, encourage illegal immigrants to use public services such as health clinics without risking deportation.

For many illegal immigrants, the fear of deportation outweighs the pain of illness or injury, so they live with their afflictions rather than seeking help until their health problems become critical. That makes things worse — for them, for hospitals that eventually treat them, and for taxpayers who ultimately foot the bill.

"They're scared to see the doctors," says Genaro Diaz , a legal resident who, at 59, is a father figure to many of the mostly male farmworkers in Benson, North Carolina. "They think they'll send them back to Mexico."

"There simply isn't enough revenue to support the network of services which heretofore has been expected," says Robert Pestronk, executive director of National Association of County and City Health Officials (NACCHO).

The cost of health care for illegal immigrants consequently is only a bleep on the government's radar screen that faces a $1.8 trillion budget gap by the end of this fiscal year. Still, the illegals are easy marks for the ax-wielding budget-conscious governmental agencies.

I wonder what Maurice thinks about it now.

Related links:

Deficit Plays Into Health Reform - washingtonpost.com

In hard times, illegal immigrants lose healthcare | csmonitor.com

High Cost of Medical Care for Illegal Immigrants

A Little Self Responsibility, Please

I wouldn't go as far as comic/satirist Bill Maher saying the American public is stupid. Rather, a large percentage is gullible as we have seen time and again on the town hall video clips Congressmen are conducting this August recess.

Wrote Maher in The Huffington Post: I’m the bad guy for saying it’s a stupid country, yet polls show that a majority of Americans cannot name a single branch of government, or explain what the Bill of Rights is. Twenty-four percent could not name the country America fought in the Revolutionary War. More than two-thirds of Americans don’t know what’s in Roe v. Wade. Two-thirds don’t know what the Food and Drug Administration does.

What I see in what is wistfully described as a health care reform debate is a bunch of angry old white men and women passionately defending the Medicare benefits they believe they are entitled. Your guess is as good as mine how they reached that conclusion.

One piece of evidence is a draft bill in Congress that would reduce $2 billion in Medicare "savings" and shift it to MediCaid.

Not to worry, soothes President Barack Obama at his Portsmouth, New Hampshire, hearing earlier this week. The AARP endorses the administration's plans for health reform, he claimed.

Naught!

The president was politely repudiated by AARP executives, saying the 40-million members have not judged the plans as of yet but its top brass is working closely on the issue with the White House.

If you can't believe Obama, whom do you trust? I would offer no one, based on the fragmentation of the proposed legislation now in both houses of Congress.

I would take this a step further. I wouldn't trust the outcome of the AARP member polling if the sentiment is close to that we have seen at the town hall meetings. These are the activists, the loud mouths, the ones driven by fear and passion. They are the ones responding to the polls in greater numbers than those whose minds are still open or undecided. Old people are leery of change and are driven to oppose something just like the rest of the population than rising up to challenge the world of health care delivery as we know it.

I'll take it another step. One of the cornerstones of the Obama health reform plan is to offer no copay for preventive medicine screening. That sounds good but will people who will benefit most -- the young and indestructible -- actually partake. The verdict is inconclusive.

It goes to the heart of the problem. That is the American people must take responsibility for their own welfare and stop passing the costs onto others whether covered by government or private insurance.

The health insurance industry is opposed saying some health experts caution that not all preventive services have been proven to save lives, and even fewer can limit health spending. Kaiser Health Plan advocates report:

"In the field of prevention, few areas save a lot of lives and money," Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health, said in an interview. While most childhood immunizations and smoking cessation programs are cost-efficient, the answer is less clear for screenings for breast and cervical cancer, he said. He stressed that screening tests such as these can still be worthwhile in saving lives, even though they may not save money over the long run.

It points out a Congressional Budget Office analysis of the House bill that the removal of copayments and deductibles will cost Medicare $2.8 billion and Medicaid $7.1 billion over the next 10 years.

Under the House plan, patients could receive free an initial physical exam, diabetes screening tests, blood tests for heart disease, mammography, pap smears, bone mass measurements, flu and pneumonia vaccines, screenings for colon and rectal cancer, and ultrasound screenings for abdominal aortic aneurysm.

The Kaiser report did have the honesty of reporting a Brown University study that the number of women receiving free mammograms fell 8% when they had to pay $12 for screening. Some insurance carriers such as Aetna introduced plans for small employers this year for no copay preventive routine physicals, vision and gynecological exams in addition to well-child visits.

America’s Health Insurance Plans, the industry’s top lobbying group, opposes the mandate. Spokesman Robert Zirkelbach cited the need to give insurers flexibility in designing benefit packages.

With child obesity and juvenile diabetes becoming close to epidemic proportions, even the most jaundiced observer would agree that early childhood screening and prevention would save billions of dollars in disease-related heart, circulatory, lung and kidney ailments sometimes requiring amputation of one's feet.

But these so-called free preventive programs don't do a damned bit of good of the patient doesn't take responsibility for himself.